Antioxidant defense responses to sleep loss and sleep recovery

Investigating the consequences of chronic short sleep for metabolism and survival of oxidative stress

In previous work, we found that short sleep caused sensitivity to oxidative stress; here we set out to characterize the physiological state of a diverse group of chronically short-sleeping mutants during hyperoxia as an acute oxidative stress. Using RNA-sequencing analysis, we found that short-sleeping mutants had a normal transcriptional oxidative stress response relative to controls. In both short-sleeping mutants and controls, hyperoxia led to downregulation of glycolytic genes and upregulation of genes involved in fatty acid metabolism, reminiscent of metabolic shifts during sleep. We hypothesized that short-sleeping mutants may be sensitive to hyperoxia because of defects in metabolism. Consistent with this, short-sleeping mutants were sensitive to starvation. Using metabolomics, we identified a pattern of low levels of long chain fatty acids and lysophospholipids in short-sleeping mutants relative to controls during hyperoxia, suggesting a defect in lipid metabolism. Though short-sleeping mutants did not have common defects in many aspects of lipid metabolism (basal fat stores, usage kinetics during hyperoxia, respiration rates, and cuticular hydrocarbon profiles), they were all sensitive to dehydration, suggesting a general defect in cuticular hydrocarbons, which protect against dehydration. To test the bi-directionality of sleep and lipid metabolism, we tested flies with both diet-induced obesity and genetic obesity. Flies with diet-induced obesity had no sleep or oxidative stress phenotype; in contrast, the lipid metabolic mutant, brummer , slept significantly more than controls but was sensitive to oxidative stress. Previously, all short sleepers tested were sensitive and all long sleepers resistant to oxidative stress. brummer mutants, the first exceptions to this rule, lack a key enzyme required to mobilize fat stores, suggesting that a defect in accessing lipid stores can cause sensitivity to oxidative stress. Taken together, we found that short-sleeping mutants have many phenotypes in common: sensitivity to oxidative stress, starvation, dehydration, and defects in lipid metabolites. These results argue against a specific role for sleep as an antioxidant and suggest the possibility that lipid metabolic defects underlie the sensitivity to oxidative stress of short-sleeping mutants.

Transcriptome-Based Revelation of the Effects of Sleep Deprivation on Hepatic Metabolic Rhythms in Tibetan Sheep (Ovis aries)

Sleep deprivation (SD) disrupts circadian rhythms; however, its effects on SD and the mechanisms involved require further investigation. Previous studies on SD were mainly conducted on rodents, such as mice, with few studies on its effects on the liver of large diurnal animals, such as sheep. In this study, we used a Tibetan sheep model for the first time to investigate the effects of SD on the liver by exposing Tibetan sheep (Ovis aries) to 7 days of SD (6 h/day) and performed transcriptome sequencing analysis on liver samples taken at 4 h intervals over 24 h. The results revealed that SD significantly altered the circadian expression of genes and their expression patterns in the liver of Tibetan sheep. Enrichment analysis of the circadian rhythm-altered genes revealed changes in the pathways related to lipid metabolism in the liver. Further evidence from serum markers and gene expression analyses using qualitative real-time polymerase chain reaction and Oil Red O and apoptosis staining indicated that SD leads to abnormal lipid metabolism in the liver, potentially causing liver damage. Therefore, our results suggest that SD disrupts the circadian rhythms of metabolism-related genes in the Tibetan sheep liver, thereby affecting metabolic homeostasis.

Antioxidants and the risk of sleep disorders: results from NHANES and two-sample Mendelian randomization study

Background

Sleep disorders have emerged as a major public health concern. Observational research indicates that antioxidants might mitigate the risk of sleep disturbances, yet the causal relationship remains uncertain.

Materials and methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2018, focusing on adults who reported sleep disorders. The analysis included 25,178 American adults. We examined the association between the Composite Dietary Antioxidant Index (CDAI) and the prevalence of sleep disorders. Additionally, a two-sample Mendelian randomization analysis was conducted to explore the potential causal link between CDAI and the risk of sleep disorders.

Results

Analysis of data from the 2011-2018 NHANES survey revealed a significant negative association between CDAI and sleep disorders (OR = 0.854, 95% CI 0.821-0.888, P < 0.001). A multivariable logistic regression model showed that each unit increase in CDAI corresponded to a 14.6% reduction in sleep disorder risk, exhibiting a nonlinear trend where the risk decreased until reaching the inflection point of -0.134. Additionally, MR analysis demonstrated that genetically determined selenium reduces the risk of OSA (OR = 0.992, 95% CI 0.860-0.989, P = 0.023). Furthermore, vitamin E (γ-tocopherol) and vitamin C were protective against sleep-wake disorders (OR = 0.016, 95% CI 0.001-0.674, P = 0.03) and (OR = 0.049, 95% CI 0.007-0.346, P = 0.002), respectively.

Conclusion

Dietary antioxidants may help prevent sleep disorders. However, further studies are required to clarify the pathways through which antioxidants exert this protective effect.

Sleep and Oxidative Stress: Current Perspectives on the Role of NRF2

Sleep is a fundamental conserved physiological state across evolution, suggesting vital biological functions that are yet to be fully clarified. However, our understanding of the neural and molecular basis of sleep regulation has increased rapidly in recent years. Among various processes implicated in controlling sleep homeostasis, a bidirectional relationship between sleep and oxidative stress has recently emerged. One proposed function of sleep may be the mitigation of oxidative stress in both brain and peripheral tissues, contributing to the clearance of reactive species that accumulate during wakefulness. Conversely, reactive species, such as reactive oxygen species (ROS) and reactive nitrogen species (RNS), at physiological levels, may act as signaling agents to regulate redox-sensitive transcriptional factors, enzymes, and other effectors involved in the regulation of sleep. As a primary sensor of intracellular oxidation, the transcription factor NRF2 is emerging as an indispensable component to maintain cellular redox homeostasis during sleep. Indeed, a number of studies have revealed an association between NRF2 dysfunction and the most common sleep conditions, including sleep loss, obstructive sleep apnea, and circadian sleep disturbances. This review examines the evidence of the intricate link between oxidative stress and NRF2 function in the context of sleep, and highlights the potential of NRF2 modulators to alleviate sleep disturbances.

Phylogenetic conservation of the interdependent homeostatic relationship of sleep regulation and redox metabolism

Sleep is an essential and evolutionarily conserved process that affects many biological functions that are also strongly regulated by cellular metabolism. The interdependence between sleep homeostasis and redox metabolism, in particular, is such that sleep deprivation causes redox metabolic imbalances in the form of over-production of ROS. Likewise (and vice versa), accumulation of ROS leads to greater sleep pressure. Thus, it is theorized that one of the functions of sleep is to act as the brain's "antioxidant" at night by clearing oxidation built up from daily stress of the active day phase. In this review, we will highlight evidence linking sleep homeostasis and regulation to redox metabolism by discussing (1) the bipartite role that sleep-wake neuropeptides and hormones have in redox metabolism through comparing cross-species cellular and molecular mechanisms, (2) the evolutionarily metabolic changes that accompanied the development of sleep loss in cavefish, and finally, (3) some of the challenges of uncovering the cellular mechanism underpinning how ROS accumulation builds sleep pressure and cellularly, how this pressure is cleared.

A Narrative Review of the Reciprocal Relationship Between Sleep Deprivation and Chronic Pain: The Role of Oxidative Stress

Sleep is crucial for human health, insufficient sleep or poor sleep quality may negatively affect sleep function and lead to a state of sleep deprivation. Sleep deprivation can result in various health problems, including chronic pain. The intricate relationship between sleep and pain is complex and intertwined, with daytime pain affecting sleep quality and poor sleep increasing pain intensity. The article first describes the influence of sleep on the onset and development of pain, and then explores the impact of daytime pain intensity on nighttime sleep quality and subsequent pain thresholds. However, the primary emphasis is placed on the pivotal role of oxidative stress in this bidirectional relationship. Although the exact mechanisms underlying sleep and chronic pain are unclear, this review focuses on the role of oxidative stress. Numerous studies on sleep deprivation have demonstrated that it can lead to varying degrees of increased pain sensitivity, while chronic pain leads to sleep deprivation and further exacerbates pain. Further research on the role of oxidative stress in the mechanism of sleep deprivation-induced pain sensitization seems reasonable. This article comprehensively reviews the current research on the interrelationship between sleep deprivation, pain and the crucial role of oxidative stress.

Sleep fragmentation induces heart failure in a hypertrophic cardiomyopathy mouse model by altering redox metabolism

Sleep fragmentation (SF) disrupts normal biological rhythms and has major impacts on cardiovascular health; however, it has never been shown to be a risk factor involved in the transition from cardiac hypertrophy to heart failure (HF). We now demonstrate devastating effects of SF on hypertrophic cardiomyopathy (HCM). We generated a transgenic mouse model harboring a patient-specific myosin binding protein C3 (MYBPC3) variant displaying HCM, and measured the progression of pathophysiology in the presence and absence of SF. SF induces mitochondrial damage, sarcomere disarray, and apoptosis in HCM mice; these changes result in a transition of hypertrophy to an HF phenotype by chiefly targeting redox metabolic pathways. Our findings for the first time show that SF is a risk factor for HF transition and have important implications in clinical settings where HCM patients with sleep disorders have worse prognosis, and strategic intervention with regularized sleep patterns might help such patients.

What happens when the lights are left on? Transcriptomic and phenotypic habituation to light pollution

Artificial light at night (ALAN) is a ubiquitous pollutant worldwide. Exposure can induce immediate behavioral and physiological changes in animals, sometimes leading to severe health consequences. Nevertheless, many organisms persist in light-polluted environments and may have mechanisms of habituating, reducing responses to repeated exposure over time, but this has yet to be tested experimentally. Here, we tested whether zebra finches (Taeniopygia guttata) can habituate to dim (0.3 lux) ALAN, measuring behavior, physiology (oxidative stress and telomere attrition), and gene expression in a repeated measures design, over 6 months. We present evidence of tolerance to chronic exposure, persistent behavioral responses lasting 8 weeks post-exposure, and attenuation of responses to re-exposure. Oxidative stress decreased under chronic ALAN. Changes in the blood transcriptome revealed unique responses to past exposure and re-exposure. Results demonstrate organismal resilience to chronic stressors and shed light on the capacity of birds to persist in an increasingly light-polluted world.

Insomnia and related mental health conditions: Essential neurobiological underpinnings towards reduced polypharmacy utilization rates

Insomnia represents a significant public health burden, with a 10% prevalence in the general population. Reduced sleep affects social and working functioning, productivity, and patient's quality of life, leading to a total of $100 billion per year in direct and indirect healthcare costs. Primary insomnia is unrelated to any other mental or medical illness; secondary insomnia co-occurs with other underlying medical, iatrogenic, or mental conditions. Epidemiological studies found a 40-50% comorbidity prevalence between insomnia and psychiatric disorders, suggesting a high relevance of mental health in insomniacs. Sleep disturbances also worsen the outcomes of several psychiatric disorders, leading to more severe psychopathology and incomplete remission, plausibly contributing to treatment-resistant conditions. Insomnia and psychiatric disorder coexistence can lead to polypharmacy, namely, the concurrent use of two or more medications in the same patient, regardless of their purpose or rationale. Polypharmacy increases the risk of using unnecessary drugs, the likelihood of drug interactions and adverse events, and reduces the patient's compliance due to regimen complexity. The workup of insomnia must consider the patient's sleep habits and inquire about any medical and mental concurrent conditions that must be handled to allow insomnia to be remitted adequately. Monotherapy or limited polypharmacy should be preferred, especially in case of multiple comorbidities, promoting multipurpose molecules with sedative properties and with bedtime administration. Also, non-pharmacological interventions for insomnia, such as sleep hygiene, relaxation training and Cognitive Behavioral Therapy may be useful in secondary insomnia to confront behaviors and thoughts contributing to insomnia and help optimizing the pharmacotherapy. However, insomnia therapy should always be patient-tailored, considering drug indications, contraindications, and pharmacokinetics, besides insomnia phenotype, clinical picture, patient preferences, and side effect profile.

Amelioration of pain and anxiety in sleep-deprived rats by intra-amygdala injection of cinnamaldehyde

Background

Sleep disorders are accompanied by increased anxiety and somatic pain. In addition, it has been observed that anxiety and pain have a boosting effect on each other, resulting in continued sleep disturbances. Amygdala's (CeA) central nucleus plays a crucial role in these processes. Cinnamaldehyde (Cinn) is an aromatic compound with anti-anxiety, antioxidant, and sleep-promoting properties. The present study uses sleep-deprived rats to examine the effects of an intra-CeA injection of Cinn on pain and anxiety.

Methods

Sleep deprivation (SD) was induced using the platform technique. 35 male Wistar rats were divided into five groups. Anxiety state and nociception were evaluated among groups using formalin test (F.T.), open field test (OFT), and elevated plus maze (EPM). Anxiety tests (OFT and EPM) were conducted in all groups. The first group was undergone FT without induction of SD (SD-FT+). The second group received SD without FT(SD+FT-). The third group received both SD and FT(SD+FT+). The treatment and vehicle groups have undergone both SD and FT in addition to the respectively intra-CeA injection of Cinn (SD+FT+ Cinn) and Cinn vehicle (SD+FT+ VC). The recorded behaviors were analyzed between groups using IBM SPSS 24th version.

Results

SD did not lead to any significant difference in nociceptive behaviors in FT between groups SD-FT+ and SD+FT+ (P ≥ 0.05). At the same time, there was a considerable discrepancy in rearing behaviors (P < 0.006) and the number of fecal boli (P < 0.004) recorded in OFM between these groups. Treatment with Cinn led to decreased nociception (P < 0.038), decreased rearing behaviors (P < 0.01), and reduced defecation (P < 0.004) in group SD + FT+ Cinn in comparison to the group SD+FT+. There were no differences in anxiety test results between the first and second groups (P ≥ 0.05).

Conclusion

SD can lead to elevated anxiety, while intra-CeA injection of Cinn ameliorated both perceptions of acute pain and anxiety. Besides, the conduction of FT before the anxiety test led to no disturbance in the results of anxiety tests.

The Integration of the Maternal Care with Sleep During the Postpartum Period

Our entire life occurs in a constant alternation between wakefulness and sleep. The impossibility of living without sleep implies that any behavior must adapt to the need for sleep, and maternal behavior does not escape from this determination. Additionally, maternal behavior in mammals is a highly motivated behavior, essential for the survival of the offspring. Thus, the mother has to adapt her physiology of sleep to the constant demands of the pups, where each species will have different strategies to merge these two physiological needs. However, all studied female mammals will experience sleep disturbances at some point of the postpartum period.

Effects of Dendropanax morbiferus Leaf Extract on Sleep Parameters in Invertebrate and Vertebrate Models

Dendropanax morbiferus is highly valued in traditional medicine and has been used to alleviate the symptoms of numerous diseases owing to its excellent antioxidant activity. This study aimed to evaluate the sleep promotion and related signaling pathways of D. morbiferus extract (DE) via behavioral analysis, molecular biological techniques, and electrophysiological measurements in invertebrate and vertebrate models. In Drosophila, the group treated with 4% DE experienced decreased subjective nighttime movement and sleep bout and increased total sleeping time. Moreover, substantial changes in locomotor activity, including distance moved, velocity, and movement, were confirmed in the 4% DE-treated group. Compared to Drosophila in which insomnia and oxidative stress were induced by exposure to 0.1% caffeine, the DE-treated group improved sleep-related parameters to the level of the normal group. In the Drosophila model, exposure to 4% DE upregulated the expression of gamma-aminobutyric acid (GABA)-related receptors and serotonin receptor (5-HT1A), along with the expression of antioxidant-related factors, glutathione, and catalase. In the pentobarbital-induced sleep test using ICR mice, the duration of sleep was markedly increased by high concentration of DE. In addition, through the electroencephalography analysis of SD-rats, a significant increase in non-rapid-eye-movement sleep and delta waves was confirmed with high concentrations of DE administration. The increase in sleep time and improvement in sleep quality were confirmed to be related to the expression of altered GABA receptors and the enhancement of the contents of the neurotransmitters GABA and serotonin (5-HT) because of high DE administration. High-dose administration of DE also increased the expression of antioxidant-related factors in the brain and significantly decreased malondialdehyde content. Taken together, DE induced improvements in sleep quantity and quality by regulating neurotransmitter content and related receptor expression, along with high antioxidant activity, and may have a therapeutic effect on sleep disorders.

Association between Mediterranean dietary pattern with sleep duration, sleep quality and brain derived neurotrophic factor (BDNF) in Iranian adults

Data on the association between Mediterranean diet, sleep and brain-derived neurotrophic factor (BDNF) were limited in Middle Eastern populations. We examined the association between Mediterranean dietary pattern with sleep quality/quantity, and serum BDNF in Iranian adults. This cross-sectional study was performed among 535 middle-aged adults (54% men), selected by multistage cluster random sampling method. The Pittsburgh sleep quality index and a validated food frequency questionnaire were used to assess sleep quality, sleep quantity, and Mediterranean diet score (MDS). Twelve-hour fasting blood samples were taken to evaluate serum BDNF values. Participants in the highest tertile of MDS, in comparison to those in the lowest tertile, had lower odds of having short sleep (OR = 0.44, 95%CI: 0.21-0.91) and poor sleep quality (OR = 0.48, 95%CI: 0.22-0.96), after adjustment for potential confounders. Among specific domains of sleep quality, lower odds of subjective sleep quality, sleep latency, and daytime dysfunction were associated with increased MDS. Higher adherence to MDS among individuals with overweight or obesity reduced the odds of having short sleep; this relation was not seen among individuals with normal weight. In contrast, the association between sleep quality and the MDS was significant in individuals with normal weight, but not those with overweight or obesity. Participants with higher adherence to MDS had lower odds for low BDNF values; however, this relation was not statistically significant. Overall, Iranian adults with a higher adherence to MDS had considerably lower odds of having short sleep and poor sleep quality. BDNF would not be an intermediate molecule for this connection.

Probiotics Supplementation Attenuates Inflammation and Oxidative Stress Induced by Chronic Sleep Restriction

Background: Insufficient sleep is a serious public health problem in modern society. It leads to increased risk of chronic diseases, and it has been frequently associated with cellular oxidative damage and widespread low-grade inflammation. Probiotics have been attracting increasing interest recently for their antioxidant and anti-inflammatory properties. Here, we tested the ability of probiotics to contrast oxidative stress and inflammation induced by sleep loss. Methods: We administered a multi-strain probiotic formulation (SLAB51) or water to normal sleeping mice and to mice exposed to 7 days of chronic sleep restriction (CSR). We quantified protein, lipid, and DNA oxidation as well as levels of gut-brain axis hormones and pro and anti-inflammatory cytokines in the brain and plasma. Furthermore, we carried out an evaluation of microglia morphology and density in the mouse cerebral cortex. Results: We found that CSR induced oxidative stress and inflammation and altered gut-brain axis hormones. SLAB51 oral administration boosted the antioxidant capacity of the brain, thus limiting the oxidative damage provoked by loss of sleep. Moreover, it positively regulated gut-brain axis hormones and reduced peripheral and brain inflammation induced by CSR. Conclusions: Probiotic supplementation can be a possible strategy to counteract oxidative stress and inflammation promoted by sleep loss.

Sleep Fragmentation Accelerates Carcinogenesis in a Chemical-Induced Colon Cancer Model

Aims of this study were to test whether sleep fragmentation (SF) increased carcinogenesis and to investigate the possible mechanisms of carcinogenesis in a chemical-induced colon cancer model. In this study, eight-week-old C57BL/6 mice were divided into Home cage (HC) and SF groups. After the azoxymethane (AOM) injection, the mice in the SF group were subjected to SF for 77 days. SF was accomplished in a sleep fragmentation chamber. In the second protocol, mice were divided into 2% dextran sodium sulfate (DSS)-treated, HC, and SF groups and were exposed to the HC or SF procedures. Immunohistochemical and immunofluorescent stainings were conducted to determine the level of 8-OHdG and reactive oxygen species (ROS), respectively. Quantitative real-time polymerase chain reaction was used to assess the relative expression of inflammatory and ROS-generating genes. The number of tumors and average tumor size were significantly higher in the SF group than in the HC group. The intensity (%) of the 8-OHdG stained area was significantly higher in the SF group than in the HC group. The fluorescence intensity of ROS was significantly higher in the SF group than the HC group. SF accelerated cancer development in a murine AOM/DSS-induced model of colon cancer, and the increased carcinogenesis was associated with ROS- and oxidative stress-induced DNA damage.

The effect of mild to moderate sleep restriction on subjective hunger in healthy young men

There is good evidence to indicate severe sleep restriction increases subjective feelings of hunger, but the impact of mild to moderate sleep restriction (i.e., 5-7 h) on hunger has not been systematically evaluated. Healthy male participants (n = 116; 22.8 ± 2.1 years; 22.9 ± 3.7 kg⋅m^-2) were recruited to a ten-day laboratory study. In a between groups design, participants were allocated to one of five time in bed conditions (5 h, 6 h, 7 h, 8 h or 9 h) for seven consecutive nights. Participants were provided a eucaloric diet and ratings of hunger, nausea and desire to eat certain foods were collected using visual analogue scales prior to meals (breakfast, lunch, afternoon snack, dinner and evening snack) on four days during the study. Data were analysed using linear mixed models with time in bed, time of day and study day as fixed effects and participant as a random effect. There was no main effect of time in bed, and no interaction between time in bed and study day, on hunger, nausea, prospective hunger or desire to eat certain foods. However, post-hoc analyses indicated that participants in the 5-h condition had an elevated desire to consume sweet foods and fruit on the final morning of the protocol. There was a main effect of time of day and study day on hunger; participants were hungriest prior to lunch time and hunger decreased over consecutive days of the protocol. When provided with a eucaloric diet, only 5-h time in bed increased desire to consume sweet foods and fruit in healthy young men.

Estimation of gingival crevicular fluid oxidative stress markers in school-aged children and teenagers with insufficient sleep

BACKGROUND

Sleep is crucial for survival. Sleep deprivation causes ROS accumulation and, consequently, oxidative stress. The goal of the study was to evaluate gingival crevicular fluid (GCF) levels of the oxidative stress status hydrogen peroxide (H₂O₂), superoxide glutathione (GSH), and cellular oxidative damage marker malondialdehyde (MDA) in school-aged children and teenagers with insufficient sleep.

METHODS

This study investigated sleep duration in 80 participants from two different developmental stages: school-aged children (6-13 years) and teenagers (14-17 years). GCF samples were obtained from all individuals, and samples were investigated to detect H₂O₂, GSH, and MDA levels using the micro method.

RESULTS

Results reveal that GCF MDA and H₂O₂ in school-age children and teenagers with insufficient sleep were significantly higher than in children with sufficient sleep. GCF GSH with insufficient sleep was insignificantly lower than in children with sufficient sleep. There was no significant difference between school-age and teenage populations.

CONCLUSION

Sleep deprivation causes increased levels of oxidative stress in gingival crevicular fluid, and adequate sleep is essential for maintaining redox balance.

Role of Oxidative Stress and Inflammation in Insomnia Sleep Disorder and Cardiovascular Diseases: Herbal Antioxidants and Anti-inflammatory Coupled with Insomnia Detection using Machine Learning

Insomnia is well-known as trouble in sleeping and enormously influences human life due to the shortage of sleep. Reactive Oxygen Species (ROS) accrue in neurons during the waking state, and sleep has a defensive role against oxidative damage and dissipates ROS in the brain. In contrast, insomnia is the source of inequity between ROS generation and removal by an endogenous antioxidant defense system. The relationship between insomnia, depression, and anxiety disorders damages the cardiovascular systems' immune mechanisms and functions. Traditionally, polysomnography is used in the diagnosis of insomnia. This technique is complex, with a long time overhead. In this work, we have proposed a novel machine learning-based automatic detection system using the R-R intervals extracted from a single-lead electrocardiograph (ECG). Additionally, we aimed to explore the role of oxidative stress and inflammation in sleeping disorders and cardiovascular diseases, antioxidants' effects, and the psychopharmacological effect of herbal medicine. This work has been carried out in steps, which include collecting the ECG signal for normal and insomnia subjects, analyzing the signal, and finally, automatic classification. We used two approaches, including subjects (normal and insomnia), two sleep stages, i.e., wake and rapid eye movement, and three Machine Learning (ML)-based classifiers to complete the classification. A total number of 3000 ECG segments were collected from 18 subjects. Furthermore, using the theranostics approach, the role of mitochondrial dysfunction causing oxidative stress and inflammatory response in insomnia and cardiovascular diseases was explored. The data from various databases on the mechanism of action of different herbal medicines in insomnia and cardiovascular diseases with antioxidant and antidepressant activities were also retrieved. Random Forest (RF) classifier has shown the highest accuracy (subjects: 87.10% and sleep stage: 88.30%) compared to the Decision Tree (DT) and Support Vector Machine (SVM). The results revealed that the suggested method could perform well in classifying the subjects and sleep stages. Additionally, a random forest machine learning-based classifier could be helpful in the clinical discovery of sleep complications, including insomnia. The evidence retrieved from the databases showed that herbal medicine contains numerous phytochemical bioactives and has multimodal cellular mechanisms of action, viz., antioxidant, anti-inflammatory, vasorelaxant, detoxifier, antidepressant, anxiolytic, and cell-rejuvenator properties. Other herbal medicines have a GABA-A receptor agonist effect. Hence, we recommend that the theranostics approach has potential and can be adopted for future research to improve the quality of life of humans.

Anxiety, Insomnia, and Memory Impairment in Metabolic Syndrome Rats Are Alleviated by the Novel Functional Ingredients from Anacardium occidentale

Despite an increase in the coexistence of metabolic syndrome (MetS) and psychological disorders, together with their great impact on socio-economic burdens, no protective strategies that focus on these situations are available. Due to the role of oxidative stress in the pathophysiology of metabolic syndrome (MetS) and psychological disorders, we hypothesized that substances possessing antioxidant activity such as the novel functional ingredients from Anacardium occidentale (AO) could mitigate common psychological disorders in MetS rats. Male Wistar rats, weighing 200-250 g, were induced with MetS through a 12-week high-fat and high-cholesterol diet (HFHC). Then, they were given AO orally via a gastric gavage needle at doses of 1, 10 and 100 mg/kg BW for 14 days. Spatial memory, anxiety, depression, and sleep behaviors, together with changes in oxidative stress status and neurotransmitters, were assessed. All doses of AO significantly improved memory, anxiety, and sleep, together with the suppression of oxidative stress, AChE, and GABA-T in the cerebral cortex and hippocampus. These results suggest the protective effect of AO against anxiety, insomnia, and memory impairment that coexist with the MetS condition via an improvement in oxidative stress and the functions of the cholinergic and GABAergic systems. However, this benefit requires clinical confirmation.

Effects of sleep deprivation on coronary heart disease

The presence of artificial light enables humans to be active 24 h a day. Many people across the globe live in a social culture that encourages staying up late to meet the demands of various activities, such as work and school. Sleep deprivation (SD) is a severe health problem in modern society. Meanwhile, as with cardiometabolic disease, there was an obvious tendency that coronary heart disease (CHD) to become a global epidemic chronic disease. Specifically, SD can significantly increase the morbidity and mortality of CHD. However, the underlying mechanisms responsible for the effects of SD on CHD are multilayered and complex. Inflammatory response, lipid metabolism, oxidative stress, and endothelial function all contribute to cardiovascular lesions. In this review, the effects of SD on CHD development are summarized, and SD-related pathogenesis of coronary artery lesions is discussed. In general, early assessment of SD played a vital role in preventing the harmful consequences of CHD.

Contrasting effects of sleep fragmentation and angiotensin-II treatment upon pro-inflammatory responses of mice

Disordered sleep promotes inflammation in brain and peripheral tissues, but the mechanisms that regulate these responses are poorly understood. One hypothesis is that activation of the sympathetic nervous system (SNS) from sleep loss elevates blood pressure to promote vascular sheer stress leading to inflammation. As catecholamines produced from SNS activation can directly regulate inflammation, we pharmacologically altered blood pressure using an alternative approach-manipulation of the renin-angiotensin system (RAS). Male C57BL6/J mice were treated with angiotensin or captopril to elevate and reduce blood pressure, respectively and then exposed to 24-h of sleep fragmentation (SF) or allowed to sleep (control). Pro- and anti-inflammatory cytokine gene expression and as endothelial adhesion gene expression as well as serum glucocorticoids (corticosterone) were measured. RAS manipulation elevated cytokines and endothelial adhesion expression in heart and aorta while SF increased cytokine expression in peripheral tissues, but not brain. However, there were interactive effects of angiotensin-II and SF upon cytokine gene expression in hippocampus and hypothalamus, but not prefrontal cortex. SF, but not RAS manipulation, elevated serum corticosterone concentration. These findings highlight the contrasting effects of RAS manipulation and SF, implying that inflammation from SF is acting on different pathways that are largely independent of RAS manipulation.

Evidence-based pathogenesis and treatment of ulcerative colitis: A causal role for colonic epithelial hydrogen peroxide

In this comprehensive evidence-based analysis of ulcerative colitis (UC), a causal role is identified for colonic epithelial hydrogen peroxide (H₂O₂) in both the pathogenesis and relapse of this debilitating inflammatory bowel disease. Studies have shown that H₂O₂ production is significantly increased in the non-inflamed colonic epithelium of individuals with UC. H₂O₂ is a powerful neutrophilic chemotactic agent that can diffuse through colonic epithelial cell membranes creating an interstitial chemotactic molecular “trail” that attracts adjacent intravascular neutrophils into the colonic epithelium leading to mucosal inflammation and UC. A novel therapy aimed at removing the inappropriate H₂O₂ mediated chemotactic signal has been highly effective in achieving complete histologic resolution of colitis in patients experiencing refractory disease with at least one (biopsy-proven) histologic remission lasting 14 years to date. The evidence implies that therapeutic intervention to prevent the re-establishment of a pathologic H₂O₂ mediated chemotactic signaling gradient will indefinitely preclude neutrophilic migration into the colonic epithelium constituting a functional cure for this disease. Cumulative data indicate that individuals with UC have normal immune systems and current treatment guidelines calling for the suppression of the immune response based on the belief that UC is caused by an underlying immune dysfunction are not supported by the evidence and may cause serious adverse effects. It is the aim of this paper to present experimental and clinical evidence that identifies H₂O₂ produced by the colonic epithelium as the causal agent in the pathogenesis of UC. A detailed explanation of a novel therapeutic intervention to normalize colonic H₂O₂, its rationale, components, and formulation is also provided.

A greater modified Mediterranean diet score is associated with lower insomnia score among adolescent girls: a cross-sectional study

Background

Previous studies has shown that a low quality diet is related to sleep disorders. A Mediterranean diet is considered to be a high quality diet and has been shown to have beneficial effects on overall health. Thus, the aim of our study was to investigate the association between adherence to Mediterranean dietary pattern and insomnia score among adolescent girls.

Methods

The data for 733 adolescent girls between 12–18 years old was assessed in this cross-sectional study. A 147 item-food frequency questionnaire was used to assess dietary intake. A modified model of Mediterranean diet score was calculated that ranged from 0–9 points. A validated version of Insomnia Severity Index questionnaire was used to assess insomnia. To explore the association between modified Mediterranean (mMED) diet score and insomnia, linear regression was conducted in crude and adjusted models (energy intake adjustmet in Model I, further adjustments were performed for physical activity, father’s and mother’s education in Model II and full adjusted model adjusted for age, body mass index percentiles, and abdominal obesity).

Results

A significant inverse association between mMED diet score and insomnia score was observed using a crude model (β = -0.091, 95% confidence interval (CI): -0.392 to -0.046); P-value = 0.013) and also after adjustment for confounding factors in Model I (β = -0.098, CI: -0.423 to -0.045; P = 0.015), Model II (β = -0.092, CI: -0.410 to -0.029; P-value = 0.024), Model III (β = -0.082, CI: -0.385 to -0.006); P = 0.044).

Conclusion

There was an inverse relationship between adherence to the mMED diet score and insomnia level among Iranian adolescent girls. Prospective studies are needed to confirm these results and clarify whether a causal relationship exists.

The mediation role of sleep quality in the relationship between cognitive decline and depression

Objectives

Associations between cognitive decline and depression have been inconclusive. We examined 1) whether sleep quality mediates these relationships and 2) which factor of sleep quality mediates these relationships.

Methods

This study utilized baseline data from the 2018 West China Health and Aging Trend study (WCHAT), a large cohort data-set that including participants aged over 50 years old. We defined depression using the 15-item Geriatric Depression Scale (GDS-15). Cognitive status was measured using the Short Portable Mental Status Questionnaire (SPMSQ) and sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). Direct relationships between cognitive decline, sleep quality and depression were assessed using multiple linear regression. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of specific aspects of sleep (e.g., quality, duration) in the relationship between cognitive decline and depression.

Results

Of 6828 participants aged 50 years old or older, the proportion of depression was 17.4%. Regression analysis indicated a total association between cognitive scores (β = 0.251, 95% CI 0.211 to 0.290, p < 0.001) and depression status. After adjusted PSQI scores, the association between cognitive scores and depression status was still significant (β = 0.242, 95% CI 0.203 to 0.281, p < 0.001), indicating a partial mediation effect of sleep quality. Mediation analysis verified sleep quality partially mediate the associations between cognitive decline and depression (indirect effect estimate = 0.0308, bootstrap 95% CI 0.023 to 0.040; direct effect estimate = 0.3124, bootstrap 95% CI 0.269 to 0.350). And daytime dysfunction had a highest mediation effect with a proportion of mediation up to 14.6%.

Conclusions

Sleep quality partially mediated the relationship between cognitive decline and depression. Daytime dysfunction had a highest mediation effect. Further research is necessary to examine the effects of sleep quality on the relationship of cognitive decline and depression.

Evaluating the effect of selenium on spatial memory impairment induced by sleep deprivation

Sleep deprivation (SD) impairs memory due to disturbing oxidative stress parameters. Selenium is a main component of several antioxidant enzymes and provides a neuroprotective effect. The present study aimed to investigate the potential neuroprotective effect of chronic selenium administration on cognitive impairments induced by chronic SD. Adult male Wister rats were randomly assigned into five groups (n = 12/group). The SD was induced in rats using modified multiple platform model. Selenium (6 µg/kg of animal's body weight) was administered to rats via oral gavage for 6 weeks. The spatial learning and memory were assessed using the radial arm water maze (RAWM). Moreover, we measured the levels of reduced glutathione (GSH), oxidized glutathione (GSSG) and GSH/GSSG, catalase, glutathione peroxidase (GPx), superoxide dismutase (SOD), thiobarbituric acid reactive substances (TBARS) and brain derived neurotrophic factor (BDNF) in the hippocampus. The results indicate that short- and long-term memory were impaired by chronic sleep deprivation (P < 0.05), while selenium administration prevented this effect. Moreover, selenium normalized antioxidants activities which were reduced by SD such as: catalase (P < 0.05), and SOD (P < 0.05), and significantly enhanced the ratio of GSH/GSSG in sleep-deprived rats (P < 0.05), without significant alteration of BDNF (P > 0.05), GSH (P > 0.05), or TBARS levels (P > 0.05). In conclusion, chronic SD induced memory impairment, and chronic treatment with selenium prevented this impairment by normalizing antioxidant enzymes activities in the hippocampus.

Sleep Duration and Hypertension: Epidemiological Evidence and Underlying Mechanisms

While the contribution of several physiological systems to arterial blood pressure regulation has been studied extensively, the role of normal and disrupted sleep as a modifiable determinant of blood pressure control, and in the pathophysiology of hypertension, has only recently emerged. Several sleep disorders, including sleep apnea and insomnia, are thought to contribute to the development of hypertension, although less attention is paid to the relationship between sleep duration and blood pressure independent of sleep disorders per se. Accordingly, this review focuses principally on the physiology of sleep and the consequences of abnormal sleep duration both experimentally and at the population level. Clinical implications for patients with insomnia who may or may not have abbreviated sleep duration are explored. As a corollary, we further review studies of the effects of sleep extension on blood pressure regulation. We also discuss epidemiological evidence suggesting that long sleep may also be associated with hypertension and describe the parabolic relationship between total sleep time and blood pressure. We conclude by highlighting gaps in the literature regarding the potential role of gut microbial health in the cross-communication of lifestyle patterns (exercise, diet, and sleep) with blood pressure regulation. Additionally, we discuss populations at increased risk of short sleep, and specifically the need to understand mechanisms and therapeutic opportunities in women, pregnancy, the elderly, and in African Americans.

Is Oxidative Stress the Link Between Cerebral Small Vessel Disease, Sleep Disruption, and Oligodendrocyte Dysfunction in the Onset of Alzheimer's Disease?

Oxidative stress is an early occurrence in the development of Alzheimer’s disease (AD) and one of its proposed etiologic hypotheses. There is sufficient experimental evidence supporting the theory that impaired antioxidant enzymatic activity and increased formation of reactive oxygen species (ROS) take place in this disease. However, the antioxidant treatments fail to stop its advancement. Its multifactorial condition and the diverse toxicological cascades that can be initiated by ROS could possibly explain this failure. Recently, it has been suggested that cerebral small vessel disease (CSVD) contributes to the onset of AD. Oxidative stress is a central hallmark of CSVD and is depicted as an early causative factor. Moreover, data from various epidemiological and clinicopathological studies have indicated a relationship between CSVD and AD where endothelial cells are a source of oxidative stress. These cells are also closely related to oligodendrocytes, which are, in particular, sensitive to oxidation and lead to myelination being compromised. The sleep/wake cycle is another important control in the proliferation, migration, and differentiation of oligodendrocytes, and sleep loss reduces myelin thickness. Moreover, sleep plays a crucial role in resistance against CSVD, and poor sleep quality increases the silent markers of this vascular disease. Sleep disruption is another early occurrence in AD and is related to an increase in oxidative stress. In this study, the relationship between CSVD, oligodendrocyte dysfunction, and sleep disorders is discussed while focusing on oxidative stress as a common occurrence and its possible role in the onset of AD.

Sleep deprivation induces oxidative stress in the liver and pancreas in young and aging rats

The aging process is characterized by a gradual impairment generally caused by oxidative stress and, more specifically, sleep deprivation, which induces oxidative stress in the brain. The objective of this study was to assess the effect of three types of paradoxical sleep deprivation (PSD): 96 h of PSD (96PSD group); 192 h of PSD (192PSD group); 192 h of PSD followed by a recovery period of 20 days (192PSD + Recovery group) on an oral glucose tolerance test (OGTT), lipid peroxidation (LPO), and superoxide dismutase (SOD) and catalase (CAT) activities in the liver and pancreas of young (3-month-old) and adult (14-month-old) rats. The 96PSD and 192PSD groups of young rats showed lower glucose levels on the OGTT than the control group. In the adult rats, only the 96PSD group had lower glucose levels than the control group. However, the areas under the curve for the young and adult 192 and 192PSD + Recovery groups showed significant differences. Both LPO and SOD increased in the 192PSD and 192PSD + Recovery groups, but CAT decreased in the liver of young rats in the 192PSD group. Regarding the pancreas, LPO and SOD levels increased after 96 h of PSD. In adult animals, CAT decreased in the liver after 96 and 192 h of PSD, while LPO and SOD increased in the pancreas of the 192PSD and PSD + Recovery groups. Differences in the SOD and CAT activities in the liver and SOD activities in the pancreas were also observed between the young and adult rats and maintained across all the PSD groups. In conclusion, PSD induced differential responses that appeared to depend on the duration of the induced condition, the animals’ age, and the tissue analyzed. It was found that adult rats were more susceptible to the effects of PSD than young rats.

Effects of Supplementation With Antioxidant Agents on Sleep in Autism Spectrum Disorder: A Review

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition, whose etiology remains poorly understood in most cases. Several genetic, epigenetic and environmental factors have been implicated in ASD pathogenesis and numerous studies have provided evidences for increased levels of oxidative stress and reduced antioxidant capacity in patients with ASD. Recent clinical trials explored supplementation with antioxidant agents as a potential therapeutic strategy for ASD, investigating the impact of this treatment on behavioral symptoms and on most common comorbidities of the disease, including sleep disturbances. Among all medical conditions associated to ASD, sleep problems are highly prevalent and are supposed to be positively related to the severity of the disease. Moreover, studies on animal models support the hypothesis of a relationship between oxidative stress and sleep deprivation. The aim of this review is to summarize the current state of the literature on the effect of antioxidant treatment on sleep disturbances in patients with ASD. Twenty-one articles were included in final synthesis. Of them, 15 studies involved Melatonin, 1 Tryptophan and 5 focused on supplementation with other antioxidant agents (namely Coenzyme Q10, L-Carnosine, Luteolin and Quercetin). Despite the high prevalence of comorbid sleep troubles in ASD, there is a paucity of data on the efficacy of antioxidant agents in those patients. Further research is needed to better define the role of antioxidants agents as adjunctive therapy in the management sleep disorders in children and adolescents affected with ASD.

Effect of L-Carnosine as adjunctive therapy in the management of children with autism spectrum disorder: a randomized controlled study

L-Carnosine is an amino acid that acts as an anti-oxidant, anti-toxic and neuroprotective agent. There is a paucity of data about the effectiveness of L-Carnosine in the management of autism spectrum disorder (ASD) in children. This study aimed at investigating the effectiveness of L-Carnosine as adjunctive therapy in the management of ASD. This was a randomized controlled trial. Children aged 3-6 years with a diagnosis of mild to moderate ASD were assigned to standard care arm (occupational and speech therapy) and intervention care arm (L-Carnosine, 10-15 mg/kg in 2 divided doses) plus standard care treatment. The children were assessed at the baseline and the end of 2 months for the scores of Childhood Autism Rating Scale, Second Edition-Standard Version (CARS2-ST), Autism Treatment Evaluation Checklist (ATEC), BEARS sleep screening tool and 6-item Gastrointestinal Severity Index (6-GSI). Of the sixty-seven children enrolled, sixty-three children had completed the study. No statistically significant difference (p > 0.05) was observed for any of the outcome measures assessed. Supplementation of L-Carnosine did not improve the total score of CARS2-ST, ATEC, BEARS sleep screening tool and 6-GSI scores of children with ASD. Further investigations are needed with more objective assessments to critically validate the effectiveness of L-Carnosine on ASD children for more decisive results.

Sleep Loss Can Cause Death through Accumulation of Reactive Oxygen Species in the Gut

The view that sleep is essential for survival is supported by the ubiquity of this behavior, the apparent existence of sleep-like states in the earliest animals, and the fact that severe sleep loss can be lethal. The cause of this lethality is unknown. Here we show, using flies and mice, that sleep deprivation leads to accumulation of reactive oxygen species (ROS) and consequent oxidative stress, specifically in the gut. ROS are not just correlates of sleep deprivation but drivers of death: their neutralization prevents oxidative stress and allows flies to have a normal lifespan with little to no sleep. The rescue can be achieved with oral antioxidant compounds or with gut-targeted transgenic expression of antioxidant enzymes. We conclude that death upon severe sleep restriction can be caused by oxidative stress, that the gut is central in this process, and that survival without sleep is possible when ROS accumulation is prevented. VIDEO ABSTRACT.

The association between self-reported sleep dissatisfaction after the Great East Japan Earthquake, and a deteriorated socioeconomic status in the evacuation area: the Fukushima Health Management Survey

BACKGROUND

Currently, few studies have thoroughly investigated the socioeconomic factors related to sleep problems among evacuees following a disaster.

OBJECTIVES

To examine sleep problems in evacuees using data from a large-scale cohort survey of evacuees conducted after the 2011 Great East Japan Earthquake (GEJE).

METHODS

In sum, 73,433 residents who were living in evacuation zones responded to The 2011 Fukushima Health Management Survey. We excluded 16,659 participants who did not answer the question about sleep problems or those younger than 20 years. Thus, data from 56,774 participants (24,959 men and 31,815 women) were used for this analysis. Evacuees' self-reported sleep dissatisfaction was determined based on their response to the question 'Are you satisfied with the quality of your sleep? '. The response options 'Unsatisfied' and 'Very unsatisfied' were considered as the outcome for the present study. Prevalence ratios (PRs) and 95% confidence intervals (CIs) for the prevalence of self-reported sleep disturbance were estimated using modified Poisson regression models.

RESULTS

Of the qualifying survey respondents, 20.3% (4387 men and 7128 women) reported sleep dissatisfaction. Compared with participants living in their own or a relative's home (PR = 1), those living in temporary housing or rental accommodation had a higher prevalence of sleep dissatisfaction (1.47; 95% CI 1.44-1.50 and 2.16; 95% CI 2.07-2.26 in men; 1.39; 95% CI 1.36-1.41 and 1.92; 95% CI 1.86-1.99 in women). Higher educational attainment was also associated with a higher prevalence of sleep dissatisfaction in men, as were job loss and decreased income in both men and women.

CONCLUSION

Self-reported sleep dissatisfaction after the GEJE was associated with a deteriorated socioeconomic status among evacuees. However, future longitudinal studies are warranted.

Tired and stressed: Examining the need for sleep

A key feature of circadian rhythms is the sleep/wake cycle. Sleep causes reduced responsiveness to the environment, which puts animals in a particularly vulnerable state; yet sleep has been conserved throughout evolution, indicating that it fulfils a vital purpose. A core function of sleep across species has not been identified, but substantial advances in sleep research have been made in recent years using the genetically tractable model organism, Drosophila melanogaster. This review describes the universality of sleep, the regulation of sleep, and current theories on the function of sleep, highlighting a historical and often overlooked theory called the Free Radical Flux Theory of Sleep. Additionally, we summarize our recent work with short-sleeping Drosophila mutants and other genetic and pharmacological tools for manipulating sleep which supports an antioxidant theory of sleep and demonstrates a bi-directional relationship between sleep and oxidative stress.

Acute sleep deprivation during pregnancy in rats: Rapid elevation of placental and fetal inflammation and kynurenic acid

The kynurenine pathway (KP) is the dominant pathway for tryptophan degradation in the mammalian body and emerging evidence suggests that acute episodes of sleep deprivation (SD) disrupt tryptophan metabolism via the KP. Increases in the neuroactive KP metabolite kynurenic acid (KYNA) during pregnancy may lead to a higher risk for disrupted neurodevelopment in the offspring. As pregnancy is a critical period during which several factors, including sleep disruptions, could disrupt the fetal environment, we presently explored the relationship between maternal SD and KP metabolism and immune pathways in maternal, placenta, and fetal tissues. Pregnant Wistar rat dams were sleep deprived by gentle handling for 5 h from zeitgeber time (ZT) 0 to ZT 5. Experimental cohorts included: i) controls, ii) one session of SD on embryonic day (ED) 18 or iii) three sessions of SD occurring daily on ED 16, ED 17 and ED 18. Maternal (plasma, brain), placental and fetal (plasma, brain) tissues were collected immediately after the last session of SD or after 24 h of recovery from SD. Respective controls were euthanized at ZT 5 on ED 18 or ED 19. Maternal plasma corticosterone and fetal brain KYNA were significantly elevated only after one session of SD on ED 18. Importantly, maternal plasma corticosterone levels correlated significantly with fetal brain KYNA levels. In addition, placental levels of the proinflammatory cytokines interleukin-1β (IL-1β) and interleukin-6 (IL-6) were increased following maternal SD, suggesting a relationship between placental immune response to SD and fetal brain KYNA accumulation. Collectively, our results demonstrate that sleep loss during the last week of gestation can adversely impact maternal stress, placental immune function, and fetal brain KYNA levels. We introduce KYNA as a novel molecular target influenced by sleep loss during pregnancy.

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Prenatal sleep deprivation influences kynurenine pathway metabolism in utero.

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Fetal brain kynurenic acid (KYNA) is elevated after maternal sleep deprivation.

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Maternal plasma corticosterone is increased after sleep deprivation.

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Prenatal sleep deprivation induces placental and fetal brain cytokines.

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These data support an interplay with stress, in utero inflammation, and KYNA.

The Impact of Sleep and Circadian Disorders on Physician Burnout

Nearly 50% of physicians report symptoms of clinical burnout. Occupational factors and personal health play substantial roles in physician burnout. The role of sleep in physician burnout is not well understood. Burnout is at epidemic levels in health care, with research suggesting nearly one in two physicians experience clinical burnout as defined according to the Maslach Burnout Index. Sleep deprivation, burnout, and clinician health are intricately intertwined. The relation between sleep deprivation and burnout is not only suggested in hypothetical models but also confirmed in observational studies of workers of all types. Models describing the relation between burnout and sleep suggest as potential causative mechanisms of sleep disturbances the following: (1) a chronic depletion of energy stores; or (2) activation of the hypothalamic-pituitary-adrenal axis and increasing levels of bodily stress. Sleep deprivation and burnout are widespread in health-care workers, affecting not only nurses but also medical students, physicians-in-training, and practicing physicians. Although sleep deprivation is associated with clinical burnout, direct studies showing that sleep extension can improve burnout recovery are lacking. Early detection and early intervention to improve both sleep deprivation and burnout are warranted in health-care professionals. Interventions should be directed not only at individuals but also at the entire health system. This review highlights the latest developments and emerging concepts concerning the role of sleep and circadian disorders in physician burnout.

Dietary Inflammatory Index and Sleep Quality in Southern Italian Adults

BACKGROUND

Current evidence supports the central role of a subclinical, low-grade inflammation in a number of chronic illnesses and mental disorders; however, studies on sleep quality are scarce. The aim of this study was to test the association between the inflammatory potential of the diet and sleep quality in a cohort of Italian adults.

METHODS

A cross-sectional analysis of baseline data of the Mediterranean healthy Eating, Aging, and Lifestyle (MEAL) study was conducted on 1936 individuals recruited in the urban area of Catania during 2014-2015 through random sampling. A food frequency questionnaire and other validated instruments were used to calculate the dietary inflammatory index (DII®) and assess sleep quality (Pittsburg sleep quality index). Multivariable logistic regression analyses were performed to determine the association between exposure and outcome.

RESULTS

Individuals in the highest quartile of the DII were less likely to have adequate sleep quality (odds ratio (OR) = 0.49, 95% CI: 0.31, 0.78). Among individual domains of sleep quality, an association with the highest exposure category was found only for sleep latency (OR = 0.60, 95% CI: 0.39, 0.93).

CONCLUSIONS

The inflammatory potential of the diet appears to be associated with sleep quality in adults. Interventions to improve diet quality might consider including a dietary component that aims to lower chronic systemic inflammation to prevent cognitive decline and improve sleep quality.

Sleep quality mediates the relationship between frailty and cognitive dysfunction in non-demented middle aged to older adults

ABSTRACTObjectives:Frailty is associated with cognitive decline in older adults. However, the mechanisms explaining this relationship are poorly understood. We hypothesized that sleep quality may mediate the relationship between frailty and cognition.

PARTICIPANTS

154 participants aged between 50-90 years (mean = 69.1 years, SD = 9.2 years) from the McKnight Brain Registry were included.

MEASUREMENTS

Participants underwent a full neuropsychological evaluation, frailty and subjective sleep quality assessments. Direct relationships between frailty and cognitive function were assessed using linear regression models. Statistical mediation of these relationships by sleep quality was assessed using nonparametric bootstrapping procedures.

RESULTS

Frailty severity predicted weaker executive function (B = -2.77, β = -0.30, 95% CI = -4.05 - -1.29) and processing speed (B = -1.57, β = -0.17, 95% CI = -3.10 - -0.16). Poor sleep quality predicted poorer executive function (B = -0.47, β = -0.21, 95% CI = -0.79 - -0.08), processing speed (B = -0.64, β = -0.28, 95% CI = -0.98 - -0.31), learning (B = -0.42, β = -0.19, 95% CI = -0.76 - -0.05) and delayed recall (B = -0.41, β = -0.16, 95% CI = -0.80 - -0.31). Poor sleep quality mediated the relationships between frailty severity and executive function (B = -0.66, β = -0.07, 95% CI = -1.48 - -0.39), learning (B = -0.85, β = -0.07, 95% CI = -1.85 - -0.12), delayed recall (B = -0.47, β = -0.08, 95% CI = -2.12 - -0.39) and processing speed (B = -0.90, β = -0.09, 95% CI = -1.85 - -0.20).

CONCLUSIONS

Relationships between frailty severity and several cognitive outcomes were significantly mediated by poor sleep quality. Interventions to improve sleep quality may be promising avenues to prevent cognitive decline in frail older adults.

Adherence to the Mediterranean Diet is Associated with Better Sleep Quality in Italian Adults

BACKGROUND

Sleep quality has been associated with human health and diseases, including cognitive decline and dementia; however major determinants of sleep disorders are largely unknown. The aim of this study was to evaluate the association between sleep quality and adherence to the Mediterranean dietary pattern in a sample of Italian adults.

METHODS

A total of 1936 individuals were recruited in the urban area of Catania during 2014-2015 through random sampling. A food frequency questionnaire and validated instruments were used to assess the adherence to the Mediterranean diet and sleep quality (Pittsburg sleep quality index). Multivariate logistic regressions were performed to determine the association between exposure and outcome.

RESULTS

A total of 1314 individuals (67.9% of the cohort) reported adequate sleep quality: for each point increase of the Mediterranean diet score, individuals were 10% more likely to have adequate sleep quality. In an additional analysis stratifying the sample by weight status, the association between sleep quality and high adherence to the Mediterranean diet was observed only among normal/overweight individuals but not in obese participants.

CONCLUSIONS

high adherence to a Mediterranean diet is associated with better sleep quality either toward direct effect on health or indirect effects through improvement of weight status.

Sleep deprivation, oxidative stress and inflammation

Adequate sleep is essential for normal brain function, especially during early life developmental stages as postnatal brain maturation occurs during the critical period of childhood and adolescence. Therefore, sleep disturbance and/or deficit during this period can have detrimental consequences. Many epidemiological and clinical studies have linked early life sleep disturbance with occurrence of later life behavioral and cognitive impairments. Role of oxidative stress and inflammation has been implicated in sleep deprivation-related impairments. This review article presents a detailed description of the current state of the literature on the subject.

Omega-3 fatty acids protects against chronic sleep-deprivation induced memory impairment

AIMS

The current study aims to evaluate the possible protective effect of omega-3 fatty acids on memory impairment induced by sleep-deprivation in rats.

MATERIALS AND METHODS

Animals were chronically sleep deprived using the modified multiple platform model (8 h/day for 8 weeks). Omega-3 fatty acids were administered as fish oil via oral gavage at a daily dose of 100 mg omega-3 PUFA/100 g BWT. The spatial learning and memory were evaluated using the radial arm water maze (RAWM). Additionally, the following oxidative stress biomarkers were measured in the hippocampus: glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG, glutathione peroxidase (GPx), catalase, superoxide dismutase (SOD), and thiobarbituric acid reactive substance (TBARS).

KEY FINDINGS

Animals in the SD group committed significantly more errors in both short- and long- term memory tests of the RAWM compared to other groups. On the other hand, animals that were sleep deprived and treated with omega-3 fatty acids committed similar number of errors compared to the control group. This indicates that SD impaired both short- and long- term memories, and that chronic omega-3 fatty acids administration prevented these effects. Omega-3 fatty acids also prevented the decreases in hippocampal GPx, catalase and GSH/GSSG ratio and normalized the increases in GSSG levels, which were impaired by SD model. No changes were observed on hippocampal TBARS levels, or activity of SOD among experimental groups.

SIGNIFICANCE

In conclusion, a protective effect of omega-3 fatty acids administration has been observed against chronic SD-induced memory impairment probably via improving hippocampus antioxidant effects.

Early Life Sleep Deprivation: Role of Oxido-Inflammatory Processes

The adverse consequences of early-life sleep deprivation on mental health are well recognized, yet many aspects remain unknown, therefore, animal studies can offer useful insights. Male Sprague-Dawley rats at postnatal day (PND) 19 were subjected to sleep deprivation (SD) for 14 days (6-8 hours/day). Control (CON) rats were gently handled. Behavior tests were done on PND33, PND60 and PND90. SD rats exhibited anxiety-like behavior at PND33 and PND60, when compared to CON rats. Depression-like behavior was observed at PND90. Evaluation of oxidative stress and inflammatory markers revealed interesting results. Plasma 8-isoprostane and antioxidant defense enzymes; hemeoxygenase-1, superoxide dismutase, glutathione peroxidase in the prefrontal cortex (PFC), were upregulated in SD rats at PND33 but not at PND90. PFC interleukin-6 protein expression was elevated at PND33 and PND90. PFC mitogen activated protein kinase phosphatase-1 (MKP-1) and p-38 protein expression were upregulated at PND90. PFC expression of glutamate receptor subunits, post synaptic density protein (PSD-95), calcium/calmodulin-dependent protein kinase (CaMKII), and extracellular signal-regulated kinase (ERK_1/2), were significantly reduced in SD rats at PND33 and PND90. PFC brain derived neurotrophic factor (BDNF) and cAMP response element binding protein (CREB) were reduced in SD rats at PND90. Our postulation is that SD by increasing PFC oxido-inflammation, negatively affects glutamate receptor subunits and PSD95 expression, which disrupts synapse formation and maturation, potentially causing anxiety-like behavior at PND33. Oxido-inflammation further results in MKP-1 and CaMKII-mediated blockade of ERK_1/2 activation, which inhibits CREB dependent BDNF expression. This most likely disrupts neuronal circuit development, leading to depression-like behavior at PND90.

Effects of a 36-h Survival Training with Sleep Deprivation on Oxidative Stress and Muscle Damage Biomarkers in Young Healthy Men

The aim of this study was to analyze changes in oxidative stress and muscle damage markers during a 36-h survival training combined with sleep deprivation. The study included 23 male students of physical education (specialty: Physical Education for Uniformed Services), randomly divided into the survival or control group. The students in the survival group completed a 36-h survival training with moderate to low physical activity, without the possibility to sleep. The students in the control group performed only physical activity included in daily routines and had a normal sleep pattern. No significant changes in measured parameters were seen in the control group throughout the study period. In the survival group, plasma lipid hydroperoxides (LHs) and creatine kinase (CK) activity increased at 24 h and remained elevated up to 36 h (main effects for LHs: time, p = 0.006 and group × time, p = 0.00008; main effects for CK: time, p = 0.000001, group, p = 0.005, and group × time, p = 0.000001). A 12-h recovery was sufficient to normalize both LHs and CK to the pre-training level; in fact, the post-recovery LHs and CK levels were even lower than at baseline. Residual total antioxidant capacity (TAC) of plasma (without the major constituents: uric acid and albumin) was elevated at both 24 h and 36 h of survival training, but not following a 12-h recovery (main effects: group, p = 0.001 and group × time, p = 0.04). In turn, the activity of glutathione peroxidase (GPx) in whole blood and superoxide dismutase (SOD) in erythrocytes decreased between 24 h and 36 h of survival training (main group effect for GPx, p = 0.038 and SOD, p = 0.045). In conclusion, these findings imply that a 36-h survival training with sleep deprivation impairs enzymatic antioxidant defense, increases lipid peroxidation, and induces muscle damage. Our findings also indicate that at least in the case of young physically active men, a 12-h recovery after the 36-h period of physical activity with sleep deprivation may be sufficient for the normalization of oxidative and muscle damage markers and restoration of blood prooxidant-antioxidant homeostasis.

Effects of l-Carnosine Supplementation on Sleep Disorders and Disease Severity in Autistic Children: A Randomized, Controlled Clinical Trial

Sleep disorders are frequently reported in autistic patients. Evidences suggest that increased oxidative stress and reduced antioxidants may play a major role in the pathogenesis of these disorders. Carnosine acts as an antioxidant, antitoxic and neuroprotective agent. The aim of this trial study was to examine the effects of carnosine supplementation on the sleep disorders and severity of autism core symptoms in autistic patients. In this double-blind, randomized clinical trial, 43 autistic patients (31 boys and 12 girls; aged 4 to 16 years) were divided into two groups of carnosine and control that received 500 mg of carnosine and 500 mg of placebo per day for 2 months, respectively. Sleep disorders were measured using Children's Sleep Habits Questionnaires. Gilliam Autism Rating Scale 2 was used to assess the effects of carnosine supplementation on the autism severity. Carnosine supplementation did not change anthropometric indices (p > 0.05) and showed no effect on autism severity (p > 0.05), whereas it significantly reduced sleep duration (p = 0.04), parasomnias (p = 0.02) and total sleep disorders score by 7.59% (p = 0.006) when compared with the control group. The results suggest that carnosine supplementation could be effective in improving sleep disturbances, in particular sleep duration and parasomnias subscales.

Oxidative Stress: A Unifying Mechanism for Cell Damage Induced by Noise, (Water-Pipe) Smoking, and Emotional Stress-Therapeutic Strategies Targeting Redox Imbalance

SIGNIFICANCE

Modern technologies have eased our lives but these conveniences can impact our lifestyles in destructive ways. Noise pollution, mental stresses, and smoking (as a stress-relieving solution) are some environmental hazards that affect our well-being and healthcare budgets. Scrutinizing their pathophysiology could lead to solutions to reduce their harmful effects. Recent Advances: Oxidative stress plays an important role in initiating local and systemic inflammation after noise pollution, mental stress, and smoking. Lipid peroxidation and release of lysolipid by-products, disturbance in activation and function of nuclear factor erythroid 2-related factor 2 (Nrf2), induction of stress hormones and their secondary effects on intracellular kinases, and dysregulation of intracellular Ca²⁺ can all potentially trigger other vicious cycles. Recent clinical data suggest that boosting the antioxidant system through nonpharmacological measures, for example, lifestyle changes that include exercise have benefits that cannot easily be achieved with pharmacological interventions alone.

CRITICAL ISSUES

Indiscriminate manipulation of the cellular redox network could lead to a new series of ailments. An ideal approach requires meticulous scrutiny of redox balance mechanisms for individual pathologies so as to create new treatment strategies that target key pathways while minimizing side effects.

FUTURE DIRECTIONS

Extrapolating our understanding of redox balance to other debilitating conditions such as diabetes and the metabolic syndrome could potentially lead to devising a unifying therapeutic strategy. Antioxid. Redox Signal. 28, 741-759.

Unraveling the Evolutionary Determinants of Sleep

Despite decades of intense study, the functions of sleep are still shrouded in mystery. The difficulty in understanding these functions can be at least partly attributed to the varied manifestations of sleep in different animals. Daily sleep duration can range from 4-20 hrs among mammals, and sleep can manifest throughout the brain, or it can alternate over time between cerebral hemispheres, depending on the species. Ecological factors are likely to have shaped these and other sleep behaviors during evolution by altering the properties of conserved arousal circuits in the brain. Nonetheless, core functions of sleep are likely to have arisen early and to have persisted to the present day in diverse organisms. This review will discuss the evolutionary forces that may be responsible for phylogenetic differences in sleep and the potential core functions that sleep fulfills.

Sleep Characteristics and Temperament in Preterm Children at Two Years of Age

STUDY OBJECTIVES

We aimed to compare 2-year-old children born preterm with children born full term regarding: (1) sleep characteristics, (2) temperament, and (3) relations between sleep pattern and habits and temperament.

METHODS

The study included 51 preterm children with normal cognitive, language, and motor development (mean = 20.94 months, standard deviation [SD] = 4.08) and 57 full-term children (mean = 21.19, SD = 4.32). To assess sleep-related difficulties and habits and child temperament, mothers completed the following questionnaires: the (1) Sleep Disturbance Scale for Children-adapted (SDSC); (2) Brief Infant Sleep Questionnaire (BISQ); and (3) Italian Temperament Questionnaires-version 12-36 months (QUIT).

RESULTS

Preterm children needed less support to fall asleep and fell asleep more often alone in their own bed compared to those born at full term; however, preterm children showed more frequent sleep difficulties, such as restlessness and breathing problems during the night. In addition, preterm children had lower scores in the temperamental dimension of attention and higher scores in negative emotionality than full-term children. Finally, sleep problems were correlated with higher motor activity, lower social orientation and attention, and increased negative emotionality; a shorter nocturnal sleep duration was related to higher motor activity and lower inhibition to novelty whereas an earlier rise time was associated with lower attention and social orientation.

CONCLUSIONS

Preterm children showed sleep pattern problems and disturbance, predominance of attention problems, and negative emotionality related to sleep disruption.

Short-term sleep deprivation leads to decreased systemic redox metabolites and altered epigenetic status

Sleep is critical for repair as well as the rejuvenation processes in the body and many of these functions are regulated via underlying cellular metabolic homeostasis. Changes in sleep pattern are reported to alter such metabolic function resulting in altered disease susceptibility or behavior. Here, we measured the extent to which overnight total sleep deprivation (SD) in young adult humans can influence systemic (plasma-derived) redox-metabolism including the major antioxidant, glutathione as well as DNA methylation levels. Nineteen participants (n = 19, μ age = 21, SD = 3.09) underwent morning testing before and after overnight total SD. Biochemical measures before and after SD revealed that glutathione, ATP, cysteine, and homocysteine levels were significantly reduced following one night of sleep deprivation (all p’s < 0.01). Parallel to the well-recognized fact that sleep deprivation (maintaining wakefulness) uses up metabolic reserves, we observed that morning cortisol levels were blunted after sleep deprivation. There were no significant correlations between self-reported or actigraphy-measured sleep and the biochemical measurements, strongly indicating that prior sleep behavior did not have any direct influence on the biochemical measures taken at baseline or after sleep deprivation. Results from the current investigation supports the previous literature implicating the induction of oxidative stress and ATP depletion with sleep deprivation. Furthermore, such altered antioxidant status can also induce downstream epigenetic changes. Although we did not measure the specific genes that were altered under the influence of such sleep deprivation, such epigenetic changes could potentially contribute towards disease predisposition.