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Patrician A, Anholm JD, Ainslie PN. A narrative review of periodic breathing during sleep at high altitude: From acclimatizing lowlanders to adapted highlanders. J Physiol 2024. [PMID: 38534039 DOI: 10.1113/jp285427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/15/2024] [Indexed: 03/28/2024] Open
Abstract
Periodic breathing during sleep at high altitude is almost universal among sojourners. Here, in the context of acclimatization and adaptation, we provide a contemporary review on periodic breathing at high altitude, and explore whether this is an adaptive or maladaptive process. The mechanism(s), prevalence and role of periodic breathing in acclimatized lowlanders at high altitude are contrasted with the available data from adapted indigenous populations (e.g. Andean and Tibetan highlanders). It is concluded that (1) periodic breathing persists with acclimatization in lowlanders and the severity is proportional to sleeping altitude; (2) periodic breathing does not seem to coalesce with poor sleep quality such that, with acclimatization, there appears to be a lengthening of cycle length and minimal impact on the average sleeping oxygen saturation; and (3) high altitude adapted highlanders appear to demonstrate a blunting of periodic breathing, compared to lowlanders, comprising a feature that withstands the negative influences of chronic mountain sickness. These observations indicate that periodic breathing persists with high altitude acclimatization with no obvious negative consequences; however, periodic breathing is attenuated with high altitude adaptation and therefore potentially reflects an adaptive trait to this environment.
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Affiliation(s)
- Alexander Patrician
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, BC, Canada
| | - James D Anholm
- Department of Medicine, Division of Pulmonary and Critical Care, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, BC, Canada
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Gao T, Hou M, Wang Q, Liu D, Chen F, Xing Y, Mei J. The roles of serum vitamin D and tobacco smoke exposure in insomnia: a cross-sectional study of adults in the United States. Front Nutr 2023; 10:1285494. [PMID: 38170097 PMCID: PMC10759233 DOI: 10.3389/fnut.2023.1285494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/23/2023] [Indexed: 01/05/2024] Open
Abstract
Aim Tobacco smoke exposure and vitamin D (VD) status were both associated with insomnia. However, the combined effect of smoking and VD on insomnia has not been discussed. This study aimed to explore the role of VD in the association between tobacco smoke exposure and insomnia. Methods Data on adults were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2005-2008 for this cross-sectional study. Weighted univariate and multivariate logistic regression analyses were used to explore the associations between serum cotinine, serum VD, and insomnia. A surface diagram was drawn to reflect the effect of VD on the association between serum cotinine and insomnia. In addition, the potential regulating effect of VD in subgroups of smoking status was also performed. The evaluation index was odds ratios (ORs) with 95% confidence intervals (CIs). Results Among the eligible participants, 1,766 had insomnia. After adjusting for covariates, we found that elevated serum cotinine levels were associated with higher odds of insomnia [OR = 1.55, 95% CI: (1.22, 1.97)]. However, the relationship between serum VD level and insomnia was not significant (P = 0.553). Higher serum cotinine levels were also associated with higher odds of insomnia [OR = 1.52, 95% CI: (1.17, 1.98)] when serum VD level was <75 nmol/L; however, this relationship became non-significant when serum VD concentration was elevated (P = 0.088). Additionally, the potential regulating effect of VD was also found in adults who were not smoking. Conclusion VD may play a potential regulative role in the association between tobacco smoke exposure and insomnia. Further studies are needed to clarify the causal relationships between VD, tobacco smoke exposure, and insomnia.
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Affiliation(s)
- Tianci Gao
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Mengxing Hou
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Qianfei Wang
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Dong Liu
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Traditional Chinese Medicine, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Fenqiao Chen
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Yueyi Xing
- School of Basic Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Jianqiang Mei
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Department of Emergency, First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
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Abate H, Letta S, Worku T, Tesfaye D, Amare E, Mechal A. Shiftwork sleep disorder and associated factors among nurses working at public hospitals in Harari Regional state and Dire Dawa Administration, Eastern Ethiopia: a cross-sectional study. BMC Nurs 2023; 22:118. [PMID: 37055815 PMCID: PMC10100203 DOI: 10.1186/s12912-023-01257-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/20/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Shiftwork sleep disorder is one of the most common health-related effects of Shiftwork, particularly among healthcare workers. It is a chronic condition that is directly related to a person's work schedule. In Ethiopia, although a mental health strategy is in place, little attention is given to studies that focus on shiftwork sleep disorders among nurses. This study aimed to determine the magnitude of shiftwork sleep disorder and associated factors among nurses working at public hospitals in Harari Regional State and the Dire Dawa Administration. METHODS Institutional based cross-sectional study was conducted from June 1-30, 2021 among 392 nurses selected by a simple random sampling technique. A structured interviewer-guided self-administered questionnaire was used for data collection. The International Classification of Sleep Disorders 3rd edition (ICSD-3), Bargen Insomnia Scale (BIS) and Epworth Sleepiness Scale were used to assess shift-work sleep disorder. The data were entered into EpiData and exported to SPSS for analysis. Bivariable logistic regression was used to see the association between the outcome and the explanatory variables. Bivariate and Multivariate analyses were performed, and AOR with 95% CI was used to measure the strength of the association. Those variables with a p-values of < 0.05 were considered as statistically significant. RESULTS In this study, the magnitude of shiftwork sleep disorder among nurses was 30.4% (95% CI: 25.4-34.5). Being female (AOR = 2.4, 95% CI: 1.3, 4.2), working an average number of nights > 11 per month in the last 12 months (AOR = 2.5, 95% CI: 1.3, 3.8), and khat use in the last 12 months (AOR = 4.9, 95% CI: 2.9, 8.7) were significantly associated with the shiftwork sleep disorder. CONCLUSIONS The study revealed that about one-third of the nurses had a shiftwork sleep disorder implying a high burden of the problem among nurses in the study setting, which endangers nurses, patients, and the healthcare system. Being female, working an average number of nights > 11 per month in the last 12 months, and khat use showed statistically significantly associated with the shiftwork sleep disorder. Early detection of shiftwork sleep disorder, having a policy on khat use and considering rest/recovery while scheduling work time should be addressed to prevent shiftwork sleep disorder.
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Affiliation(s)
- Henok Abate
- School of Nursing and Midwifery, College of Health Science and Medicine, Jigjiga University, Jigjiga, Ethiopia
| | - Shiferaw Letta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Teshager Worku
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Eldana Amare
- Comprehensive Nursing Department, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Ayalnesh Mechal
- Comprehensive Nursing Department, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
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Fischer AR, Green SRM, Gunn HE. Social-ecological considerations for the sleep health of rural mothers. J Behav Med 2021; 44:507-518. [PMID: 33083923 PMCID: PMC7574991 DOI: 10.1007/s10865-020-00189-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 09/30/2020] [Indexed: 02/03/2023]
Abstract
Using a social-ecological framework, we identify social determinants that interact to influence sleep health, identify gaps in the literature, and make recommendations for targeting sleep health in rural mothers. Rural mothers experience unique challenges and protective factors in maintaining adequate sleep health during the postpartum and early maternal years. Geographic isolation, barriers to comprehensive behavioral medicine services, and intra-rural ethno-racial disparities are discussed at the societal (e.g., public policy), social (e.g., community) and individual levels (e.g., stress) of the social-ecological model. Research on sleep health would benefit from attention to methodological considerations of factors affecting rural mothers such as including parity in population-level analyses or applying community-based participatory research principles. Future sleep health programs would benefit from using existing social support networks to disseminate sleep health information, integrating behavioral health services into clinical care frameworks, and tailoring culturally-appropriate Telehealth/mHealth programs to enhance the sleep health of rural mothers.
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Affiliation(s)
- Alexandra R Fischer
- Department of Psychology, University of Alabama, Box 87034, Tuscaloosa, AL, 35487, USA
| | | | - Heather E Gunn
- Department of Psychology, University of Alabama, Box 87034, Tuscaloosa, AL, 35487, USA.
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International study of the prevalence and factors associated with insomnia in the general population. Sleep Med 2021; 82:186-192. [PMID: 33957414 DOI: 10.1016/j.sleep.2021.03.028] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/08/2021] [Accepted: 03/26/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Insomnia is a public health problem with many repercussions. It affects a significant proportion of the general population worldwide, but the estimated prevalences in different countries are difficult to compare due to the use of heterogeneous methodologies. The objectives of the study were to compare the prevalence of insomnia in the general population in different sites around the world and to identify sociodemographic and mental health associated factors, using the same tool and within a single study. METHODS This multicenter cross-sectional study is based on the Mental Health in the General Population survey (MHPG). It included several sites in France and 12 countries around the world with a representative sampling of the general population. The prevalence of short-term insomnia disorder was estimated by the occurrence within one month of at least one symptom, at a minimum frequency of three per week, with repercussions on everyday life. RESULTS Out of the 57,298 participants, 11.3% had a diagnosis of short-term insomnia disorder, with significant differences in prevalence between sites, ranging from 2.3% to 25.5%. Insomnia was significantly related to having mood disorders, anxiety disorders, substance use disorders and psychotic disorders. Insomnia was also more common among women, older adults, working participants and those who practice a religion. CONCLUSIONS The prevalence of insomnia was highly variable between sites, but the predictors appeared to be the same everywhere. Insomnia seemed to be more related to the presence of mood and anxiety disorders than a site-specific effect and thus may be a good indicator of mental health.
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Dosman JA, Karunanayake CP, Fenton M, Ramsden VR, Skomro R, Kirychuk S, Rennie DC, Seeseequasis J, Bird C, McMullin K, Russell BP, Koehncke N, Smith-Windsor T, King M, Abonyi S, Pahwa P. Prevalence of Insomnia in Two Saskatchewan First Nation Communities. Clocks Sleep 2021; 3:98-114. [PMID: 33525338 PMCID: PMC7931024 DOI: 10.3390/clockssleep3010007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 12/19/2022] Open
Abstract
Insomnia is a common problem in Canada and has been associated with increased use of health care services and economic burden. This paper examines the prevalence and risk factors for insomnia in two Cree First Nation communities in Saskatchewan, Canada. Five hundred and eighty-eight adults participated in a baseline survey conducted as part of the First Nations Sleep Health Collaborative Project. The prevalence of insomnia was 19.2% among participants with an Insomnia Severity Index score of ≥15. Following the definition of nighttime insomnia symptoms, however, the prevalence of insomnia was much higher, at 32.6%. Multivariate logistic regression modeling revealed that age, physical health, depression diagnosis, chronic pain, prescription medication use for any health condition, and waking up during the night due to terrifying dreams, nightmares, or flashbacks related to traumatic events were risk factors for insomnia among participants from two Saskatchewan Cree First Nation communities.
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Affiliation(s)
- James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
| | - Mark Fenton
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Vivian R Ramsden
- West Winds Primary Health Centre, Department of Academic Family Medicine, University of Saskatchewan, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada;
| | - Robert Skomro
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Donna C Rennie
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada;
| | | | - Clifford Bird
- Community B, PO Box 250, Montreal Lake, SK S0J 1Y0, Canada;
| | - Kathleen McMullin
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
| | - Brooke P Russell
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
| | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | | | - Malcolm King
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (M.K.); (S.A.)
| | - Sylvia Abonyi
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (M.K.); (S.A.)
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (S.K.); (K.M.); (B.PR.); (N.K.); (P.P.)
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (M.K.); (S.A.)
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