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Lok R, Suh S, Rue S, Weed L, Zeitzer JM. How many days are enough? Sleep-wake timing regularity and fragmentation scores change with the number of days included. J Sleep Res 2024:e14332. [PMID: 39317644 DOI: 10.1111/jsr.14332] [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: 05/28/2024] [Revised: 08/05/2024] [Accepted: 08/22/2024] [Indexed: 09/26/2024]
Abstract
The duration of sleep data collection from actigraphy is often influenced by practical factors (e.g. workdays versus non-workdays), but the impact of the variation of duration on outcome measures of interest has not been well explored. This study investigates the effect of the duration of actigraphy measurement on non-parametric measures of 24-hr sleep-wake rhythms. We examined regularity inter-daily stability and fragmentation intra-daily variation over 14 days or the first 7 days in participants (n = 41) undergoing evaluation for sleep disorders. Bland-Altman plots assessed the impact of fewer than 14 or 7 days, respectively, on inter-daily stability and intra-daily variation scores. Intra-daily variation values were also calculated for each day and compared with the 14-day intra-daily variation. Compared with the entire 14-day period, using shorter durations (< 7 days) led to a higher estimated bias and increased variance in the limits of agreement for inter-daily stability. Intra-daily variation values showed increased variation in the limits of agreement with fewer days. Similar trends were observed when comparing shorter actigraphy periods 3 or 5 days-7 days. Daily intra-daily variation calculations indicate that individuals with higher daily fragmentation experienced more pronounced day-to-day fragmentation and greater variability in the degree of fragmentation, in a linear association between daily intra-daily variation standard deviation and 14-day intra-daily variation values. Our data indicate that a minimum of 7 full days of actigraphy is recommended to reduce measurement errors, and intra-daily variation and inter-daily stability derived from less than 7 days cannot be compared with those from more than 7 days without significant error.
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Affiliation(s)
- Renske Lok
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, South Korea
| | - Stella Rue
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Lara Weed
- Department of Biomechanical Engineering, Stanford University, Stanford, California, USA
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California, USA
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2
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Volkers KM, Douma JG, Hoeksma JB, Scherder EJA. Effect of an 18-Month Walking Intervention on the Rest-Activity Rhythm of Older Adults With Mild-Moderate Dementia. J Aging Phys Act 2024; 32:350-359. [PMID: 38335947 DOI: 10.1123/japa.2022-0450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/12/2023] [Accepted: 11/14/2023] [Indexed: 02/12/2024]
Abstract
The objective of this 18-month walking intervention was to evaluate the effect on rest-activity rhythm (RAR) for older adults with mild-to-moderate dementia (65.8% female; aged M = 82.4 [SD = 6.5]). The intervention group (n = 44) was intended to walk 30 min, five times per week for 18 months. The control group (n = 35) received sedentary activities or usual care. RAR was measured at baseline to after 18 months and five times in between actigraphy outcome variables (interdaily stability, intradaily variability, relative amplitude, activity 10 most active hours, and activity 5 least active hours). Hierarchical mixed model analyses revealed no significant intervention effects (with or without baseline confounders as covariate) on RAR. However, participants in the intervention group were able to significantly increase their daily life activity (activity 10 most active hours) from the onset of the preceding measurement, b = 0.10, t(239.32) = 2.36, p = .019. More research is warranted to study the effect of regular walks on older persons with dementia whose RAR is worst at baseline.
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Affiliation(s)
| | | | - Jan Binne Hoeksma
- Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Erik Johan Anton Scherder
- Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands
- Center for Human Movement Sciences, University of Groningen, Groningen, The Netherlands
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3
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Luthra NS, Christou DD, Clow A, Corcos DM. Targeting neuroendocrine abnormalities in Parkinson's disease with exercise. Front Neurosci 2023; 17:1228444. [PMID: 37746149 PMCID: PMC10514367 DOI: 10.3389/fnins.2023.1228444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
Parkinson's Disease (PD) is a prevalent and complex age-related neurodegenerative condition for which there are no disease-modifying treatments currently available. The pathophysiological process underlying PD remains incompletely understood but increasing evidence points to multiple system dysfunction. Interestingly, the past decade has produced evidence that exercise not only reduces signs and symptoms of PD but is also potentially neuroprotective. Characterizing the mechanistic pathways that are triggered by exercise and lead to positive outcomes will improve understanding of how to counter disease progression and symptomatology. In this review, we highlight how exercise regulates the neuroendocrine system, whose primary role is to respond to stress, maintain homeostasis and improve resilience to aging. We focus on a group of hormones - cortisol, melatonin, insulin, klotho, and vitamin D - that have been shown to associate with various non-motor symptoms of PD, such as mood, cognition, and sleep/circadian rhythm disorder. These hormones may represent important biomarkers to track in clinical trials evaluating effects of exercise in PD with the aim of providing evidence that patients can exert some behavioral-induced control over their disease.
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Affiliation(s)
- Nijee S. Luthra
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Demetra D. Christou
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, United States
| | - Angela Clow
- Department of Psychology, School of Social Sciences, University of Westminster, London, United Kingdom
| | - Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, McCormick School of Engineering, Northwestern University, Chicago, IL, United States
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Zečević K, Popović N, Vuksanović Božarić A, Vukmirović M, Rizzo M, Muzurović E. Timing Is Important-Management of Metabolic Syndrome According to the Circadian Rhythm. Biomedicines 2023; 11:biomedicines11041171. [PMID: 37189789 DOI: 10.3390/biomedicines11041171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/01/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Physiological processes occur in accordance with a rhythm regulated by the endogenous biological clock. This clock is programmed at the molecular level and synchronized with the daily light-dark cycle, as well as activities such as feeding, exercise, and social interactions. It consists of the core clock genes, Circadian Locomotor Output Cycles Protein Kaput (CLOCK) and Brain and Muscle Arnt-Like protein 1 (BMAL1), and their products, the period (PER) and cryptochrome (CRY) proteins, as well as an interlocked feedback loop which includes reverse-strand avian erythroblastic leukemia (ERBA) oncogene receptors (REV-ERBs) and retinoic acid-related orphan receptors (RORs). These genes are involved in the regulation of metabolic pathways and hormone release. Therefore, circadian rhythm disruption leads to development of metabolic syndrome (MetS). MetS refers to a cluster of risk factors (RFs), which are not only associated with the development of cardiovascular (CV) disease (CVD), but also with increased all-cause mortality. In this review, we consider the importance of the circadian rhythm in the regulation of metabolic processes, the significance of circadian misalignment in the pathogenesis of MetS, and the management of MetS in relation to the cellular molecular clock.
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Affiliation(s)
- Ksenija Zečević
- Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
| | - Nataša Popović
- Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
| | | | - Mihailo Vukmirović
- Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
- Cardiology Clinic, Clinical Center of Montenegro, 81000 Podgorica, Montenegro
| | - Manfredi Rizzo
- Promise Department, School of Medicine, University of Palermo, 90127 Palermo, Italy
| | - Emir Muzurović
- Faculty of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
- Department of Internal Medicine, Endocrinology Section, Clinical Center of Montenegro, 81000 Podgorica, Montenegro
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5
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Bennett S, Sato S. Enhancing the metabolic benefits of exercise: Is timing the key? Front Endocrinol (Lausanne) 2023; 14:987208. [PMID: 36875451 PMCID: PMC9974656 DOI: 10.3389/fendo.2023.987208] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Physical activity represents a potent, non-pharmacological intervention delaying the onset of over 40 chronic metabolic and cardiovascular diseases, including type 2 diabetes, coronary heart disease, and reducing all-cause mortality. Acute exercise improves glucose homeostasis, with regular participation in physical activity promoting long-term improvements in insulin sensitivity spanning healthy and disease population groups. At the skeletal muscle level, exercise promotes significant cellular reprogramming of metabolic pathways through the activation of mechano- and metabolic sensors, which coordinate downstream activation of transcription factors, augmenting target gene transcription associated with substrate metabolism and mitochondrial biogenesis. It is well established that frequency, intensity, duration, and modality of exercise play a critical role in the type and magnitude of adaptation; albeit, exercise is increasingly considered a vital lifestyle factor with a critical role in the entrainment of the biological clock. Recent research efforts revealed the time-of-day-dependent impact of exercise on metabolism, adaptation, performance, and subsequent health outcomes. The synchrony between external environmental and behavioural cues with internal molecular circadian clock activity is a crucial regulator of circadian homeostasis in physiology and metabolism, defining distinct metabolic and physiological responses to exercise unique to the time of day. Optimising exercise outcomes following when to exercise would be essential to establishing personalised exercise medicine depending on exercise objectives linked to disease states. We aim to provide an overview of the bimodal impact of exercise timing, i.e. the role of exercise as a time-giver (zeitgeber) to improve circadian clock alignment and the underpinning clock control of metabolism and the temporal impact of exercise timing on the metabolic and functional outcomes associated with exercise. We will propose research opportunities that may further our understanding of the metabolic rewiring induced by specific exercise timing.
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Scott J, Hennion V, Meyrel M, Bellivier F, Etain B. An ecological study of objective rest-activity markers of lithium response in bipolar-I-disorder. Psychol Med 2022; 52:2281-2289. [PMID: 33183364 DOI: 10.1017/s0033291720004171] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite its pivotal role in prophylaxis for bipolar-I-disorders (BD-I), variability in lithium (Li) response is poorly understood and only a third of patients show a good outcome. Converging research strands indicate that rest-activity rhythms can help characterize BD-I and might differentiate good responders (GR) and non-responders (NR). METHODS Seventy outpatients with BD-I receiving Li prophylaxis were categorized as GR or NR according to the ratings on the retrospective assessment of response to lithium scale (Alda scale). Participants undertook 21 consecutive days of actigraphy monitoring of sleep quantity (SQ), sleep variability (SV) and circadian rhythmicity (CR). RESULTS Twenty-five individuals were categorized as GR (36%). After correcting statistical analysis to minimize false discoveries, four variables (intra-daily variability; median activity level; amplitude; and relative amplitude of activity) significantly differentiated GR from NR. The odds of being classified as a GR case were greatest for individuals showing more regular/stable CR (1.41; 95% confidence interval (CI) 1.08, 2.05; p < 0.04). Also, there was a trend for lower SV to be associated with GR (odds ratio: 0.56; 95% CI 0.31, 1.01; p < 0.06). CONCLUSIONS To our knowledge, this is the largest actigraphy study of rest-activity rhythms and Li response. Circadian markers associated with fragmentation, variability, amount and/or amplitude of day and night-time activity best-identified GR. However, associations were modest and future research must determine whether these objectively measured parameters, singly or together, represent robust treatment response biomarkers. Actigraphy may offer an adjunct to multi-platform approaches aimed at developing personalized treatments or stratification of individuals with BD-I into treatment-relevant subgroups.
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Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- Centre for Affective Disorders, IoPPN, Kings College, London, UK
- Université de Paris, Paris, France
| | - Vincent Hennion
- Université de Paris, Paris, France
- AP-HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Manon Meyrel
- Université de Paris, Paris, France
- AP-HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Frank Bellivier
- Université de Paris, Paris, France
- AP-HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- INSERM, UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
| | - Bruno Etain
- Centre for Affective Disorders, IoPPN, Kings College, London, UK
- Université de Paris, Paris, France
- AP-HP.Nord, DMU Neurosciences, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- INSERM, UMR-S 1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, Paris, France
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7
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Hammad G, Reyt M, Beliy N, Baillet M, Deantoni M, Lesoinne A, Muto V, Schmidt C. pyActigraphy: Open-source python package for actigraphy data visualization and analysis. PLoS Comput Biol 2021; 17:e1009514. [PMID: 34665807 PMCID: PMC8555797 DOI: 10.1371/journal.pcbi.1009514] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/29/2021] [Accepted: 10/01/2021] [Indexed: 02/05/2023] Open
Abstract
Over the past 40 years, actigraphy has been used to study rest-activity patterns in circadian rhythm and sleep research. Furthermore, considering its simplicity of use, there is a growing interest in the analysis of large population-based samples, using actigraphy. Here, we introduce pyActigraphy, a comprehensive toolbox for data visualization and analysis including multiple sleep detection algorithms and rest-activity rhythm variables. This open-source python package implements methods to read multiple data formats, quantify various properties of rest-activity rhythms, visualize sleep agendas, automatically detect rest periods and perform more advanced signal processing analyses. The development of this package aims to pave the way towards the establishment of a comprehensive open-source software suite, supported by a community of both developers and researchers, that would provide all the necessary tools for in-depth and large scale actigraphy data analyses. The possibility to continuously record locomotor movements using accelerometers (actigraphy) has allowed field studies of sleep and rest-activity patterns. It has also enabled large-scale data collections, opening new avenues for research. However, each brand of actigraph devices encodes recordings in its own format and closed-source proprietary softwares are typically used to read and analyse actigraphy data. In order to provide an alternative to these softwares, we developed a comprehensive open-source toolbox for actigraphy data analysis, pyActigraphy. It allows researchers to read actigraphy data from 7 different file formats and gives access to a variety of rest-activity rhythm variables, automatic sleep detection algorithms and more advanced signal processing techniques. Besides, in order to empower researchers and clinicians with respect to their analyses, we created a series of interactive tutorials that illustrate how to implement the key steps of typical actigraphy data analyses. As an open-source project, all kind of user’s contributions to our toolbox are welcome. As increasing evidence points to the predicting value of rest-activity patterns derived from actigraphy for brain integrity, we believe that the development of the pyActigraphy package will not only benefit the sleep and chronobiology research, but also the neuroscientific community at large.
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Affiliation(s)
- Grégory Hammad
- GIGA-CRC In vivo Imaging, University of Liège, Liège, Belgium
- * E-mail:
| | - Mathilde Reyt
- GIGA-CRC In vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition, Faculty of Psychology, University of Liège, Liège, Belgium
| | - Nikita Beliy
- GIGA-CRC In vivo Imaging, University of Liège, Liège, Belgium
| | - Marion Baillet
- GIGA-CRC In vivo Imaging, University of Liège, Liège, Belgium
| | | | - Alexia Lesoinne
- GIGA-CRC In vivo Imaging, University of Liège, Liège, Belgium
| | - Vincenzo Muto
- GIGA-CRC In vivo Imaging, University of Liège, Liège, Belgium
| | - Christina Schmidt
- GIGA-CRC In vivo Imaging, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition, Faculty of Psychology, University of Liège, Liège, Belgium
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8
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Giri A, Srinivasan A, Sundar IK. COVID-19: Sleep, Circadian Rhythms and Immunity - Repurposing Drugs and Chronotherapeutics for SARS-CoV-2. Front Neurosci 2021; 15:674204. [PMID: 34220430 PMCID: PMC8249936 DOI: 10.3389/fnins.2021.674204] [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: 02/28/2021] [Accepted: 05/05/2021] [Indexed: 01/08/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has affected nearly 28 million people in the United States and has caused more than five hundred thousand deaths as of February 21, 2021. As the novel coronavirus continues to take its toll in the United States and all across the globe, particularly among the elderly (>65 years), clinicians and translational researchers are taking a closer look at the nexus of sleep, circadian rhythms and immunity that may contribute toward a more severe coronavirus disease-19 (COVID-19). SARS-CoV-2-induced multi-organ failure affects both central and peripheral organs, causing increased mortality in the elderly. However, whether differences in sleep, circadian rhythms, and immunity between older and younger individuals contribute to the age-related differences in systemic dysregulation of target organs observed in SARS-CoV-2 infection remain largely unknown. Current literature demonstrates the emerging role of sleep, circadian rhythms, and immunity in the development of chronic pulmonary diseases and respiratory infections in human and mouse models. The exact mechanism underlying acute respiratory distress syndrome (ARDS) and other cardiopulmonary complications in elderly patients in combination with associated comorbidities remain unclear. Nevertheless, understanding the critical role of sleep, circadian clock dysfunction in target organs, and immune status of patients with SARS-CoV-2 may provide novel insights into possible therapies. Chronotherapy is an emerging concept that is gaining attention in sleep medicine. Accumulating evidence suggests that nearly half of all physiological functions follow a strict daily rhythm. However, healthcare professionals rarely take implementing timed-administration of drugs into consideration. In this review, we summarize recent findings directly relating to the contributing roles of sleep, circadian rhythms and immune response in modulating infectious disease processes, and integrate chronotherapy in the discussion of the potential drugs that can be repurposed to improve the treatment and management of COVID-19.
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Affiliation(s)
| | | | - Isaac Kirubakaran Sundar
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
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Graves JL, Qiao Y(S, Moored KD, Boudreau RM, Venditti EM, Krafty RT, Shiroma EJ, Harezlak J, Glynn NW. Profiles of Accelerometry-Derived Physical Activity Are Related to Perceived Physical Fatigability in Older Adults. SENSORS 2021; 21:s21051718. [PMID: 33801352 PMCID: PMC7958607 DOI: 10.3390/s21051718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 11/16/2022]
Abstract
Physical activity (PA) is associated with greater fatigability in older adults; little is known about magnitude, shape, timing and variability of the entire 24-h rest–activity rhythm (RAR) associated with fatigability. We identified which features of the 24-h RAR pattern were independently and jointly associated with greater perceived physical fatigability (Pittsburgh Fatigability Scale, PFS, 0–50) in older adults (n = 181, 71.3 ± 6.7 years). RARs were characterized using anti-logistic extended cosine models and 4-h intervals of PA means and standard deviations across days. A K-means clustering algorithm approach identified four profiles of RAR features: “Less Active/Robust”, “Earlier Risers”, “More Active/Robust” and “Later RAR”. Quantile regression tested associations of each RAR feature/profile on median PFS adjusted for age, sex, race, body mass index and depression symptomatology. Later rise times (up mesor; β = 1.38, p = 0.01) and timing of midpoint of activity (acrophase; β = 1.29, p = 0.01) were associated with higher PFS scores. Lower PA between 4 a.m. and 8 a.m. was associated with higher PFS scores (β = −4.50, p = 0.03). “Less Active/Robust” (β = 6.14, p = 0.01) and “Later RAR” (β = 3.53, p = 0.01) patterns were associated with higher PFS scores compared to “Earlier Risers”. Greater physical fatigability in older adults was associated with dampened, more variable, and later RARs. This work can guide development of interventions aimed at modifying RARs to reduce fatigability in older adults.
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Affiliation(s)
- Jessica L. Graves
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (J.L.G.); (Y.Q.); (K.D.M.); (R.M.B)
| | - Yujia (Susanna) Qiao
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (J.L.G.); (Y.Q.); (K.D.M.); (R.M.B)
| | - Kyle D. Moored
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (J.L.G.); (Y.Q.); (K.D.M.); (R.M.B)
| | - Robert M. Boudreau
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (J.L.G.); (Y.Q.); (K.D.M.); (R.M.B)
| | | | - Robert T. Krafty
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA 30322, USA;
| | - Eric J. Shiroma
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD 21225, USA;
| | - Jaroslaw Harezlak
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47405, USA;
| | - Nancy W. Glynn
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA; (J.L.G.); (Y.Q.); (K.D.M.); (R.M.B)
- Correspondence:
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10
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Shih YH, Pai MC, Lin HS, Sung PS, Wang JJ. Effects of walking on sundown syndrome in community-dwelling people with Alzheimer's disease. Int J Older People Nurs 2019; 15:e12292. [PMID: 31814316 DOI: 10.1111/opn.12292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 09/30/2019] [Accepted: 10/30/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Sundown syndrome is an important care issue for people with dementia (PwD) and for family caregivers. Walking is a safe and simple physical activity for most PwD, yet no research has explored the effects of different long-term walking periods on sundown syndrome. OBJECTIVES This study aimed to determine the effects of walking on sundown syndrome, and to identify whether different walking time periods would show different effects on sundown syndrome in community-dwelling people with Alzheimer's disease. METHODS A quasi-experimental designed study with repeated measurements was conducted. Sixty PwD were recruited and assigned to either the control group or the morning or afternoon walking group according to their caregiver's preference. The participants in the two walking groups completed an average of 120-min walking per week, accompanied by their caregivers. Forty-six achieved the 6-month intervention. Four measurements were taken, one at the pretest and one at weeks 8, 16 and 24. The Chinese version of the Cohen-Mansfield Agitation Inventory, community form (C-CMAI) was used to assess the severity of the sundown syndrome. The generalised estimating equation (GEE) was applied for the longitudinal data analysis. RESULTS There was a significant change across the study period (p = .048) in the morning walking group, indicating that the score for sundown syndrome decreased when PwD walked in the morning. Considering group effects, compared to the control group, the C-CMAI scores significantly decreased after 16 weeks of walking in the afternoon walking group (p = .001) and after 24 weeks in both the morning and afternoon walking groups (p = .001), indicating that after PwD had walked for 16 weeks, sundown syndrome ameliorated in the afternoon group and continually decreased after 24 weeks in both the morning and afternoon groups. However, there was no significant group difference between the morning and afternoon walking groups during the 24-week walking intervention. CONCLUSIONS The results indicated that both morning walking and afternoon walking are beneficial for ameliorating the symptoms of sundown syndrome; however, walking in the afternoon may have a faster effect on the symptoms than walking in the morning. Walking is a safe, simple, feasible and effective intervention to benefit individuals with sundown syndrome. IMPLICATIONS FOR PRACTICE Regularly walking for 30 min a day, four times a week, is beneficial to alleviate sundown syndrome among PwD living in the community. Either morning or afternoon walking is effective for decreasing sundown syndrome, and the longer the walking time, the greater the impact on sundown syndrome.
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Affiliation(s)
- Yen-Hua Shih
- Department of Nursing, MeiHo University, Pingtung, Taiwan ROC
| | - Ming-Chyi Pai
- Division of Behavioral Neurology, Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan ROC
| | - Huey-Shyan Lin
- Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan ROC
| | - Pi-Shan Sung
- Department of Neurology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan ROC
| | - Jing-Jy Wang
- Department of Nursing, National Cheng Kung University, Tainan, Taiwan ROC
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11
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Ferreira ABD, Schaedler T, Mendes JV, Anacleto TS, Louzada FM. Circadian ontogeny through the lens of nonparametric variables of actigraphy. Chronobiol Int 2019; 36:1184-1189. [PMID: 31272231 DOI: 10.1080/07420528.2019.1636814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Studies focusing on human rhythmicity show that human circadian rhythm suffers constant changes across lifespan. Changes in rest-activity patterns can be studied through nonparametric variables of actigraphy: L5 (an individual's least active 5 h), M10 (an individual's most active 10 h) and RA (relative amplitude of the rest-activity rhythm). The variable RA is the normalized difference between L5 and M10 - the higher the RA, the greater the difference between these two variables. This study used the data bank of the Human Chronobiology Laboratory of Federal University of Paraná (Brazil). It analyzed actimetric data of 93 children between 4 and 11 years of age in their naturalistic context in order to describe the development of nonparametric variables. Correlation between age and L5 was significantly negative (rho = - 0.29, p = 0.004), while correlation between age and RA was significantly positive (rho = 0.31, p = 0.003). The variables M10, sL5 (start of L5) and sM10 (start of M10) did not show significant correlation to age. Furthermore, there were no statistical differences between genders. The population of this study, healthy children, has been poorly assessed by similar literature. Through our results, we have demonstrated that, as children age, L5 significantly decreases, which reflects a smaller fragmentation of circadian rhythm. As an expected consequence, RA significantly increases. In other words, these nonparametric variables of actimetry successfully demonstrate that children tend to reduce nocturnal activity as they age, a phenomenon that reflects the ongoing consolidation of circadian rhythm.
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Affiliation(s)
| | - Thais Schaedler
- a Department of Physiology, Federal University of Paraná , Curitiba , Brazil
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12
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Gehrman PR, Ghorai A, Goodman M, McCluskey R, Barilla H, Almasy L, Roenneberg T, Bucan M. Twin-based heritability of actimetry traits. GENES BRAIN AND BEHAVIOR 2019; 18:e12569. [PMID: 30916437 DOI: 10.1111/gbb.12569] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/06/2019] [Accepted: 03/22/2019] [Indexed: 01/21/2023]
Abstract
There is a critical need for phenotypes with substantial heritability that can be used as endophenotypes in behavioral genetic studies. Activity monitoring, called actimetry, has potential as a means of assessing sleep and circadian rhythm traits that could serve as endophenotypes relevant to a range of psychopathologies. This study examined a range of actimetry traits for heritability using a classic twin design. The sample consisted of 195 subjects from 45 monozygotic (MZ) and 50 dizygotic (DZ) twin pairs aged 16-40 years. Subjects wore both a research-grade actimeter (GENEActiv) and a consumer-oriented device (FitBit) for 2 weeks. Sleep and circadian traits were extracted from GENEActiv data using PennZzz and ChronoSapiens software programs. Sleep statistics for a limited number of FitBit-collected traits were generated by its accompanying mobile app. Broad sense heritability was computed on a set of 33 MZ and 38 DZ twin pairs with complete data using both OpenMX and SOLAR software. These analyses yielded a large number of actimetry-derived traits, 20 of which showed high heritability (h2 > 0.6), seven of which remain significant after Bonferroni correction. These results indicate that actimetry enables assessing a range of phenotypes with substantial heritability that may be useful as endophenotypes for genetic studies.
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Affiliation(s)
- Philip R Gehrman
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Arpita Ghorai
- Department of Genetics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Matthew Goodman
- Department of Genetics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Richard McCluskey
- Department of Neurology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Holly Barilla
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura Almasy
- Department of Genetics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Maja Bucan
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Genetics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
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13
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Fifel K, Videnovic A. Chronotherapies for Parkinson's disease. Prog Neurobiol 2019; 174:16-27. [PMID: 30658126 PMCID: PMC6377295 DOI: 10.1016/j.pneurobio.2019.01.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/18/2018] [Accepted: 01/14/2019] [Indexed: 02/08/2023]
Abstract
Parkinson's disease (PD) is the second-most common progressive neurodegenerative disorder. Although the clinical diagnosis of PD is still based on its cardinal motor dysfunctions, several non-motor symptoms (NMS) have been established as integral part of the disease. Unlike motor disorders, development of therapies against NMS are still challenging and remain a critical unmet clinical need. During the last decade, several studies have characterised the molecular, physiological and behavioural alterations of the circadian system in PD patients. As a consequence, and given the ubiquitous nature of circadian rhythms in the entire organism, the biological clock has emerged as a potential therapeutic target to ease suffering from both motor and NMS in PD patients. Here we discuss the emerging field of using bright light, physical exercise and melatonin as chronotherapeutic tools to alleviate motor disorders, sleep/wake alterations, anxiety and depression in PD patients. We also highlight the potential of these readily available therapies to improve the general quality of life and wellbeing of PD patients. Finally, we provide specific data- and mechanisms-driven recommendations that might help improve the therapeutic benefit of light and physical exercise in PD patients.
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Affiliation(s)
- Karim Fifel
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan; Department of Molecular Cell Biology, Neurophysiology unit, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands; Stem Cell and Brain Research Institute, Department of Chronobiology, 18 Avenue du Doyen Lépine, 69500, Bron, France; Laboratory of Pharmacology, Neurobiology and Behavior, Associated CNRST Unit (URAC-37), Cadi Ayyad University, Marrakech, Morocco.
| | - Aleksandar Videnovic
- Movement Disorders Unit and Division of Sleep Medicine, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 600, Boston, MA, 02446, USA
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14
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Abstract
OBJECTIVE Although cognitive behavior therapy (CBT) is efficacious for major depression in patients with heart failure (HF), approximately half of patients do not remit after CBT. To identify treatment moderators that may help guide treatment allocation strategies and serve as new treatment targets, we performed a secondary analysis of a randomized clinical trial. Based on evidence of their prognostic relevance, we evaluated whether clinical and activity characteristics moderate the effects of CBT. METHODS Participants were randomized to enhanced usual care (UC) alone or CBT plus enhanced UC. The single-blinded outcomes were 6-month changes in Beck Depression Inventory total scores and remission (defined as a Beck Depression Inventory ≤ 9). Actigraphy was used to assess daily physical activity patterns. We performed analyses to identify the specific activity and clinical moderators of the effects of CBT in 94 adults (mean age = 58, 49% female) with HF and major depressive disorder. RESULTS Patients benefited more from CBT (versus UC) if they had the following: more medically severe HF (i.e., a higher New York Heart Association class or a lower left ventricular ejection fraction), more stable activity patterns, wider active periods, and later evening settling times. These individual moderator effects were small (|r| = 0.10-0.21), but combining the moderators yielded a medium moderator effect size (r = 0.38; 95% CI = 0.20-0.52). CONCLUSIONS These findings suggest that increasing the cross-daily stability of activity patterns, and prolonging the daily active period, might help increase the efficacy of CBT. Given moderating effects of HF severity measures, research is also needed to clarify and address factors in patients with less severe HF that diminish the efficacy of CBT. CLINICAL TRIAL REGISTRATION clinicaltrials.gov identifier: NCT01028625.
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15
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Lewis P, Korf HW, Kuffer L, Groß JV, Erren TC. Exercise time cues (zeitgebers) for human circadian systems can foster health and improve performance: a systematic review. BMJ Open Sport Exerc Med 2018; 4:e000443. [PMID: 30687511 PMCID: PMC6330200 DOI: 10.1136/bmjsem-2018-000443] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 01/27/2023] Open
Abstract
Background Circadian system time cues (zeitgebers) acting synergistically at the right times can foster chronobiological homeostasis and ultimately health. Modern 24/7 societies are challenging chronobiological homeostasis and public health. Exercise has been discussed as a potential zeitgeber for the human circadian system. Thus, if timed correctly, exercise may help in maintenance of chronobiological homeostasis and foster public health amidst increasingly challenging 24/7 lifestyles. Objective To test, using a systematic review of the literature, the following hypothesis: exercise is a zeitgeber for the human circadian system. Data sources The PubMed database was systematically searched on 19 October 2017 for relevant scientific studies and reports concerning chronobiology and exercise. Eligibility criteria were defined to include articles considering exercise as a potential zeitgeber for human circadian rhythmicity or chronobiological effects of exercise on health and/or physical performance. Cognitive effects and effects on children were excluded from the synthesis. Results Our systematic literature search and synthesis is compatible with the validity of the hypothesis. We report that potential exercise-zeitgeber properties may be used to improve health and performance. Conclusions Informed timing of exercise, specific to the circadian rhythm phase and zeitgeber exposure of the individual, must be advocated in performance and disease contexts as an adjunct therapeutic or preventative strategy and physical enhancer.
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Affiliation(s)
- Philip Lewis
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany
| | - Horst W Korf
- Institute of Anatomy I, University of Düsseldorf, Düsseldorf, Germany
| | - Liz Kuffer
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany
| | - J Valérie Groß
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany
| | - Thomas C Erren
- Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany
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16
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Asai Y, Obayashi K, Oume M, Ogura M, Takeuchi K, Yamagami Y, Tai Y, Kurumatani N, Saeki K. Farming habit, light exposure, physical activity, and depressive symptoms. A cross-sectional study of the HEIJO-KYO cohort. J Affect Disord 2018; 241:235-240. [PMID: 30138807 DOI: 10.1016/j.jad.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 07/12/2018] [Accepted: 08/03/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bright light therapy and exercise interventions are effective methods for treating seasonal and non-seasonal affective disorders. Synchronization of internal circadian rhythms with the external environment by light therapy and physical activity may partly explain its efficacy. In the present study, we objectively measured daytime light exposure and physical activity in real life situations with elderly participants, and investigated the association between farming habits and the prevalence of depressive symptoms. METHODS This cross-sectional was conducted among 1005 participants (mean age: 71.5) of a community-based cohort study. Depressive symptoms were assessed by the Geriatric Depression Scale (GDS score ≥ 6) and administration of antidepressant. RESULTS Farming habit with long duration (> 7.0 h/week) showed significantly lower odds ratios (OR) for depressive symptoms (adjusted OR 0.63, 95% confidential interval,0.41 to 0.96) compared with participants without farming habit independent of confounders such as age, gender, body mass index smoking, drinking, daytime ambulatory systolic blood pressure, diabetes, living alone, education, income, and daylength. Even in farming with short duration (≤ 7.0 h/week), we found significant association with lower OR for depressive symptoms (adjusted OR 0.64, 95%CI, 0.42 to 0.97). Light exposure and daytime physical activity measured by wrist actigraphy were significantly higher among participants with longer farming habits (p for trend < 0.01). Physical activity mediated 12.0% of association between farming habit and depressive symptoms. LIMITATIONS A cross-sectional association may be found because the participants with depressive symptoms tended to avoid farming. A longitudinal study is warranted to determine the direction of causality. CONCLUSIONS Participants with farming habit showed significantly lower OR for depressive symptoms than those without farming habit, and it was partly mediated by physical activity.
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Affiliation(s)
- Yuji Asai
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Masataka Oume
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Moe Ogura
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Katsuya Takeuchi
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Yuki Yamagami
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Yoshiaki Tai
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan; Department of General Medicine, Nara Medical University School of Medicine, Nara, Japan
| | - Norio Kurumatani
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
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17
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Short form of the Social Rhythm Metric: a tool to evaluate the social and functional impact on stroke patients. Sleep Biol Rhythms 2018. [DOI: 10.1007/s41105-018-0179-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Smagula SF, Krafty RT, Thayer JF, Buysse DJ, Hall MH. Rest-activity rhythm profiles associated with manic-hypomanic and depressive symptoms. J Psychiatr Res 2018; 102:238-244. [PMID: 29705489 PMCID: PMC6005763 DOI: 10.1016/j.jpsychires.2018.04.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 04/05/2018] [Accepted: 04/18/2018] [Indexed: 11/23/2022]
Abstract
Rest-activity rhythm (RAR) disturbances are associated with mood disorders. But there remains a need to identify the particular RAR profiles associated with psychiatric symptom dimensions. Establishing such profiles would support the development of tools that track the 24-h sleep-wake phenotypes signaling clinical heterogeneity. We used data-driven clustering to identify RAR profiles in 145 adults aged 36-82 years (mean = 60, standard deviation = 9). Then we evaluated psychiatric symptom dimensions (including positive and negative affect, depressive, manic-hypomanic, panic-agoraphobic, and substance use symptoms) associated with these empirically-derived RAR profiles. Clustering identified three sub-groups characterized, on average, by: (1) earlier and more robust RARs ("earlier/robust," n = 55, 38%); (2) later and irregular RARs ("later/irregular," n = 31, 21%); and (3) later RARs and a narrower active period ("later/narrower," n = 59, 41%). Compared with the "earlier/robust" group: the "later/irregular" group had higher levels of lifetime manic-hypomanic symptoms (β (standard error) = 0.80 (0.22) higher standardized symptom units, p = 0.0004) and lifetime depression symptoms (β (standard error) = 0.73 (0.21) higher standardized symptom units, p = 0.0009); the "later/narrower" group had more lifetime depression symptoms (β (standard error) = 0.48 (0.18) higher standardized symptom units, p = 0.0076). These associations persisted after adjustments for sleep continuity and duration, suggesting that RARs are distinct behavioral correlates of clinical heterogeneity. Longitudinal studies are needed to confirm whether RAR characteristics contribute to the risk of manic and/or depressive episodes, and whether they reflect the consequences of psychiatric disturbance (e.g., on quality of life or disability). Opportunities to monitor or intervene on objectively-assessed RARs could facilitate better mental health related outcomes.
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Affiliation(s)
- Stephen F Smagula
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Robert T Krafty
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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19
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Cavalcanti-Ferreira P, Berk L, Daher N, Campus T, Araujo J, Petrofsky J, Lohman E. A nonparametric methodological analysis of rest-activity rhythm in type 2 diabetes. ACTA ACUST UNITED AC 2018; 11:281-289. [PMID: 30746047 PMCID: PMC6361299 DOI: 10.5935/1984-0063.20180044] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to analyze the rest-activity rhythm of type 2
diabetics mellitus (T2DM) and compare it to healthy controls using the
nonparametric analytic approach. Twenty-one diabetics and 21 healthy subjects
matched for gender and age were recruited to participate in the study. Data were
analyzed using the Independent t-test, Mann-Whitney U test, and Spearmans
correlation. T2DM subjects demonstrate lower interdaily stability (IS)
(p=.03), higher intradaily variability
(p=.046) and lower rhythm amplitude (p=.02)
when compared to healthy controls. Also, there was a positive correlation
between IS and most active 10 hr (M10) in the average of 24 hours pattern (r
=.44; p=.046) in the diabetes group and a negative correlation
between IV and M10 in the healthy group (r =-.57; p=.007).
These data together suggest that T2DM exhibits a dysfunction in the
rest-activity rhythm due to alterations in the circadian function as well as in
the homeostatic capacity to maintain sleep; mainly characterized by less
consistency across days of the daily circadian signal, higher rhythm
fragmentation and lower rhythm amplitude. Future approaches may be developed
considering the influence of circadian glucose variations throughout the day on
the coupling of the rest-activity rhythm to zeitgeber and rhythm
fragmentation.
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Affiliation(s)
- Paula Cavalcanti-Ferreira
- Loma Linda University, Physical Therapy - Loma Linda - CA - United States.,California State University, Northridge - CA - United States
| | - Lee Berk
- Loma Linda University, Physical Therapy - Loma Linda - CA - United States
| | - Noha Daher
- Loma Linda University, Physical Therapy - Loma Linda - CA - United States
| | - Tania Campus
- Universidade Federal do Rio Grande do Norte, Physical Therapy - Natal - RN - Brazil
| | - John Araujo
- Universidade Federal do Rio Grande do Norte, Physical Therapy - Natal - RN - Brazil
| | - Jerrold Petrofsky
- Loma Linda University, Physical Therapy - Loma Linda - CA - United States
| | - Everett Lohman
- Loma Linda University, Physical Therapy - Loma Linda - CA - United States
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20
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Night-time activity forecast by season and weather in a longitudinal design - natural light effects on three years' rest-activity cycles in nursing home residents with dementia. Int Psychogeriatr 2017; 29:2071-2080. [PMID: 28689500 DOI: 10.1017/s1041610217001235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Backround: Night-time agitation is a frequent symptom of dementia. It often causes nursing home admission and has been linked to circadian rhythm disturbances. A positive influence of light interventions on night-time agitation was shown in several studies. The aim of our study was to investigate whether there is a long-term association between regional weather data (as indicator for daylight availability) and 24-hour variations of motor activity. METHODS Motor activity of 20 elderly nursing home residents living with dementia was analyzed using recordings of continuously worn wrist activity monitors over a three-year period. The average recording duration was 479 ± 206 days per participant (mean ± SD). Regional cloud amount and day length data from the local weather station (latitude: 52°56'N) were included in the analysis to investigate their effects on several activity variables. RESULTS Nocturnal rest, here defined as the five consecutive hours with the least motor activity during 24 hours (L5), was the most predictable activity variable per participant. There was a significant interaction of night-time activity with day length and cloud amount (F 1,1174 = 4.39; p = 0.036). Night-time activity was higher on cloudy short days than on clear short days (p = 0.007), and it was also higher on cloudy short days than on cloudy long days (p = 0.032). CONCLUSIONS The need for sufficient zeitgeber (time cue) strength during winter time, especially when days are short and skies are cloudy, is crucial for elderly people living with dementia. Activity forecast by season and weather might be a valuable approach to anticipate adequately complementary use of electrical light and thereby foster lower night-time activity.
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Phillips C. Physical Activity Modulates Common Neuroplasticity Substrates in Major Depressive and Bipolar Disorder. Neural Plast 2017; 2017:7014146. [PMID: 28529805 PMCID: PMC5424494 DOI: 10.1155/2017/7014146] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/10/2017] [Accepted: 03/16/2017] [Indexed: 12/13/2022] Open
Abstract
Mood disorders (MDs) are chronic, recurrent mental diseases that affect millions of individuals worldwide. Although the biogenic amine model has provided some clinical utility, a need remains to better understand the interrelated mechanisms that contribute to neuroplasticity deficits in MDs and the means by which various therapeutics mitigate them. Of those therapeutics being investigated, physical activity (PA) has shown clear and consistent promise. Accordingly, the aims of this review are to (1) explicate key modulators, processes, and interactions that impinge upon multiple susceptibility points to effectuate neuroplasticity deficits in MDs; (2) explore the putative mechanisms by which PA mitigates these features; (3) review protocols used to induce the positive effects of PA in MDs; and (4) highlight implications for clinicians and researchers.
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Ferreira SE, dos Santos AKDM, Okano AH, Gonçalves BDSB, Araújo JF. Efeitos agudos do exercício físico no tratamento da dependência química. REVISTA BRASILEIRA DE CIÊNCIAS DO ESPORTE 2017. [DOI: 10.1016/j.rbce.2016.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Weinert D, Schöttner K, Müller L, Wienke A. Intensive voluntary wheel running may restore circadian activity rhythms and improves the impaired cognitive performance of arrhythmic Djungarian hamsters. Chronobiol Int 2016; 33:1161-1170. [DOI: 10.1080/07420528.2016.1205083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Dietmar Weinert
- Institute of Biology, Department of Zoology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Konrad Schöttner
- Institute of Entomology, Biology Centre CAS, Ceske Budejovice, Czech Republic
| | - Lisa Müller
- Institute of Biology, Department of Zoology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin Luther University Halle-Wittenberg, Halle, Germany
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Kodama A, Kume Y, Tsugaruya M, Ishikawa T. Deriving the reference value from the circadian motor active patterns in the “non-dementia” population, compared to the “dementia” population: What is the amount of physical activity conducive to the good circadian rhythm. Chronobiol Int 2016; 33:1056-63. [DOI: 10.1080/07420528.2016.1196696] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ayuto Kodama
- Doctor Course, Graduate School of Health Sciences, Akita University, Hondo Akitaken, Japan
| | - Yu Kume
- Department of Occupational Therapy, Graduate School of Health Sciences, Akita University, Hondo Akitaken, Japan
| | - Megumi Tsugaruya
- Department of Occupational Therapy, Graduate School of Health Sciences, Akita University, Hondo Akitaken, Japan
| | - Takashi Ishikawa
- Department of Occupational Therapy, Graduate School of Health Sciences, Akita University, Hondo Akitaken, Japan
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Blume C, Santhi N, Schabus M. 'nparACT' package for R: A free software tool for the non-parametric analysis of actigraphy data. MethodsX 2016; 3:430-5. [PMID: 27294030 PMCID: PMC4890079 DOI: 10.1016/j.mex.2016.05.006] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/16/2016] [Indexed: 11/30/2022] Open
Abstract
For many studies, participants’ sleep-wake patterns are monitored and recorded prior to, during and following an experimental or clinical intervention using actigraphy, i.e. the recording of data generated by movements. Often, these data are merely inspected visually without computation of descriptive parameters, in part due to the lack of user-friendly software. To address this deficit, we developed a package for R Core Team [6], that allows computing several non-parametric measures from actigraphy data. Specifically, it computes the interdaily stability (IS), intradaily variability (IV) and relative amplitude (RA) of activity and gives the start times and average activity values of M10 (i.e. the ten hours with maximal activity) and L5 (i.e. the five hours with least activity). Two functions compute these ‘classical’ parameters and handle either single or multiple files. Two other functions additionally allow computing an L-value (i.e. the least activity value) for a user-defined time span termed ‘Lflex’ value. A plotting option is included in all functions. The package can be downloaded from the Comprehensive R Archives Network (CRAN). The package ‘nparACT’ for R serves the non-parametric analysis of actigraphy data. Computed parameters include interdaily stability (IS), intradaily variability (IV) and relative amplitude (RA) as well as start times and average activity during the 10 h with maximal and the 5 h with minimal activity (i.e. M10 and L5).
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Affiliation(s)
- Christine Blume
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, Hellbrunner Strasse 34, 5020 Salzburg, Austria; Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Hellbrunner Strasse 34, 5020 Salzburg, Austria
| | - Nayantara Santhi
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Egerton Road, Guildford GU2 7XP, United Kingdom
| | - Manuel Schabus
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, Hellbrunner Strasse 34, 5020 Salzburg, Austria; Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, Hellbrunner Strasse 34, 5020 Salzburg, Austria
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26
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Pévet P. Melatonin receptors as therapeutic targets in the suprachiasmatic nucleus. Expert Opin Ther Targets 2016; 20:1209-18. [DOI: 10.1080/14728222.2016.1179284] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Paul Pévet
- Institut des neurosciences cellulaires et Integratives, INCI UPR 3212, CNRS and the University of Strasbourg, Strasbourg, France
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28
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Fleiner T, Trost A, Depiereux R, Zijlstra W, Häussermann P. Geriatric Psychiatry in Motion – Bringing Physical Exercise to Geriatric Psychiatry. GEROPSYCH-THE JOURNAL OF GERONTOPSYCHOLOGY AND GERIATRIC PSYCHIATRY 2015. [DOI: 10.1024/1662-9647/a000135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. Although programs to promote physical activity have been implemented in routine geriatric psychiatry, there are presently no evidence-based recommendations and only few randomized controlled exercise trials have been conducted. Therefore, a program called Geriatric Psychiatry in Motion was established in a psychiatric hospital. The primary objective was to promote physical activity and to investigate the effects of different physical activity programs in elderly psychiatric patients. The following key features were developed and are under investigation: (1) a program to promote general physical activity; (2) specific exercise programs for inpatients; (3) specific programs for outpatient services; and (4) the implementation of an integrative objective mobility and physical activity assessment. The first results show benefits for patients, caregivers as well as hospital staff.
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Affiliation(s)
- Tim Fleiner
- , Institute of Movement and Sport Gerontology, German Sport University Cologne, Germany
- , Department of Old Age Psychiatry, LVR-Klinik Köln, Germany
| | - Andrea Trost
- , Department of Old Age Psychiatry, LVR-Klinik Köln, Germany
| | - René Depiereux
- , Department of Old Age Psychiatry, LVR-Klinik Köln, Germany
| | - Wiebren Zijlstra
- , Institute of Movement and Sport Gerontology, German Sport University Cologne, Germany
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Dupont Rocher S, Bessot N, Sesboüé B, Bulla J, Davenne D. Circadian Characteristics of Older Adults and Aerobic Capacity. J Gerontol A Biol Sci Med Sci 2015; 71:817-22. [PMID: 26602866 DOI: 10.1093/gerona/glv195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 10/07/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Alteration of circadian rhythmicity with aging might depend on physical aerobic capacity. METHODS Three groups of participants were established based on their peak oxygen consumption (Group 1 < 20mL/min/kg; Group 2 > 20mL/min/kg and <30mL/min/kg; Group 3 > 30mL/min/kg). Each participant had an individual evaluation of their circadian rhythmicity characteristics through two well-known circadian rhythms: core temperature and rest/activity cycles. Nocturnal sleep was also recorded using actimetry and diurnal vigilance tested in a car driving simulator. RESULTS The amplitude of the oral temperature fluctuations for Group 1 is significantly lower (p < .05) than that of Group 3. Group 2 (p < .01) and Group 3 (p < .05) were significantly more active during the day than Group 1. The index of inactivity during the night for Groups 2 (p < .05) and 3 (p < .01) was higher than Group 1. Results of the car driving simulation showed that for Group 1, the number of lane crossings was significantly higher than Groups 2 (p < .01) and 3 (p < .01). In addition, diurnal vigilance was lower in Group 1. CONCLUSIONS The biological clock seems to be enhanced in older participants with a higher level of physical capacity.
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Affiliation(s)
| | - Nicolas Bessot
- INSERM, U1075 COMETE, Caen, France. Université de Caen Basse-Normandie, U1075 COMETE, France.
| | - Bruno Sesboüé
- INSERM, U1075 COMETE, Caen, France. Department of Functional Explorations, CHU de Caen, France
| | - Jan Bulla
- Department of Mathematics, University of Bergen, Norway
| | - Damien Davenne
- INSERM, U1075 COMETE, Caen, France. Université de Caen Basse-Normandie, U1075 COMETE, France
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Dekker K, Benjamins JS, Van Straten A, Hofman WF, Van Someren EJW. Effectiveness of internet-supported cognitive behavioral and chronobiological interventions and effect moderation by insomnia subtype: study protocol of a randomized controlled trial. Trials 2015; 16:292. [PMID: 26141682 PMCID: PMC4490722 DOI: 10.1186/s13063-015-0790-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/01/2015] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND DSM-V criteria for insomnia disorder are met by 6 to 10% of the adult population. Insomnia has severe consequences for health and society. One of the most common treatments provided by primary caregivers is pharmacological treatment, which is far from optimal and has not been recommended since a 2005 consensus report of the National Institutes of Health. The recommended treatment is Cognitive Behavioral Therapy for Insomnia. Effectiveness, however, is still limited. Only a few studies have evaluated the effectiveness of chronobiological treatments, including the timed application of bright light, physical activity and body warming. Another opportunity for optimization of treatment is based on the idea that the people suffering from insomnia most likely represent a heterogeneous mix of subtypes, with different underlying causes and expected treatment responses. The present study aims to evaluate the possibility for optimizing insomnia treatment along the principles of personalized and stratified medicine. It evaluates the following: 1. The relative effectiveness of internet-supported cognitive behavioral therapy, bright light, physical activity and body warming; 2. Whether the effectiveness of internet-supported cognitive behavioral therapy for insomnia can be augmented by simultaneous or prior application of bright light, physical activity and body warming; and 3. Whether the effectiveness of the interventions and their combination are moderated by the insomnia subtype. METHODS/DESIGN In a repeated measures, placebo-controlled, randomized clinical trial that included 160 people diagnosed with insomnia disorder, we are evaluating the relative effectiveness of 4 intervention weeks. Primary outcome is subjective sleep efficiency, quantified using a sleep diary. Secondary outcomes include other complaints of sleep and daytime functioning, health-related cost estimates and actigraphic objective sleep estimates. Compliance will be monitored both subjectively and objectively using activity, light and temperature sensors. Insomnia subtypes will be assessed using questionnaires. Mixed effect models will be used to evaluate intervention effects and moderation by insomnia subtype ratings. DISCUSSION The current study addresses multiple opportunities to optimize and personalize treatment of insomnia disorder. TRIAL REGISTRATION Netherlands National Trial Register NTR4010, 4 June 2013.
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Affiliation(s)
- Kim Dekker
- Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands.
| | - Jeroen S Benjamins
- Department of Clinical and Health Psychology, Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
| | - Annemieke Van Straten
- Department of Clinical Psychology, VU University Amsterdam & EMGO Institute for Health Care and Research, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
| | - Winni F Hofman
- Department of Psychology, Brain and Cognition group, University of Amsterdamy, Weesperplein 4, 1018 XA, Amsterdam, The Netherlands.
- Personal Health Institute International, Lobo-Braakensiekstraat 94, 1065 HP, Amsterdam, The Netherlands.
| | - Eus J W Van Someren
- Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands.
- Departments of Integrative Neurophysiology and Medical Psychology, Center for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam, VU University and Medical Center, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
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Ramkisoensing A, Meijer JH. Synchronization of Biological Clock Neurons by Light and Peripheral Feedback Systems Promotes Circadian Rhythms and Health. Front Neurol 2015; 6:128. [PMID: 26097465 PMCID: PMC4456861 DOI: 10.3389/fneur.2015.00128] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/19/2015] [Indexed: 12/16/2022] Open
Abstract
In mammals, the suprachiasmatic nucleus (SCN) functions as a circadian clock that drives 24-h rhythms in both physiology and behavior. The SCN is a multicellular oscillator in which individual neurons function as cell-autonomous oscillators. The production of a coherent output rhythm is dependent upon mutual synchronization among single cells and requires both synaptic communication and gap junctions. Changes in phase-synchronization between individual cells have consequences on the amplitude of the SCN’s electrical activity rhythm, and these changes play a major role in the ability to adapt to seasonal changes. Both aging and sleep deprivation negatively affect the circadian amplitude of the SCN, whereas behavioral activity (i.e., exercise) has a positive effect on amplitude. Given that the amplitude of the SCN’s electrical activity rhythm is essential for achieving robust rhythmicity in physiology and behavior, the mechanisms that underlie neuronal synchronization warrant further study. A growing body of evidence suggests that the functional integrity of the SCN contributes to health, well-being, cognitive performance, and alertness; in contrast, deterioration of the 24-h rhythm is a risk factor for neurodegenerative disease, cancer, depression, and sleep disorders.
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Affiliation(s)
- Ashna Ramkisoensing
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center , Leiden , Netherlands
| | - Johanna H Meijer
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center , Leiden , Netherlands
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Gonçalves BSB, Adamowicz T, Louzada FM, Moreno CR, Araujo JF. A fresh look at the use of nonparametric analysis in actimetry. Sleep Med Rev 2015; 20:84-91. [DOI: 10.1016/j.smrv.2014.06.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 05/22/2014] [Accepted: 06/07/2014] [Indexed: 11/15/2022]
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Douma JG, Volkers KM, Vuijk JP, Sonneveld MH, Goossens RHM, Scherder EJA. The effects of observation of walking in a living room environment, on physical, cognitive, and quality of life related outcomes in older adults with dementia: a study protocol of a randomized controlled trial. BMC Geriatr 2015; 15:26. [PMID: 25886987 PMCID: PMC4407293 DOI: 10.1186/s12877-015-0024-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 03/02/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The number of older adults with dementia is expected to increase. Dementia is not only characterized by a decline in cognition, also other functions, for example, physical functioning change. A possible means to decrease the decline in these functions, or even improve them, could be increasing the amount of physical activity. A feasible way hereto may be activation of the mirror neuron system through action observation. This method has already been shown beneficial for the performance of actions in, for example, stroke patients. The primary aim of this study is to examine the effect of observing videos of walking people on physical activity and physical performance, in older adults with dementia. Secondary, effects on cognition and quality of life related factors will be examined. METHODS/DESIGN A cluster randomized controlled trial is being performed, in which videos are shown to older adults with dementia (also additional eligibility criteria apply) in shared living rooms of residential care facilities. Due to the study design, living rooms instead of individual participants are randomly assigned to the experimental (videos of walking people) or control (videos of nature) condition, by means of drawing pieces of paper. The intervention has a duration of three months, and takes place on weekdays, during the day. There are four measurement occasions, in which physical activity, physical functioning, activities of daily living, cognition, the rest-activity rhythm, quality of life, and depression are assessed. Tests for participants are administered by a test administrator who is blind to the group the participant is in. DISCUSSION This study examines the effect of the observation of walking people on multiple daily life functions and quality of life related factors in older adults with dementia. A strength of this study is that the intervention does not require much time and attention from caregivers or researchers. A challenge of the study is therefore to get to know for how long residents watch the videos. However, the design implies a high feasibility of the study, as well as a high applicability of the intervention into daily care. TRIAL REGISTRATION NTR4708. Date of registration: 31 July 2014.
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Affiliation(s)
- Johanna G Douma
- VU University, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands.
| | - Karin M Volkers
- VU University, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands.
| | - Jelle Pieter Vuijk
- VU University, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands.
| | - Marieke H Sonneveld
- TU Delft, Faculty of Industrial Design Engineering, Landbergstraat 15, 2628, CE, Delft, the Netherlands.
| | - Richard H M Goossens
- TU Delft, Faculty of Industrial Design Engineering, Landbergstraat 15, 2628, CE, Delft, the Netherlands.
- Erasmus MC, Department of Neuroscience, Dr. Molewaterplein 50, 3015, GE, Rotterdam, the Netherlands.
| | - Erik J A Scherder
- VU University, Department of Clinical Neuropsychology, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands.
- University of Groningen, Center for Human Movement Sciences, Antonius Deusinglaan 1, 9713, AV, Groningen, the Netherlands.
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Kantermann T, Meisel A, Fitzthum K, Penzel T, Fietze I, Ulm L. Changes in chronotype after stroke: a pilot study. Front Neurol 2015; 5:287. [PMID: 25628597 PMCID: PMC4290616 DOI: 10.3389/fneur.2014.00287] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 12/17/2014] [Indexed: 12/03/2022] Open
Abstract
This study aimed to elucidate associations between stroke onset and severity as well as chronotype (phase of entrainment) and internal time of stroke. Fifty-six first-ever ischemic stroke patients participated in a cross-sectional study assessing chronotype (mid-sleep on work-free days corrected for sleep deficit on workdays; MSFsc) by applying the Munich ChronoType Questionnaire (MCTQ). The MCTQ was completed twice, on average 68 ± 24 (SD) days post stroke and retrospectively for the time before stroke. To assess the impact of stroke in relation to internal time, InTstroke was calculated as MSFsc minus local time of stroke. Stroke severity was assessed via the standard clinical National Institute Health Stroke Scale (NIHSS) and modified Ranking Scale (mRS), both at hospital admission and discharge. Overall, most strokes occurred between noon and midnight. There was no significant association between MSFsc and stroke onset. MSFsc changed significantly after stroke, especially in patients with more severe strokes. Changes in MSFsc varied with InTstroke – the earlier the internal time of a stroke relative to MSFsc-before-stroke, the more MSFsc advanced after stroke. In addition, we provide first evidence that MSFsc changes varied between stroke locations. Larger trials are needed to confirm these findings.
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Affiliation(s)
- Thomas Kantermann
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen , Groningen , The Netherlands ; Clinical Centre, Institute for Occupational, Social and Environmental Medicine, Ludwig-Maximilians University Munich , Munich , Germany
| | - Andreas Meisel
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin , Berlin , Germany ; Department of Neurology, Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin , Berlin , Germany
| | - Katharina Fitzthum
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin , Berlin , Germany ; Department of Neurology, Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin , Berlin , Germany
| | - Thomas Penzel
- Center of Sleep Medicine, Charité - Universitätsmedizin Berlin , Berlin , Germany
| | - Ingo Fietze
- Center of Sleep Medicine, Charité - Universitätsmedizin Berlin , Berlin , Germany
| | - Lena Ulm
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin , Berlin , Germany ; Department of Neurology, Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin , Berlin , Germany ; Centre for Clinical Research, The University of Queensland , Herston, QLD , Australia
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Wyse CA, Biello SM, Gill JMR. The bright-nights and dim-days of the urban photoperiod: implications for circadian rhythmicity, metabolism and obesity. Ann Med 2014; 46:253-63. [PMID: 24901354 DOI: 10.3109/07853890.2014.913422] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Artificial light decreases the amplitude of daily rhythms in human lifestyle principally by permitting activity and food intake to occur during hours of darkness, and allowing day-time activity to occur in dim light, indoors. Endogenous circadian timing mechanisms that oscillate with a period of 24 h have evolved to ensure physiology is synchronized with the daily variations in light, food, and social cues of the environment. Artificial light affects the synchronization between these oscillators, and metabolic disruption may be one consequence of this. By dampening the amplitude of environmental timing cues and disrupting circadian rhythmicity, artificial lighting might initiate metabolic disruption and contribute to the association between global urbanization and obesity. The aim of this review is to explore the historical, physiological, and epidemiological relationships between artificial light and circadian and metabolic dysfunction.
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Affiliation(s)
- Cathy A Wyse
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow , Glasgow G61 1QH , UK
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Schroeder AM, Colwell CS. How to fix a broken clock. Trends Pharmacol Sci 2013; 34:605-19. [PMID: 24120229 PMCID: PMC3856231 DOI: 10.1016/j.tips.2013.09.002] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 09/10/2013] [Accepted: 09/11/2013] [Indexed: 12/29/2022]
Abstract
Fortunate are those who rise out of bed to greet the morning light well rested with the energy and enthusiasm to drive a productive day. Others, however, depend on hypnotics for sleep and require stimulants to awaken lethargic bodies. Sleep/wake disruption is a common occurrence in healthy individuals throughout their lifespan and is also a comorbid condition to many diseases (neurodegenerative) and psychiatric disorders (depression and bipolar). There is growing concern that chronic disruption of the sleep/wake cycle contributes to more serious conditions including diabetes (type 2), cardiovascular disease, and cancer. A poorly functioning circadian system resulting in misalignments in the timing of clocks throughout the body may be at the root of the problem for many people. In this article we discuss environmental (light therapy) and lifestyle changes (scheduled meals, exercise, and sleep) as interventions to help fix a broken clock. We also discuss the challenges and potential for future development of pharmacological treatments to manipulate this key biological system.
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Affiliation(s)
- Analyne M Schroeder
- Laboratory of Circadian and Sleep Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, USA
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Madsen MT, Rosenberg J, Gögenur I. Actigraphy for measurement of sleep and sleep-wake rhythms in relation to surgery. J Clin Sleep Med 2013; 9:387-94. [PMID: 23585756 DOI: 10.5664/jcsm.2598] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Patients undergoing surgery have severe sleep and sleep-wake rhythm disturbances resulting in increased morbidity. Actigraphy is a tool that can be used to quantify these disturbances. The aim of this manuscript was to present the literature where actigraphy has been used to measure sleep and sleep-wake rhythms in relation to surgery. METHODS A systematic review was performed in 3 databases (Medline, Embase, and Psycinfo), including all literature until July 2012. RESULTS Thirty-two studies were included in the review. Actigraphy could demonstrate that total sleep time and sleep efficiency was reduced after surgery and number of awakenings was increased in patients undergoing major surgery. Disturbances were less severe in patients undergoing minor surgery. Actigraphy could be used to differentiate between delirious and non-delirious patients after major surgery. Actigraphy measurements could determine a differential effect of surgery based on the patient's age. The effect of pharmacological interventions (chronobiotics and hypnotics) in surgical patients could also be demonstrated by actigraphy. CONCLUSION Actigraphy can be used to measure sleep and sleep-wake rhythms in patients undergoing surgery.
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Affiliation(s)
- Michael T Madsen
- Department of Surgical Gastroenterology, University of Copenhagen, Herlev Hospital, Herlev, Denmark.
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Maaskant M, van de Wouw E, van Wijck R, Evenhuis HM, Echteld MA. Circadian sleep-wake rhythm of older adults with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1144-1151. [PMID: 23376049 DOI: 10.1016/j.ridd.2012.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/13/2012] [Accepted: 12/18/2012] [Indexed: 06/01/2023]
Abstract
The circadian sleep-wake rhythm changes with aging, resulting in a more fragmented sleep-wake pattern. In individuals with intellectual disabilities (ID), brain structures regulating the sleep-wake rhythm might be affected. The aims of this study were to compare the sleep-wake rhythm of older adults with ID to that of older adults in the general population, and to investigate which factors are associated with the sleep-wake rhythm in older adults with ID. This study is part of the 'Healthy Aging and Intellectual Disabilities' study (HA-ID). We applied actigraphy in 551 persons with ID and 58 persons in the general population, aged 50 years and over. Outcome measures were stability (interdaily stability), fragmentation (intradaily variability) and amplitude (relative amplitude) of the sleep-wake rhythm. Compared to older adults in the general population, the sleep-wake rhythm of older adults with ID was significantly less stable (p=0.03), more fragmented (p<0.001) and had a lower relative amplitude (p<0.001). Multivariate regression analysis revealed that higher age, dementia, depression, visual impairment, severe hearing impairment, epilepsy and spasticity are independently associated with a more disturbed sleep-wake rhythm in this group. The sleep-wake rhythm is more stable in females and those living at a setting for more intensive care. Higher physical activity levels are strongly associated with both a less fragmented (p<0.001) and a more stable (p<0.001) sleep-wake rhythm. Higher age, dementia and depression are also associated with the sleep-wake rhythm in the general population. Neurological and sensory impairments that were associated with the sleep-wake rhythm in older adults with ID, are frequent known conditions in the ID population. Further research should focus on which factors specifically influence the sleep-wake rhythm in older adults with ID, and on the effects of more physical daytime activity on the sleep-wake rhythm in this population.
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Affiliation(s)
- Marijke Maaskant
- Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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Calogiuri G, Weydahl A. Effects of sleep loss on the rest-activity circadian rhythm of helpers participating in continuous dogsled races. Biol Res Nurs 2013; 16:123-33. [PMID: 23389400 DOI: 10.1177/1099800412475077] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The Finnmarksløpet dogsled race lasts up to 7 days. Helpers, who keep time, coach, and transport equipment, have to be alert though they have little and fragmented sleep. This study investigated disruptions of the rest-activity rhythm among helpers. METHODS 10 helpers were monitored by actigraph a week before, during, and after the race. Sleep logs, sleepiness rate, and self-reported quality of sleep were collected. RESULTS Nonparametric circadian rhythm analysis showed significant differences between the pre- and postrace interdaily stability and amplitude of rhythm. Compared to prerace, sleepiness at bedtime was increased and number of nocturnal awakenings was reduced postrace, although the actigraphic outputs showed no improvement in sleep quality. Helpers who were engaged in the race for a longer span (5-6 days) had more difficulty recovering from the sleep loss accumulated during the race than those engaged for a shorter time (2-3 days). CONCLUSION Poor sleep combined with prolonged and demanding mental focus for 2 days or more has a negative influence upon the rest-activity cycle, though complete restoration of the cycle occurs over 1 week or more. Being in such a condition for ≥ 5 days leads to disruptions of the circadian component of the sleep-wake cycle that hampers the sleep recovery process. Disrupted sleep and demanding mental requirements are common in long-distance sporting events as well as among shift workers. Follow-up intervention should be made in such cases to ensure the return of a healthy rest-activity rhythm and sleep quality.
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Affiliation(s)
- Giovanna Calogiuri
- 1Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Norway
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Coomans CP, van den Berg SAA, Houben T, van Klinken JB, van den Berg R, Pronk ACM, Havekes LM, Romijn JA, van Dijk KW, Biermasz NR, Meijer JH. Detrimental effects of constant light exposure and high-fat diet on circadian energy metabolism and insulin sensitivity. FASEB J 2013; 27:1721-32. [PMID: 23303208 DOI: 10.1096/fj.12-210898] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Circadian rhythm disturbances are observed in, e.g., aging and neurodegenerative diseases and are associated with an increased incidence of obesity and diabetes. We subjected male C57Bl/6J mice to constant light [12-h light-light (LL) cycle] to examine the effects of a disturbed circadian rhythm on energy metabolism and insulin sensitivity. In vivo electrophysiological recordings in the central pacemaker of the suprachiasmatic nuclei (SCN) revealed an immediate reduction in rhythm amplitude, stabilizing at 44% of normal amplitude values after 4 d LL. Food intake was increased (+26%) and energy expenditure decreased (-13%), and we observed immediate body weight gain (d 4: +2.4%, d 14: +5.0%). Mixed model analysis revealed that weight gain developed more rapidly in response to LL as compared to high fat. After 4 wk in LL, the circadian pattern in feeding and energy expenditure was completely lost, despite continuing low-amplitude rhythms in the SCN and in behavior, whereas weight gain had stabilized. Hyperinsulinemic-euglycemic clamp analysis revealed complete abolishment of normal circadian variation in insulin sensitivity in LL. In conclusion, a reduction in amplitude of the SCN, to values previously observed in aged mice, is sufficient to induce a complete loss of circadian rhythms in energy metabolism and insulin sensitivity.
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Affiliation(s)
- Claudia P Coomans
- Leiden University Medical Center, Department of Molecular Cell Biology, Laboratory of Neurophysiology, Bldg. 2, Room T5-32, Einthovenweg 20, PO Box 9600, 2300 RC Leiden, the Netherlands.
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Tabuchi H, Kiuchi Y, Nakakura S, Ohhara Z. Periodic analysis using two-way analysis of variance for the circadian rhythm of intraocular pressure in primary open angle glaucoma. BIOL RHYTHM RES 2012. [DOI: 10.1080/09291016.2011.599649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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van Oosterhout F, Lucassen EA, Houben T, vanderLeest HT, Antle MC, Meijer JH. Amplitude of the SCN clock enhanced by the behavioral activity rhythm. PLoS One 2012; 7:e39693. [PMID: 22761873 PMCID: PMC3386260 DOI: 10.1371/journal.pone.0039693] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 05/29/2012] [Indexed: 12/19/2022] Open
Abstract
Circadian rhythms are regulated by the suprachiasmatic nucleus (SCN), a small structure at the base of the hypothalamus. While light effects on the SCN are well established, little is known of behavioral effects. This study elucidates direct modulating action of behavioral activity on the SCN by use of in vivo electrophysiology recordings, assessments of general locomotor behavior, and video-tracking of mice. The results show suppression of SCN neuronal activity by spontaneous behavior, the magnitude being dependent on the intensity, duration and type of behavioral activity. The suppression was moderate (32% of circadian amplitude) for low-intensity behavior and considerable (59%) for locomotor activity. Mild manipulation of the animals had reversed effects on the SCN indicating that different mechanisms are involved in the regulatory effect of spontaneous versus induced activity. The results indicate that exercise at the proper time of the cycle can boost the amplitude of the rhythm of the SCN clock itself. This has potentially beneficial effects for other rhythmic functions that are under the control of the SCN.
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Affiliation(s)
- Floor van Oosterhout
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Eliane A. Lucassen
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Thijs Houben
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henk Tjebbe vanderLeest
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michael C. Antle
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychology, Department of Physiology and Pharmacology, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Johanna H. Meijer
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
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Escames G, Ozturk G, Baño-Otálora B, Pozo MJ, Madrid JA, Reiter RJ, Serrano E, Concepción M, Acuña-Castroviejo D. Exercise and melatonin in humans: reciprocal benefits. J Pineal Res 2012; 52:1-11. [PMID: 21848991 DOI: 10.1111/j.1600-079x.2011.00924.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The aim of this review is to update the reader as to the association between physical exercise and melatonin, and to clarify how the melatonin rhythm may be affected by different types of exercise. Exercise may act as a zeitgeber, although the effects of exercise on the human circadian system are only now being explored. Depending on the time of the day, on the intensity of light, and on the proximity of the exercise to the onset or decline of the circadian production of melatonin, the consequence of exercise on the melatonin rhythm varies. Moreover, especially strenuous exercise per se induces an increased oxidative stress that in turn may affect melatonin levels in the peripheral circulation because indole is rapidly used to combat free radical damage. On the other hand, melatonin also may influence physical performance, and thus, there are mutually interactions between exercise and melatonin production which may be beneficial.
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Affiliation(s)
- Germaine Escames
- Centro de Investigación Biomédica, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, Granada, Spain
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VERBERNE LISAM, MAURICE-STAM HELEEN, GROOTENHUIS MARTHAA, VAN SANTEN HANNEKEM, SCHOUTEN-VAN MEETEREN ANTOINETTEYN. Sleep disorders in children after treatment for a CNS tumour. J Sleep Res 2011; 21:461-9. [DOI: 10.1111/j.1365-2869.2011.00971.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Calogiuri G, Weydahl A, Carandente F. Methodological Issues for Studying the Rest–Activity Cycle and Sleep Disturbances. Biol Res Nurs 2011; 15:5-12. [DOI: 10.1177/1099800411416224] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Shift work schedules, intensive physical exercise late in the day, psychological stress, or a busy lifestyle might induce disorders of the circadian structure, which can affect health on both the physiological and neurobehavioral levels. Rest–activity rhythm is strongly connected with an organism’s circadian structure, and irregular sleep–wake patterns can lead to a disruption of entrainment, resulting in physiological and neurobehavioral dysfunction. Shift nurses are often subject to disturbances in the quality and duration of their sleep, raising the possibility of negative impacts on their health and their patients' safety. Researchers have used actigraphy in a number of studies to assess sleep patterns. Because of the close connection between sleep and circadian structure, it may be useful to extend the evaluation of actigraphy data to the analysis of the rest–activity rhythm with rhythmometric procedures to provide a better understanding of possible sleep disorders in relation to entrainment. Actigraphy is an easy and reliable way to study these rhythms and identify possible circadian-rhythm disorders. In this article, the authors discuss methodological issues concerning the evaluation of the rest–activity rhythm, with a focus on actigraphy.
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Affiliation(s)
- Giovanna Calogiuri
- Department of Physical Education/Arctic Chronobiology, Finnmark University College, Alta, Norway
| | - Andi Weydahl
- Department of Physical Education/Arctic Chronobiology, Finnmark University College, Alta, Norway
| | - Franca Carandente
- Faculty of Exercise Science, Department of Sport Science, Nutrition and Health, University of Milan, Milan, Italy
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(Re-)activation of neurons in aging and dementia: Lessons from the hypothalamus. Exp Gerontol 2011; 46:178-84. [DOI: 10.1016/j.exger.2010.08.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 08/25/2010] [Accepted: 08/27/2010] [Indexed: 01/22/2023]
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47
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Effects of Sleep Loss and Strenuous Physical Activity on the Rest–Activity Circadian Rhythm. Biol Res Nurs 2010; 13:409-18. [DOI: 10.1177/1099800410392021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective. Rest–activity circadian rhythm is strongly linked to an organism’s entrainment. Sleep loss and prolonged fatigue could affect the circadian system, inducing neurobehavioral deficits. The Finnmarksløpet is Europe’s longest dogsled race. In this competition, lasting up to 7 days, participants (mushers) are physically active most of the time, having little and fragmented rest. Therefore, the race provides an opportunity to investigate the effects of prolonged fatigue and sleep loss. Methods. Ten mushers, participating in the 500 km and 1,000 km categories, underwent continuous actigraph monitoring (5 days) before and after the race. During the competition, heart rate (HR) was recorded by an HR monitor. Results. There was a reduction in the average activity values during the 24-hr cycle after the race. Although there were signs of a forward phase shift, these were weak and unstable. Nonparametric circadian rhythm analysis (NPCRA) showed reductions in interdaily stability (IS) and relative amplitude (RA). 1,000 km mushers also showed sleep disturbances. Conclusion. A period of 3 days of little and fragmented sleep (3–4 hr of total rest per day), in which subjects were engaged in a prolonged physical effort, was enough to significantly affect the rest–activity rhythm. A longer period (5 days) in such a condition induced even more accentuated alterations, with a disturbance in nocturnal sleep. Disrupted sleep is common among hospitalized patients and those working long shifts. This study demonstrates changes in the structure of the rest–activity circadian rhythm that can result and may suggest opportunities for intervention.
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Eggermont LHP, Blankevoort CG, Scherder EJA. Walking and night-time restlessness in mild-to-moderate dementia: a randomized controlled trial. Age Ageing 2010; 39:746-9. [PMID: 20823127 DOI: 10.1093/ageing/afq115] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laura H P Eggermont
- Department of Clinical Neuropsychology, VU University, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
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Reid KJ, Baron KG, Lu B, Naylor E, Wolfe L, Zee PC. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep Med 2010; 11:934-40. [PMID: 20813580 DOI: 10.1016/j.sleep.2010.04.014] [Citation(s) in RCA: 317] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 04/12/2010] [Accepted: 04/13/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia. METHODS Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.3] years; 16 female) participated in a randomized controlled trial comparing 16 weeks of aerobic physical activity plus sleep hygiene to non-physical activity plus sleep hygiene. Eligibility included primary insomnia for at least 3 months, habitual sleep duration <6.5h and a Pittsburgh Sleep Quality Index (PSQI) score >5. Outcomes included sleep quality, mood and quality of life questionnaires (PSQI, Epworth Sleepiness Scale [ESS], Short-form 36 [SF-36], Center for Epidemiological Studies Depression Scale [CES-D]). RESULTS The physical activity group improved in sleep quality on the global PSQI (p<.0001), sleep latency (p=.049), sleep duration (p=.04), daytime dysfunction (p=.027), and sleep efficiency (p=.036) PSQI sub-scores compared to the control group. The physical activity group also had reductions in depressive symptoms (p=.044), daytime sleepiness (p=.02) and improvements in vitality (p=.017) compared to baseline scores. CONCLUSION Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.
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Affiliation(s)
- Kathryn J Reid
- Department of Neurology, Northwestern University, Suite 500, Chicago, IL 60611, USA
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Merrilees J, Hubbard E, Mastick J, Miller BL, Dowling GA. Rest-activity and behavioral disruption in a patient with frontotemporal dementia. Neurocase 2009; 15:515-26. [PMID: 19736599 PMCID: PMC2829101 DOI: 10.1080/13554790903061371] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The neurological deterioration in dementia is associated with disturbances in circadian rhythms and rest-activity patterns. These disruptions have been documented in Alzheimer's disease (AD) and dementia with Lewy bodies but little is known about rest-activity patterns in patients with frontotemporal dementia (FTD). We report longitudinal (2 year) actigraphy results for a patient who met diagnostic criteria for FTD and his family caregiver. The subject and his family caregiver wore Actiwatches continuously for 2 weeks at 1-year intervals. The findings suggest that with disease progression there is worsening in multiple areas of rest-activity measures for the patient and a negative impact on sleep quality for the family caregiver.
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Affiliation(s)
- J Merrilees
- University of California, San Francisco, Memory and Aging Center, 350 Parnassus Ave., San Francisco, CA 94019-1207, USA.
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