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Kurtoğlu A, Eken Ö, Aydın E, Çar B, Nobari H. The impact of strategic napping on peak expiratory flow and respiratory function in young elite athletes. BMC Sports Sci Med Rehabil 2024; 16:41. [PMID: 38336766 PMCID: PMC10854142 DOI: 10.1186/s13102-024-00842-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/08/2024] [Indexed: 02/12/2024]
Abstract
Respiratory health is a critical determinant of athletic performance, and the utilization of restorative strategies, such as strategic napping, may offer a competitive edge to athletes. This study investigates the effects of nap duration on the respiratory function of young elite athletes who have achieved top rankings national competitions. Participants engage in three test sessions with varying nap durations: no nap (N0), a 25-minute nap (N25), and a 45-minute nap (N45), with a minimum 72-hour interval between sessions. Respiratory parameters including Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), FEV1/FVC ratio, Peak Expiratory Flow rate (PEF), Forced Expiratory Flow at 25-75% of FVC (FEF25-75%), and Forced Expiratory Time (FET) are assessed. Results reveal a significant enhancement in PEF values following a 45-minute nap (N45) compared to the no-nap control (N0) [F1 - 11=7.356, p =.004, ηp2 = 0.401, (95% CI for difference: -1.56 to - 0.056)], indicating a potential positive influence of napping on maximum expiratory flow rate and, consequently, athletes' respiratory performance. While no significant changes are observed in other respiratory parameters across different nap durations, these findings underscore the potential benefits of strategic napping in optimizing respiratory health in young elite athletes.
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Affiliation(s)
- Ahmet Kurtoğlu
- Department of Coaching Education, Faculty of Sport Science, Bandirma Onyedi Eylul University, Balıkesir, 10200, Turkey
| | - Özgür Eken
- Department of Physical Education and Sport Teaching, Faculty of Sports Sciences, Inonu University, Malatya, 44280, Turkey
| | - Engin Aydın
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, Istanbul, 34668, Turkey
| | - Bekir Çar
- Department of Physical Education and Sport Teaching, Faculty of Sport Sciences, Bandirma Onyedi Eylul University, Balıkesir, 10200, Turkey
| | - Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, Cáceres, 10003, Spain.
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran.
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2
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Xing C, Zhai B, Zhang Y, Fang Y, Zhang M, Zhang C, Wang W, Ding M, Huang X, Shen B, Wang R, Song L. Sleep deprivation reduced LPS-induced IgG2b production by up-regulating BMAL1 and CLOCK expression. Biochem Biophys Res Commun 2024; 691:149326. [PMID: 38035406 DOI: 10.1016/j.bbrc.2023.149326] [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: 11/10/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023]
Abstract
Sleep deprivation (SD) weakens the immune system and leads to increased susceptibility to infectious or inflammatory diseases. However, it is still unclear how SD affects humoral immunity. In the present study, sleep disturbance was conducted using an sleep deprivation instrument, and the bacterial endotoxin lipopolysaccharide (LPS) was used to activate the immune response. It was found that SD-pretreatment reduced LPS-induced IgG2b+ B cells and IgG2b isotype antibody production in lymphocytes of spleen. And, SD-pretreatment decreased the proportion of CD4+T cells, production of CD4+T cells derived TGF-β1 and its contribution in helping IgG2b production. Additionally, BMAL1 and CLOCK were selectively up-regulated in lymphocytes after SD. Importantly, BMAL1 and CLOCK deficiency contributed to TGF-β1 expression and production of IgG2b+ B cells. Thus, our results provide a novel insight to explain the involvement of BMAL1 and CLOCK under SD stress condition, and their roles in inhibiting TGF-β1 expression and contributing to reduction of LPS induced IgG2b production.
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Affiliation(s)
- Chen Xing
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China.
| | - Bing Zhai
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China; Department of Geriatric Hematology, Nanlou Division, Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, 100853, China
| | - Yifan Zhang
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Ying Fang
- Department of Rheumatology, First Hospital of Jilin University, Changchun, 130021, China
| | - Min Zhang
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Chongchong Zhang
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China; Laboratory of Cellular and Molecular Immunology, School of Medicine, Henan University, Kaifeng, 475004, China
| | - Wei Wang
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China; School of Pharmacy, Jiamusi University, Jiamusi, Heilongjiang, 154007, China
| | - Mengnan Ding
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Xin Huang
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Beifen Shen
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Renxi Wang
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, 100069, China.
| | - Lun Song
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China.
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Raman S, Hyland P, Coogan AN. Stability of social jetlag and sleep timing into the second year of the Covid-19 pandemic: Results from a longitudinal study of a nationally representative adult sample in Ireland. Chronobiol Int 2024; 41:29-37. [PMID: 38093635 DOI: 10.1080/07420528.2023.2292098] [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: 09/06/2023] [Accepted: 12/02/2023] [Indexed: 01/16/2024]
Abstract
The early phase of the COVID-19 pandemic has previously been associated with marked changes in sleep/wake timing arising from the imposition of society-wide infection mitigation measures. Such observations are considered of broader significance as they reveal the social pressures that sleep timing normally operates under. In order to assess how persistent such changes were as the COVID-19 pandemic developed, we assessed sleep timing and quality in a longitudinal study of a nationally-representative sample of Irish adults with data collected at two time-points (December 2021 and March 2021). Data on social jetlag and chronotype was derived from the micro Munich Chronotype Questionnaire from 830 and 843 participants who provided data in December 2020 and March 2021 respectively, of which 338 contributed data to both timepoints. Demographics and measures of insomnia symptoms, anxiety, depression and loneliness were also collected, and data was analysed both within-subjects and cross-sectionally within data waves. Social jetlag (the mismatch between sleep timing on "work" and "free" days) and other measures of sleep timing were stable across the two time-points, although insomnia symptoms improved slightly from December 2020 to March 2021. The mean social jetlag at both timepoints was ~ 30 minutes, considerably lesser than reported pre-pandemic levels in similar populations. Multiple regression analysis of cross-sectional data reveals that the timing of midsleep on "free" days was only a weak-to-moderate predictor of social jetlag, whilst hours worked per week was the strongest predictor of social jetlag. Requirement for "face-to-face" contact with the public at work and urban location of residence also emerged as predictors of social jetlag, although insomnia, anxiety and depression symptoms and loneliness rating did not. We conclude that sleep timing changes that occurred during the initial phase of the COVID-19 pandemic persisted into the second year of the pandemic, and these results further illustrate the key roles working practices and other social factors have in shaping social jetlag.
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Affiliation(s)
- Sudha Raman
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, Kildare, Ireland
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Arrona-Palacios A, Díaz-Morales JF, Duffy JF. The influence of a permanent double-shift school start time on adolescent sleep and chronotype across different age groups. Chronobiol Int 2023; 40:850-863. [PMID: 37212086 DOI: 10.1080/07420528.2023.2215343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/27/2023] [Accepted: 05/12/2023] [Indexed: 05/23/2023]
Abstract
The main objective of this study was to explore the differences in sleep habits and chronotype across different age groups in Mexican adolescents attending a permanent double-shift school system. This cross-sectional study consisted of 1,969 (1,084 girls) students from public elementary, secondary, and high schools, as well as undergraduate university students from Mexico. Age range was 10-22 [15.33 ± 3.28 (mean ± SD)] years, 988 morning shift and 981 afternoon shift students. Questions regarding usual self-reported bedtime and rise time were collected, and from that, estimates for time in bed, midpoint of sleep, social jetlag, and chronotype were evaluated. Afternoon shift students reported later rise times, bedtimes, midpoint of sleep, and longer time in bed on school days than morning shift students, as well as less social jetlag. Overall, afternoon shift students reported a later chronotype than morning shift students. Peak lateness of chronotype in afternoon shift students was at age 15, with girls peaking at age 14 and boys at age 15. Meanwhile, morning shift students reported peak lateness of chronotype around age 20. In this study, adolescents from different age ranges attending an extremely delayed school start time reported adequate sleep compared with adolescents attending a fixed morning school start time. In addition, the analysis presented in this study seems to suggest that the peak of late chronotype may be influenced by school start times.
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Affiliation(s)
- Arturo Arrona-Palacios
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Writing Lab, Institute for the Future of Education, Tecnologico de Monterrey, Monterrey, Mexico
| | - Juan F Díaz-Morales
- Department of Social Psychology, Work and Individual Differences, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Jeanne F Duffy
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Huang J, Qin M, Lu W, Shen X. Dexmedetomidine Improved Sleep Quality in the Intensive Care Unit After Laryngectomy. Drug Des Devel Ther 2023; 17:1631-1640. [PMID: 37287698 PMCID: PMC10243355 DOI: 10.2147/dddt.s413321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023] Open
Abstract
Purpose To examine whether nighttime dexmedetomidine infusion improved sleep quality in patients after laryngectomy. Patients and Methods Thirty-five post-laryngectomy patients admitted to the intensive care unit (ICU) were randomly assigned to a 9-h (from 2100 h on surgery day to 0600 h the morning after laryngectomy) dexmedetomidine (0.3 μg/kg/h continuous infusion) or placebo group. Polysomnography results were monitored during the dexmedetomidine infusion period. The percentage of stage 2 non-rapid eye movement (stage N2) sleep was the primary outcome measure. Results Thirty-five patients (18 placebo group; 17 dexmedetomidine group) had complete polysomnogram recordings. The percentage of stage N3 sleep was significantly increased in the dexmedetomidine infusion group (from median 0% (0 to 0) in placebo group to 0% (interquartile range, 0 to 4) in dexmedetomidine group (difference, -2.32%; 95% CI, -4.19 to -0.443; P = 0.0167)). Infusion had no effect on total sleep time, stage N1 or N2 sleep percentages, or sleep efficiency. It decreased muscle tensity and snore non-rapid eye movement. Subjective sleep quality improved. Hypotension incidence increased in the dexmedetomidine group, but significant intervention was not required. Conclusion Dexmedetomidine infusion improved overall patient sleep quality in the ICU after laryngectomy.
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Affiliation(s)
- Jingjing Huang
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital of Fudan University, Shanghai, People’s Republic of China
- Shanghai Municipal Key Clinical Specialty, Eye & ENT Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Minju Qin
- Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Weisha Lu
- Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Xia Shen
- Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai, People’s Republic of China
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Murata E, Yoshizaki A, Fujisawa TX, Tachibana M, Taniike M, Mohri I. What daily factors affect the sleep habits of Japanese toddlers? J Clin Sleep Med 2023; 19:1089-1101. [PMID: 36789883 PMCID: PMC10235708 DOI: 10.5664/jcsm.10508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023]
Abstract
STUDY OBJECTIVES Good sleep, especially during early childhood, is important for development. In Japan, the mean nocturnal sleep duration of toddlers is < 10 hours, and even if toddlers slept for > 11 hours/day, as recommended by the National Sleep Foundation, some of them showed late bedtime and late wake-up time or took long naps. Therefore, we provisionally assumed the minimal sleep conditions for Japanese toddlers, named Nenne-criteria, such as bedtime before 10:00 pm, nocturnal sleep duration of ≥ 9 hours, and < 1 average time of awakening after sleep onset, and investigated the important factors for good sleep. METHODS We analyzed cross-sectional data from online surveys describing the sleep-related behaviors of 2,124 toddlers and their caregivers. We compared the daily schedules that affect sleep between the Nenne-criteria-meet group and the not-meet group. RESULTS The Nenne-criteria-meet group showed better daytime behaviors than the not-meet group. Structural equation modeling on daily schedules revealed that, to increase sleep pressure at the appropriate time, it is important to restrict media viewing, play outdoors in the morning, have an early nap ending time, avoid hyperarousal-inducing behaviors before bedtime, maintain daily schedules regularly, and decrease social jetlag. CONCLUSIONS The Nenne-criteria are useful for screening Japanese toddlers who require intervention for sleep hygiene. To improve toddlers' sleep, it is important not only to guide the ideal bedtime but also to provide tips for improving daily schedules and to avoid suboptimal sleep-related behaviors. CITATION Murata E, Yoshizaki A, Fujisawa TX, Tachibana M, Taniike M, Mohri I. What daily factors affect the sleep habits of Japanese toddlers? J Clin Sleep Med. 2023;19(6):1089-1101.
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Affiliation(s)
- Emi Murata
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Arika Yoshizaki
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Takashi X. Fujisawa
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Masaya Tachibana
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Masako Taniike
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Ikuko Mohri
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
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Guo R, Vaughan DT, Rojo ALA, Huang YH. Sleep-mediated regulation of reward circuits: implications in substance use disorders. Neuropsychopharmacology 2023; 48:61-78. [PMID: 35710601 PMCID: PMC9700806 DOI: 10.1038/s41386-022-01356-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 12/11/2022]
Abstract
Our modern society suffers from both pervasive sleep loss and substance abuse-what may be the indications for sleep on substance use disorders (SUDs), and could sleep contribute to the individual variations in SUDs? Decades of research in sleep as well as in motivated behaviors have laid the foundation for us to begin to answer these questions. This review is intended to critically summarize the circuit, cellular, and molecular mechanisms by which sleep influences reward function, and to reveal critical challenges for future studies. The review also suggests that improving sleep quality may serve as complementary therapeutics for treating SUDs, and that formulating sleep metrics may be useful for predicting individual susceptibility to SUDs and other reward-associated psychiatric diseases.
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Affiliation(s)
- Rong Guo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- Allen Institute, Seattle, WA, 98109, USA
| | - Dylan Thomas Vaughan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Ana Lourdes Almeida Rojo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Yanhua H Huang
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA.
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA.
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Barton J, Mio M, Timmins V, Mitchell RHB, Murray BJ, Goldstein BI. Factors Associated With Sleep Disturbance Amongst Youth With Bipolar Disorder. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2022; 31:165-175. [PMID: 36425019 PMCID: PMC9661909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 07/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND While sleep disturbances and their impact on functioning are well-established in adults with bipolar disorder (BD), little is known about this topic in youth. OBJECTIVE This study investigates the prevalence and correlates of sleep disturbance among youth with BD. METHODS The study included 103 youth (72 BD, 31 healthy controls [HC]), ages 14-20 years. Study measures included a semi-structured diagnostic interview and the Pittsburgh Sleep Quality Index (PSQI). PSQI yields a global score and 7 subscale scores. Analyses examined between group differences in PSQI scores, and correlates of PSQI within BD. RESULTS BD youth had significantly higher (worse) global sleep scores, and higher scores on 5/7 subscales (quality, latency, disturbance, sleep medication use, daytime dysfunction). In univariate analyses, poorer sleep quality was associated with higher lifetime and current depression severity, mixed mood state, self-reported affective lability, and borderline personality traits. Lifetime lithium treatment and euthymic mood state were associated with better sleep scores. In multivariate analyses, greater current depression severity and self-reported affective lability were most robustly associated with poor sleep quality. CONCLUSIONS Converging with data from adults, present findings indicate greater sleep disturbance among youth with BD versus HC. Also convergent with adults with BD, mood disturbance, whether depression severity or emotional lability, comprised the predominant correlates of sleep disturbance among youth with BD. Future research is warranted to better understand the temporal association between sleep disturbance and its correlates in youth with BD. Relatedly, interventions that address both mood and sleep disturbances may help improve overall functioning.
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Affiliation(s)
- Jessica Barton
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, Ontario
| | - Megan Mio
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Pharmacology, University of Toronto, Toronto, Ontario
| | - Vanessa Timmins
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, Ontario
| | - Rachel H B Mitchell
- Department of Psychiatry, University of Toronto, Toronto, Ontario
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | - Brian J Murray
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, Ontario
- Department of Psychiatry, University of Toronto, Toronto, Ontario
- Department of Pharmacology, University of Toronto, Toronto, Ontario
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Grandner MA, Valencia DY, Seixas AA, Oliviér K, Gallagher RA, Killgore WDS, Hale L, Branas C, Alfonso-Miller P. Development and Initial Validation of the Assessment of Sleep Environment (ASE): Describing and Quantifying the Impact of Subjective Environmental Factors on Sleep. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13599. [PMID: 36294179 PMCID: PMC9602531 DOI: 10.3390/ijerph192013599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to develop and test the reliability and validity of a 13-item self-report Assessment of Sleep Environment (ASE). This study investigates the relationship between subjective experiences of environmental factors (light, temperature, safety, noise, comfort, humidity, and smell) and sleep-related parameters (insomnia symptoms, sleep quality, daytime sleepiness, and control over sleep). The ASE was developed using an iterative process, including literature searches for item generation, qualitative feedback, and pilot testing. It was psychometrically assessed using data from the Sleep and Healthy Activity Diet Environment and Socialization (SHADES) study (N = 1007 individuals ages 22-60). Reliability was determined with an internal consistency and factor analysis. Validity was evaluated by comparing ASE to questionnaires of insomnia severity, sleep quality, daytime sleepiness, sleep control, perceived stress, and neighborhood disorder. The ASE demonstrated high internal consistency and likely reflects a single factor. ASE score was associated with insomnia symptoms (B = 0.09, p < 0.0001), sleep quality (B = 0.07, p < 0.0001), and sleep control (B = -0.01, p < 0.0001), but not daytime sleepiness. The ASE was also associated with perceived stress (B = 0.20, p < 0.0001) and neighborhood disorder (B = -0.01, p < 0.0001). Among sleep environment factors, only smell was not associated with sleep quality; warmth and safety were negatively associated with sleepiness; and of the sleep environment factors, only light/dark, noise/quiet, and temperature (warm/cool) were not associated with insomnia symptoms. The ASE is a reliable and valid measure of sleep environment. Physical environment (light, temperature, safety, noise, comfort, humidity, and smell) was associated with insomnia symptoms and sleep quality but not sleepiness.
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Affiliation(s)
- Michael A. Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA
| | - Dora Y. Valencia
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA
| | - Azizi A. Seixas
- Department of Population Health, NYU Langone Medical Center, New York, NY 10016, USA
| | - Kayla Oliviér
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724, USA
| | - Rebecca A. Gallagher
- Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY 11794, USA
| | - Charles Branas
- Department of Epidemiology, Columbia University, New York, NY 10032, USA
| | - Pamela Alfonso-Miller
- Northumbria Sleep Research, Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
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10
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Agadagba SK, Eldaly ABM, Chan LLH. Transcorneal Electrical Stimulation Induces Long-Lasting Enhancement of Brain Functional and Directional Connectivity in Retinal Degeneration Mice. Front Cell Neurosci 2022; 16:785199. [PMID: 35197826 PMCID: PMC8860236 DOI: 10.3389/fncel.2022.785199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/14/2022] [Indexed: 12/21/2022] Open
Abstract
To investigate neuromodulation of functional and directional connectivity features in both visual and non-visual brain cortices after short-term and long-term retinal electrical stimulation in retinal degeneration mice. We performed spontaneous electrocorticography (ECoG) in retinal degeneration (rd) mice following prolonged transcorneal electrical stimulation (pTES) at varying currents (400, 500 and 600 μA) and different time points (transient or day 1 post-stimulation, 1-week post-stimulation and 2-weeks post-stimulation). We also set up a sham control group of rd mice which did not receive any electrical stimulation. Subsequently we analyzed alterations in cross-frequency coupling (CFC), coherence and directional connectivity of the primary visual cortex and the prefrontal cortex. It was observed that the sham control group did not display any significant changes in brain connectivity across all stages of electrical stimulation. For the stimulated groups, we observed that transient electrical stimulation of the retina did not significantly alter brain coherence and connectivity. However, for 1-week post-stimulation, we identified enhanced increase in theta-gamma CFC. Meanwhile, enhanced coherence and directional connectivity appeared predominantly in theta, alpha and beta oscillations. These alterations occurred in both visual and non-visual brain regions and were dependent on the current amplitude of stimulation. Interestingly, 2-weeks post-stimulation demonstrated long-lasting enhancement in network coherence and connectivity patterns at the level of cross-oscillatory interaction, functional connectivity and directional inter-regional communication between the primary visual cortex and prefrontal cortex. Application of electrical stimulation to the retina evidently neuromodulates brain coherence and connectivity of visual and non-visual cortices in retinal degeneration mice and the observed alterations are largely maintained. pTES holds strong possibility of modulating higher cortical functions including pathways of cognition, awareness, emotion and memory.
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Affiliation(s)
- Stephen K. Agadagba
- Department of Electrical Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Abdelrahman B. M. Eldaly
- Department of Electrical Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Electrical Engineering Department, Faculty of Engineering, Minia University, Minia, Egypt
| | - Leanne Lai Hang Chan
- Department of Electrical Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- *Correspondence: Leanne Lai Hang Chan,
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Bent B, Cho PJ, Henriquez M, Wittmann A, Thacker C, Feinglos M, Crowley MJ, Dunn JP. Engineering digital biomarkers of interstitial glucose from noninvasive smartwatches. NPJ Digit Med 2021; 4:89. [PMID: 34079049 PMCID: PMC8172541 DOI: 10.1038/s41746-021-00465-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/11/2021] [Indexed: 12/14/2022] Open
Abstract
Prediabetes affects one in three people and has a 10% annual conversion rate to type 2 diabetes without lifestyle or medical interventions. Management of glycemic health is essential to prevent progression to type 2 diabetes. However, there is currently no commercially-available and noninvasive method for monitoring glycemic health to aid in self-management of prediabetes. There is a critical need for innovative, practical strategies to improve monitoring and management of glycemic health. In this study, using a dataset of 25,000 simultaneous interstitial glucose and noninvasive wearable smartwatch measurements, we demonstrated the feasibility of using noninvasive and widely accessible methods, including smartwatches and food logs recorded over 10 days, to continuously detect personalized glucose deviations and to predict the exact interstitial glucose value in real time with up to 84% and 87% accuracy, respectively. We also establish methods for designing variables using data-driven and domain-driven methods from noninvasive wearables toward interstitial glucose prediction.
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Affiliation(s)
- Brinnae Bent
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Peter J Cho
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Maria Henriquez
- Department of Statistical Science, Duke University, Durham, NC, USA
| | - April Wittmann
- Division of Endocrinology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Connie Thacker
- Division of Endocrinology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Mark Feinglos
- Division of Endocrinology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Matthew J Crowley
- Division of Endocrinology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Jessilyn P Dunn
- Department of Biomedical Engineering, Duke University, Durham, NC, USA. .,Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.
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Ferris CF. Rethinking the Conditions and Mechanism for Glymphatic Clearance. Front Neurosci 2021; 15:624690. [PMID: 33897347 PMCID: PMC8060639 DOI: 10.3389/fnins.2021.624690] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 03/10/2021] [Indexed: 11/13/2022] Open
Abstract
Critical studies that form the foundation of the glymphatic system and the clearance of metabolic by-products of unwanted proteins from the brain are reviewed. Concerns are raised about studying glymphatic flow in anesthetized animals and making assumptions about the whole brain based upon data collected from a cranial window on the cortex. A new model is proposed arguing that the flow of cerebral spinal fluid and parenchymal clearance in the perivascular system of unwanted proteins is regulated by circadian changes in brain temperature and blood flow at the level of the microvasculature.
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Affiliation(s)
- Craig F Ferris
- Department Psychology and Pharmaceutical Sciences, Center for Translational Neuroimaging, Northeastern University, Boston, MA, United States
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13
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Kunze KN, Rasio J, Clapp I, Nho SJ. Improvements in Sleep Quality Are Maintained at a Minimum of 2 Years Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome. Arthroscopy 2021; 37:873-878. [PMID: 33186697 DOI: 10.1016/j.arthro.2020.10.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 10/31/2020] [Accepted: 10/31/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To present the results of a mid-term follow-up study on sleep quality at a minimum of 2 years after hip arthroscopy for femoroacetabular impingement syndrome. METHODS Original inclusion criteria were consecutive patients undergoing primary hip arthroscopy for cam/pincer correction between March 1, 2017, and July 1, 2017, who did not respond to nonoperative management, whereas exclusion criteria were revision arthroscopy, gluteus medius repair, contralateral procedure during the follow-up period, and known sleep disorders. Patients who had followed up at 6 months were contacted at a minimum of 2 years following their surgery. In total, 37 of 55 (67.3%) were available for follow-up. New Pittsburgh Sleep Quality Index (PSQI) scores were obtained and compared with previously reported scores at preoperative and 6-month time points. The PSQI ranges from 0 to 21, with a score of ≥5 indicating poor sleep quality. Point biserial correlations and χ2 tests of associations were used to investigate associations between demographics, preoperative patient-reported outcome measures, and the incidence of poor sleep quality at 2 years postoperatively. RESULTS Preoperatively, 94.5% of patients (52/55) had a PSQI of ≥5 with a mean PSQI score of 9.8 ± 4.2. Statistically significant improvements were observed at both 6 (PSQI: 2.2 ± 0.2, P < .001) and 24 months (PSQI: 4.3 ± 3.9) postoperatively compared to baseline (P < .001, both). The mean PSQIs at 2 years and 6 months postoperatively were not statistically different (P = .06). A total of 21.7% (10/46) of patients continued to experience poor sleep quality at 6 months postoperatively, whereas a total of 29.7% (11/37) did so at 2 years postoperatively (P = .36). No preoperative factors were associated with poor sleep quality (P > .05 all). CONCLUSIONS The early improvements in sleep quality observed 6 months postoperatively from an original small cohort were maintained at a mean 2.8-year follow-up in those who responded. However, approximately 30% of hip arthroscopy patients still experience poor sleep quality. LEVEL OF EVIDENCE IV, therapeutic case series.
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Affiliation(s)
- Kyle N Kunze
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A..
| | - Jonathan Rasio
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Ian Clapp
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Shane J Nho
- Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, U.S.A
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Alshabibi AS, Suleiman ME, Tapia KA, Heard R, Brennan PC. Impact of Hours Awake and Hours Slept at Night on Radiologists' Mammogram Interpretations. J Am Coll Radiol 2021; 18:730-738. [PMID: 33482116 DOI: 10.1016/j.jacr.2020.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine whether radiologists' mammogram reading performance varies according to how long they have been awake ("hours awake") and the number of hours they slept ("hours slept") the night before a reading session. METHODS Retrospective data were retrieved from the BreastScreen Reader Assessment Strategy database. Malignancy-enriched mammographic readings were performed by 133 radiologists. Information on their hours awake and hours slept was collected. Analysis of covariance was performed to determine whether these two variables influenced radiologists' sensitivity, specificity, lesion sensitivity, receiver operating characteristic (ROC) curve, and jackknife alternative free-response ROC. Radiologists were divided into a more experienced and a less experienced groups (based on reading ≥2,000 and <2,000 mammogram readings per year, respectively). RESULTS The hours awake significantly influenced less experienced radiologists' lesion sensitivity (F6,63 = 2.51; P = .03). Those awake for <2 hours had significantly lower lesion sensitivity than those awake for 8 to 10 hours (P = .01), and those awake for 4 to 6 hours had significantly lower lesion sensitivity than those awake for 8 to 10 hours (P = .002) and 10 to 12 hours (P = .02). The hours slept also influenced the ROC values of less experienced radiologists (F1,68 = 4.96; P = .02). Radiologists with up to 6 hours of sleep had a significantly lower value (0.72) than those who had slept more than 6 hours (0.77). No statistically significant findings were noted for more experienced radiologists. CONCLUSION Inexperienced radiologists' performance may be influenced by the hours awake and hours slept before reading sessions.
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Affiliation(s)
- Abdulaziz S Alshabibi
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Cumberland Campus, Lidcombe, Australia; Department of Radiology and Medical Imaging, College of Applied Medical Sciences of King Saud University, Riyadh, Saudi Arabia.
| | - Mo'ayyad E Suleiman
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Cumberland Campus, Lidcombe, Australia
| | - Kriscia A Tapia
- Australian Council on Healthcare Standards, Ultimo, Australia
| | - Robert Heard
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Cumberland Campus, Lidcombe, Australia
| | - Patrick C Brennan
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, University of Sydney, Cumberland Campus, Lidcombe, Australia
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15
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Naddeo A, Cappetti N. Comfort driven design of innovative products: A personalized mattress case study. Work 2020; 68:S139-S150. [PMID: 33337415 DOI: 10.3233/wor-208013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Human-centred design asks for wellbeing and comfort of the customer/worker when interacting with a product. Having a good perception-model and an objective method to evaluate the experienced (dis)comfort by the product user is needed for performing a preventive comfort evaluation as early as possible in the product development plan. The mattress of a bed is a typical product whose relevance in everyday life of people is under-evaluated. Fortunately, this behaviour is quickly changing, and the customer wants to understand the product he/she buys and asks for more comfortable and for scientifically assessed products. No guidelines for designing a personalized mattress are available in the literature. OBJECTIVES This study deals with the experience of designing an innovative product whose product-development-plan is focused on the customer perceived comfort: a personalized mattress. The research question is: which method can be used to innovate or create a comfort-driven human-centred product? METHODS Virtual prototyping was used to develop a correlated numerical model of the mattress. A comfort model for preventively assessing the perceived comfort was proposed and experimentally tested. Mattress testing sessions with subjects were organized, and collected data were compared with already tested mattresses. Brainstorming and multi-expert methods were used to propose, realize, and test an archetype of a new mattress for final comfort assessment. RESULTS A new reconfigurable mattress was developed, resulting in two patents. The mattress design shows that personalized products can be tuned according to the anthropometric data of the customer in order to improve the comfort experience during sleep. CONCLUSIONS A "comfort-driven design guideline" was proposed; this method has been based on the use of virtual prototyping, virtual optimization and physical prototyping and testing. It allowed to improve an existing product in a better way and to bring innovation in it.
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Astin F, Stephenson J, Wakefield J, Evans B, Rob P, Joanna G, Harris E. Night-time Noise Levels and Patients’ Sleep Experiences in a Medical Assessment Unit in Northern England. Open Nurs J 2020. [DOI: 10.2174/1874434602014010080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Hospital in-patients need sleep so that restorative process and healing can take place. However, over one third of in-patients experience sleep disturbance, often caused by noise. This can compromise patients’ perceptions of care quality and cause physical and psychological ill health.
Aims:
To assess 1) in-patients sleep quality, quantity, reported sources of sleep disturbance and their suggestions for improvement 2) objectively measure decibel levels recorded at night.
Methods:
This descriptive study conducted in a Medical Assessment Unit used multi-methods; a semi-structured ‘sleep experience’ questionnaire administered to a purposive sample of in-patients; recording of night-time noise levels, on 52 consecutive nights, using two calibrated Casella sound level meters.
Results:
Patient ratings of ‘in-hospital’ sleep quantity (3.25; 2.72 SD) and quality (2.91; 2.56 SD) was poorer compared to ‘home’ sleep quantity (5.07; 2.81 SD) and quality (5.52; 2.79 SD). The difference in sleep quality (p<0.001) and quantity (p<0.001) ratings whilst in hospital, compared to at home, was statistically significant. Care processes, noise from other patients and the built environment were common sources of sleep disturbance. Participants’ suggestions for improvement were similar to interventions identified in current research. The constant noise level ranged from 38-57 decibels (equivalent to an office environment), whilst peak levels reached a maximum of 116 decibels, (equivalent to banging a car door one metre away).
Conclusion:
The self-rated patient sleep experience was significantly poorer in hospital, compared to home. Noise at night contributed to sleep disturbance. Decibel levels were equivalent to those reported in other international studies. Data informed the development of a ‘Sleep Smart’ toolkit designed to improve the in-patient sleep experience.
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17
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Fisher AJ, Bosley HG. Identifying the presence and timing of discrete mood states prior to therapy. Behav Res Ther 2020; 128:103596. [DOI: 10.1016/j.brat.2020.103596] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/07/2020] [Accepted: 02/24/2020] [Indexed: 11/29/2022]
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18
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CHANG WP, Yang CM. Influence of sleep-wake cycle on body mass index in female shift-working nurses with sleep quality as mediating variable. INDUSTRIAL HEALTH 2020; 58:161-169. [PMID: 31582591 PMCID: PMC7118058 DOI: 10.2486/indhealth.2019-0066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 09/20/2019] [Indexed: 06/10/2023]
Abstract
This study investigated the relationship between the sleep-wake cycle and body mass index (BMI) of female shift-working nurses and examine the mediating effect of sleep quality on this relationship. We recruited a total of 147 female nurses working monthly rotating shifts at a teaching hospital in Taiwan from the day (n=63), evening (n=50), and night (n=34) shifts. Our research instruments utilized a questionnaire to collect demographic and work-related information, the Pittsburgh Sleep Quality Index (PSQI), and actigraphs to record sleep patterns for seven consecutive days. The sleep-wake cycles were then estimated using the dichotomy index (I<O). The I<O values were negatively associated with both BMI (β=-0.28, p=0.001) and PSQI scores (β=-0.29, p<0.001), the bootstrapping results indicated that the estimate of the indirect effect was -0.28, and the 95% confidence interval ranged from -0.68 to -0.05. For female shift-working nurses, sleep quality mediates the influence of the sleep-wake cycle on BMI, indicating that the maintenance of a regular sleep-wake cycle and good sleep quality could be important for female shift-working nurses.
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Affiliation(s)
- Wen-Pei CHANG
- School of Nursing, College of Nursing, Taipei Medical
University, Taiwan
- Department of Nursing, Shuang Ho Hospital, Taipei Medical
University, Taiwan
| | - Ching-Mei Yang
- Department of Nursing, Shuang Ho Hospital, Taipei Medical
University, Taiwan
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19
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Ye B, Zhu Y, Wang X, Wei S, Liang Y. Association between sleep-wake habits and use of health care services of middle-aged and elderly adults in China. Aging (Albany NY) 2020; 12:3926-3935. [PMID: 32092045 PMCID: PMC7066913 DOI: 10.18632/aging.102860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/04/2020] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To examine the relationship between sleep-wake habits and the use of health care services. RESULTS The proportions of the participants who were "early to bed" and "late to bed" were 48.7% and 51.3%, respectively. In the full sample, compared with those who were early to bed and early to rise, participants who went to bed late were more likely to report physician visits (late to bed and early to rise: OR = 1.13, 95% CI: 1.08-1.19, late to bed and late to rise: OR = 1.27, 95% CI: 1.18-1.38, respectively). We found no significant association between sleep-wake habits and the number of hospitalization. CONCLUSIONS Those middle-aged and elderly people who stayed up late and got up late are more likely to visit the doctors than those who went to bed early and got up early. METHODS We obtained data from a cohort study of retired employees in China, and 36,601 (95.59%) involved in the present study. The participants were allocated into 4 sleep-wake habits groups: Early-bed/Early-rise, Early-bed/Late-rise, Late-bed/Early-rise, and Late-bed/Late-rise. We explored the association between sleep-wake habits with the number of physician visits and hospitalizations.
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Affiliation(s)
- Beizhu Ye
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yimei Zhu
- School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7JA, UK
| | - Xiaoyu Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Sheng Wei
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yuan Liang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
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Stange JP, Kleiman EM, Mermelstein RJ, Trull TJ. Using ambulatory assessment to measure dynamic risk processes in affective disorders. J Affect Disord 2019; 259:325-336. [PMID: 31610996 PMCID: PMC7250154 DOI: 10.1016/j.jad.2019.08.060] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/30/2019] [Accepted: 08/18/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Rapid advances in the capability and affordability of digital technology have begun to allow for the intensive monitoring of psychological and physiological processes associated with affective disorders in daily life. This technology may enable researchers to overcome some limitations of traditional methods for studying risk in affective disorders, which often (implicitly) assume that risk factors are distal and static - that they do not change over time. In contrast, ambulatory assessment (AA) is particularly suited to measure dynamic "real-world" processes and to detect fluctuations in proximal risk for outcomes of interest. METHOD We highlight key questions about proximal and distal risk for affective disorders that AA methods (with multilevel modeling, or fully-idiographic methods) allow researchers to evaluate. RESULTS Key questions include between-subject questions to understand who is at risk (e.g., are people with more affective instability at greater risk than others?) and within-subject questions to understand when risk is most acute among those who are at risk (e.g., does suicidal ideation increase when people show more sympathetic activation than usual?). We discuss practical study design and analytic strategy considerations for evaluating questions of risk in context, and the benefits and limitations of self-reported vs. passively-collected AA. LIMITATIONS Measurements may only be as accurate as the observation period is representative of individuals' usual life contexts. Active measurement techniques are limited by the ability and willingness to self-report. CONCLUSIONS We conclude by discussing how monitoring proximal risk with AA may be leveraged for translation into personalized, real-time interventions to reduce risk.
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Affiliation(s)
- Jonathan P Stange
- University of Illinois at Chicago, Department of Psychiatry, 1601 W Taylor St., Chicago, IL, 60612, USA.
| | - Evan M Kleiman
- Rutgers, The State University of New Jersey, Department of Psychology, Tillett Hall, 53 Avenue E, Piscataway, NJ, 08854, USA
| | - Robin J Mermelstein
- University of Illinois at Chicago, Department of Psychology and Institute for Health Research and Policy, 1747 W Roosevelt Rd., Chicago, IL, 60608, USA
| | - Timothy J Trull
- University of Missouri, Department of Psychological Sciences, 210 McAlester Hall, Columbia, MO, 65211, USA
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21
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Patterson RE, Lochtefeld D, Larson KG, Christensen-Salem A. Computational Modeling of the Effects of Sleep Deprivation on the Vigilance Decrement. HUMAN FACTORS 2019; 61:1099-1111. [PMID: 30908091 DOI: 10.1177/0018720819829949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE We developed a computational model of the effects of sleep deprivation on the vigilance decrement by employing the methods of system dynamics modeling. BACKGROUND Situations that require sustained attention for a prolonged duration can cause a decline in cognitive performance, the so-called vigilance decrement. One factor that should influence the vigilance decrement is fatigue in the form of sleep deprivation. METHOD We employed the methods of system dynamics modeling (numerical-integration techniques for modeling complex feedback systems) to create a computational model of the vigilance decrement. We then simulated the computational effects of sleep deprivation on the behavior of that model, using empirical data obtained from the literature for calibrating such effects. RESULTS Sleep deprivation of 2 hr over a 14-day period should produce an additional decline of 9% in detection performance over that found with the typical vigilance decrement, whereas 4 hr of sleep deprivation over 14 days should produce an additional decline of 14% in detection performance. CONCLUSION With respect to dual-process theory, it is through its deleterious effects on analytical cognition that sleep deprivation should impact the vigilance decrement. APPLICATION Such computational modeling may be advantageous for human-machine teaming by theoretically allowing a future autonomous software agent to anticipate the decline of human performance and compensate accordingly.
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22
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Carissimi A, A. B. Oliveira M, Frey BN, Navarro JF, Hidalgo MP, Adan A. Validation and psychometric properties of the Spanish Mood Rhythm Instrument. BIOL RHYTHM RES 2019. [DOI: 10.1080/09291016.2019.1675023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Alicia Carissimi
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, UFRGS, Porto Alegre, Brasil
| | - Melissa A. B. Oliveira
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, UFRGS, Porto Alegre, Brasil
| | - Benicio N. Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Mood Disorders Program and Women’s Health Concerns Clinic, St. Joseph’s Healthcare, Hamilton, ON, Canada
| | | | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono do Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brasil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, UFRGS, Porto Alegre, Brasil
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
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Feature Extraction and Evaluation for Driver Drowsiness Detection Based on Thermoregulation. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9173555] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Numerous reports state that drowsiness is one of the major factors affecting driving performance and resulting in traffic accidents. In the past, methods to detect driver drowsiness have been developed based on physiological, behavioral, and vehicular features. In this pilot study, we test the use of a new set of features for detecting driver drowsiness based on physiological changes related to thermoregulation. Nineteen participants successfully performed a driving simulation, while the temperature of the nose (Tnose) and wrist (Twrist) as well as the heart rate (HR) were monitored. On average, an initial increase in temperature followed by a gradual decrease was observed in drivers who experienced drowsiness. For non-drowsy drivers, no such trends were observed. In addition, HR decreased on average in both groups, yet the decrease in the drowsy group was more distinct. Next, a classification based on each of these variables resulted in an accuracy of 68.4%, 88.9%, and 70.6% for Tnose, Twrist, and HR, respectively. Combining the information of all variables resulted in an accuracy of 89.5%, meaning that ultimately the state of 17 out of 19 drivers was detected correctly. Hence, we conclude that the use of physiological features related to thermoregulation shows potential for future research in this field.
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Bastos MAV, Oliveira Bastos PRHD, Portella RB, Soares LFG, Conde RB, Rodrigues PMF, Lucchetti G. Pineal gland and schizophrenia: A systematic review and meta-analysis. Psychoneuroendocrinology 2019; 104:100-114. [PMID: 30831343 DOI: 10.1016/j.psyneuen.2019.02.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/17/2019] [Accepted: 02/24/2019] [Indexed: 12/29/2022]
Abstract
Melatonin (MLT), the main hormone of the pineal gland (PG), is assumed to support initiation and maintenance of sleep, and a stable sleep-wake cycle, exerting antioxidative and neuroprotective actions. Evidence demonstrates that sleep and circadian rhythm abnormalities are very common in schizophrenia patients. Some imaging studies suggest structural abnormalities of the PG in these patients as well. We aimed to critically appraise the literature on PG imaging and melatonin secretion in schizophrenia patients, in comparison to matched healthy controls, and to review placebo-controlled trials of add-on exogenous MLT treatment in schizophrenia patients. In this systematic review, twenty-nine studies were included. Meta-analytical evaluation of data was possible only for MLT secretion finding that midnight plasma levels were significantly reduced in individuals with schizophrenia as compared to healthy controls (Hedge`s g = 1.32, p < 0.01). Imaging studies demonstrated greater prevalence of enlarged calcifications (>1 cm) of the PG (2 out of 2 computed tomography studies) and smaller PG volume (2 out of 3 magnetic resonance studies) compared with healthy controls. Anatomic and functional abnormalities of the PG were not associated with duration of illness or with treatment factors, maybe suggesting them to be primary characteristics of the disease and genetically based. Add-on MLT treatment leads to a modest improvement of objective and subjective sleep quality, of metabolic adverse effects of antipsychotics, and of tardive dyskinesia symptoms in schizophrenia patients. It remains to be established whether MLT treatment in prodromal phases of the disease could prevent neurostructural abnormalities.
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Affiliation(s)
- Marco Aurélio Vinhosa Bastos
- Federal University of Mato Grosso do Sul, Postgraduate Program in Health and Development, Av. Senador Filinto Muller, s/n - Cidade Universitária, Campo Grande, MS, 79070-900, Brazil.
| | - Paulo Roberto Haidamus de Oliveira Bastos
- Federal University of Mato Grosso do Sul, Postgraduate Program in Health and Development, Av. Senador Filinto Muller, s/n - Cidade Universitária, Campo Grande, MS, 79070-900, Brazil
| | - Renata Boschi Portella
- Federal University of Mato Grosso do Sul, Faculty of Medicine, Av. Senador Filinto Muller, s/n - Cidade Universitária, Campo Grande, MS, 79070-900, Brazil
| | - Leonardo Fabrício Gomes Soares
- Federal University of Mato Grosso do Sul, Postgraduate Program in Health and Development, Av. Senador Filinto Muller, s/n - Cidade Universitária, Campo Grande, MS, 79070-900, Brazil
| | - Ricardo Brilhante Conde
- Proexames Imaging Clinic, Av. Mato Grosso, 1772 - Centro, Campo Grande, MS, 79020-201, Brazil
| | | | - Giancarlo Lucchetti
- Federal University of Juiz de Fora, School of Medicine, Av. Eugênio do Nascimento, s/n - Dom Bosco, Juiz de Fora, MG, 36036-330, Brazil
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Spruyt K, Herbillon V, Putois B, Franco P, Lachaux JP. Mind-wandering, or the allocation of attentional resources, is sleep-driven across childhood. Sci Rep 2019; 9:1269. [PMID: 30718835 PMCID: PMC6362223 DOI: 10.1038/s41598-018-37434-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 11/22/2018] [Indexed: 11/09/2022] Open
Abstract
Mind-wandering or the spontaneous, uncontrolled changes in the allocation of attention resources (lapses) may cause variability in performance. In childhood, the relationship between the activation state of the brain, such as in attentional performance, and sleep has not been explored in detail. We investigated the role of sleep in attentional performance, and explored the most important parameters of their relationship. We objectively measured momentary lapses of attention of 522 children and correlated them with sleep schedules. In the subgroup of young children (age 7.1 ± 0.6 years; 60.8% girls), increasing age, long sleep duration and assessment closer to the previous night’s sleep period was associated with impaired performance speed and consistency. From pre-adolescence (age 9.4 ± 0.8 years; 50.5% girls) onwards somno-typologies may develop. As a result, in adolescence (age 13.4 ± 1.2 years; 51.3% girls) not only sleep duration but also sleep midpoint and sleep regularity influence the individual speed and stability of attention. Across development, regularity of sleep, individual sleep midpoint and bedtime become increasingly important for optimal performance throughout the day. Attentional performance and sleep shared almost half of their variance, and performance was sleep-driven across childhood. Future studies should focus on intra- and inter-individual differences in sleep-wake behavior to improve performance or decrease mind-wandering in youth by targeting sleep habits.
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Affiliation(s)
- Karen Spruyt
- Lyon Neuroscience Research Center, INSERM U1028-CNRS UMR 5292 - Waking Team, University Claude Bernard, School of Medicine, Lyon, France.
| | - Vania Herbillon
- Epilepsy, Sleep and Pediatric Neurophysiology Department, University Hospitals of Lyon, Lyon, France
| | - Benjamin Putois
- Epilepsy, Sleep and Pediatric Neurophysiology Department, University Hospitals of Lyon, Lyon, France
| | - Patricia Franco
- Lyon Neuroscience Research Center, INSERM U1028-CNRS UMR 5292 - Waking Team, University Claude Bernard, School of Medicine, Lyon, France.,Epilepsy, Sleep and Pediatric Neurophysiology Department, University Hospitals of Lyon, Lyon, France
| | - Jean-Philippe Lachaux
- Lyon Neuroscience Research Center, INSERM U1028-CNRS5292 - Brain Dynamics and Cognition Team, University Claude Bernard, School of Medicine, Lyon, France
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Sleep improves memory for the content but not execution of intentions in adolescents. Sleep Med 2019; 56:111-116. [PMID: 30852129 DOI: 10.1016/j.sleep.2018.12.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/07/2018] [Accepted: 12/08/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Sleep benefits prospective memory in young adults probably in part due to its well-established role in enhancing declarative memory, thereby facilitating retrieval of the intention content. In prior work on adolescents, we did not detect differences in prospective memory comparing five nights of sleep restriction and adequate sleep. Here, we examined whether this might be attributed to a limited role of sleep in benefiting the declarative content in this age group, and whether a sleep benefit on prospective memory would be uncovered with a shorter retention interval. METHODS A total of 59 adolescents (mean ± standard deviation: 16.55 ± 0.94 years) were instructed to remember to press a special key in response to two target words embedded in a semantic categorization task. Memory was tested after a 12-h retention interval, which included either overnight sleep (21:00-09:00, n = 29) or daytime wakefulness (09:00-21:00, n = 30). RESULTS We found no significant group difference in the percentage of target words correctly responded to (mean ± standard error of the mean for the sleep group: 32.76 ± 6.69%; wake group: 41.67 ± 7.61%, t = 0.88, p = 0.38). However, participants who slept recalled more target words compared to those who stayed awake (98.28 ± 1.72% vs. 86.67 ± 5.32%, t = 2.05, p < 0.05). In addition, a significantly greater proportion of sleep participants (n = 28 of 29) compared to wake participants (n = 24 of 30) recalled both target words correctly (χ2 = 3.76, p < 0.05). CONCLUSION These findings suggest that during adolescence, sleep plays a more prominent role in improving memory for the content as compared to the execution of intentions.
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Lin LN, Chang LY, Hurng BS, Wu CC, Yen LL, Chang HY. Sex differences in sleep patterns and changes in 7th to 12th graders: a longitudinal follow-up study in Taiwan. Sleep 2019; 41:4772915. [PMID: 29309703 DOI: 10.1093/sleep/zsx211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 07/15/2017] [Indexed: 11/13/2022] Open
Abstract
Study Objectives To assess the relationship between sex and the development of sleep patterns in adolescents from grade 7 to 12. Methods We analyzed longitudinal data from annual school-based assessments of sleep habits among secondary school students in northern Taiwan. Measures of sleep patterns included sleep length on weekdays and weekends as well as weekend-weekday difference (WndD), defined as the discrepancy in the time in bed (TIB) between weekdays and weekends. Growth curve models were used to assess sex differences in sleep patterns. Associations between other covariates and sleep patterns were also explored. Results We found shorter weekday TIB in girls compared with boys at all time points. In contrast, girls had longer weekend TIB than boys over time except in the 12th grade. WndD was also longer in girls than boys. All interaction terms between sex and time were insignificant, indicating that developmental change across time was not statistically different for boys and girls. Several other factors, namely, parental education, pubertal development, self-perceived health, weight status, depressive symptoms, academic stress, infrequent exercise, and substance use, were also found to be associated with sleep patterns. Conclusions Our findings show a sex difference in TIB both on weekdays and weekends. No sex difference was found in the development of sleep patterns over time.
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Affiliation(s)
- Linen Nymphas Lin
- Department of Psychiatry, En Chu Kong Hospital, New Taipei City, Taiwan.,Department of Psychology, Chung Yuan Christian University, Taoyuan City, Taiwan.,Department of Nursing, Yuanpei University of Medical Technology, Hsinchu City, Taiwan.,Center for General Education, National Taipei University, New Taipei City, Taiwan
| | - Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Baai-Shyun Hurng
- Department of Public Health, Chung Shan Medical University, Taichung City, Taiwan
| | - Chi-Chen Wu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan
| | - Lee-Lan Yen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan.,Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan.,Institute of Public Health, National Yangming University, Taipei City, Taiwan
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Roles of tau pathology in the locus coeruleus (LC) in age-associated pathophysiology and Alzheimer’s disease pathogenesis: Potential strategies to protect the LC against aging. Brain Res 2019; 1702:17-28. [DOI: 10.1016/j.brainres.2017.12.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 11/21/2017] [Accepted: 12/19/2017] [Indexed: 12/11/2022]
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Abstract
Human circadian rhythmicity is driven by a circadian clock comprised of two distinct components: the central clock, located in the suprachiasmatic nucleus (SCN) within the hypothalamus, and the peripheral clocks, located in almost all tissues and organ systems in the body. Entrainment, or alignment, of circadian rhythmicity is dependent upon time of day and can occur through environmental influences such as light cues and physical activity exerted on skeletal muscle. Entrainment of the circadian clock through exercise has been reported to improve health by reducing risk of conditions such as cardiovascular disease (CVD), but further research is still needed. The purpose of this review is to discuss the effects exercise has on the regulation of circadian rhythmicity, specifically with respect to CVD risk factors – including hormonal levels, sleep/wake cycles, blood pressure, and heart rate. Additionally, the impact of exercise-induced circadian entrainment is discussed relative to hormone regulation, nocturnal blood pressure dipping, post-exercise hypotension, and overall cardiovascular health.
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30
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Komarzynski S, Huang Q, Innominato PF, Maurice M, Arbaud A, Beau J, Bouchahda M, Ulusakarya A, Beaumatin N, Breda G, Finkenstädt B, Lévi F. Relevance of a Mobile Internet Platform for Capturing Inter- and Intrasubject Variabilities in Circadian Coordination During Daily Routine: Pilot Study. J Med Internet Res 2018; 20:e204. [PMID: 29704408 PMCID: PMC6018238 DOI: 10.2196/jmir.9779] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/06/2018] [Accepted: 03/07/2018] [Indexed: 12/14/2022] Open
Abstract
Background Experimental and epidemiologic studies have shown that circadian clocks’ disruption can play an important role in the development of cancer and metabolic diseases. The cellular clocks outside the brain are effectively coordinated by the body temperature rhythm. We hypothesized that concurrent measurements of body temperature and rest-activity rhythms would assess circadian clocks coordination in individual patients, thus enabling the integration of biological rhythms into precision medicine. Objective The objective was to evaluate the circadian clocks’ coordination in healthy subjects and patients through simultaneous measurements of rest-activity and body temperature rhythms. Methods Noninvasive real-time measurements of rest-activity and chest temperature rhythms were recorded during the subject’s daily life, using a dedicated new mobile electronic health platform (PiCADo). It involved a chest sensor that jointly measured accelerations, 3D orientation, and skin surface temperature every 1-5 min and relayed them out to a mobile gateway via Bluetooth Low Energy. The gateway tele-transmitted all stored data to a server via General Packet Radio Service every 24 hours. The technical capabilities of PiCADo were validated in 55 healthy subjects and 12 cancer patients, whose rhythms were e-monitored during their daily routine for 3-30 days. Spectral analyses enabled to compute rhythm parameters values, with their 90% confidence limits, and their dynamics in each subject. Results All the individuals displayed a dominant circadian rhythm in activity with maxima occurring from 12:09 to 20:25. This was not the case for the dominant temperature period, which clustered around 24 hours for 51 out of 67 subjects (76%), and around 12 hours for 13 others (19%). Statistically significant sex- and age-related differences in circadian coordination were identified in the noncancerous subjects, based upon the range of variations in temperature rhythm amplitudes, maxima (acrophases), and phase relations with rest-activity. The circadian acrophase of chest temperature was located at night for the majority of people, but it occurred at daytime for 26% (14/55) of the noncancerous people and 33% (4/12) of the cancer patients, thus supporting important intersubject differences in circadian coordination. Sex, age, and cancer significantly impacted the circadian coordination of both rhythms, based on their phase relationships. Conclusions Complementing rest-activity with chest temperature circadian e-monitoring revealed striking intersubject differences regarding human circadian clocks’ coordination and timing during daily routine. To further delineate the clinical importance of such finding, the PiCADo platform is currently applied for both the assessment of health effects resulting from atypical work schedules and the identification of the key determinants of circadian disruption in cancer patients.
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Affiliation(s)
- Sandra Komarzynski
- Cancer Chronotherapy Team, School of Medicine, University of Warwick, Coventry, United Kingdom.,European Associated Laboratory of the Unité Mixte de Recherche Scientifique 935, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
| | - Qi Huang
- Cancer Chronotherapy Team, School of Medicine, University of Warwick, Coventry, United Kingdom.,Cancer Chronotherapy Team, Department of Statistics, University of Warwick, Coventry, United Kingdom
| | - Pasquale F Innominato
- Cancer Chronotherapy Team, School of Medicine, University of Warwick, Coventry, United Kingdom.,European Associated Laboratory of the Unité Mixte de Recherche Scientifique 935, Institut National de la Santé et de la Recherche Médicale, Villejuif, France.,Department of Oncology, North Wales Cancer Treatment Centre, Bodelwyddan, United Kingdom
| | - Monique Maurice
- Cancer Chronotherapy Team, School of Medicine, University of Warwick, Coventry, United Kingdom.,European Associated Laboratory of the Unité Mixte de Recherche Scientifique 935, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
| | - Alexandre Arbaud
- European Associated Laboratory of the Unité Mixte de Recherche Scientifique 935, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
| | - Jacques Beau
- European Associated Laboratory of the Unité Mixte de Recherche Scientifique 935, Institut National de la Santé et de la Recherche Médicale, Villejuif, France
| | - Mohamed Bouchahda
- European Associated Laboratory of the Unité Mixte de Recherche Scientifique 935, Institut National de la Santé et de la Recherche Médicale, Villejuif, France.,Department of Oncology, Paul Brousse Hospital, Assistance Publique-Hôpitaux de Paris, Villejuif, France
| | - Ayhan Ulusakarya
- European Associated Laboratory of the Unité Mixte de Recherche Scientifique 935, Institut National de la Santé et de la Recherche Médicale, Villejuif, France.,Department of Oncology, Paul Brousse Hospital, Assistance Publique-Hôpitaux de Paris, Villejuif, France
| | | | | | - Bärbel Finkenstädt
- European Associated Laboratory of the Unité Mixte de Recherche Scientifique 935, Institut National de la Santé et de la Recherche Médicale, Villejuif, France.,Cancer Chronotherapy Team, Department of Statistics, University of Warwick, Coventry, United Kingdom
| | - Francis Lévi
- Cancer Chronotherapy Team, School of Medicine, University of Warwick, Coventry, United Kingdom.,European Associated Laboratory of the Unité Mixte de Recherche Scientifique 935, Institut National de la Santé et de la Recherche Médicale, Villejuif, France.,Department of Oncology, Paul Brousse Hospital, Assistance Publique-Hôpitaux de Paris, Villejuif, France
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McCabe SM, Elliott C, Langdon K, Abbiss CR. Patterns and reliability of children's skin temperature prior to and during sleep in the home setting. Physiol Behav 2018; 194:292-301. [PMID: 29885918 DOI: 10.1016/j.physbeh.2018.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/05/2018] [Accepted: 06/06/2018] [Indexed: 01/13/2023]
Abstract
The relationship between patterns of change in skin temperature and sleep is well recognized. In particular, there is a rapid rise in distal skin temperature (Tdistal) and slower rise in proximal skin temperature (Tproximal) prior to sleep onset. The difference between Tdistal and Tproximal is known as the distal-proximal gradient (DPG). Rise in DPG is known as a measure of distal vasodilation, which contributes to the drop in core body temperature (Tcore) that is important to sleep onset and maintenance. Patterns of change in skin temperature before and during sleep are reported for neonates, infants, adults and elderly, however they are not known for school aged children. Therefore, the current observational study aimed to determine the patterns and reliability of skin temperatures (Tskin) and DPG in relation to sleep of school aged children in their home settings. Participants (22 children, aged 6-12) completed the Children's Sleep Habits Questionnaire and used Thermochron iButtons and actigraphy for four school nights in their typical sleep settings. There were evident patterns of Tskin change before and during sleep. In particular, Tdistal was lower but rose more rapidly than Tproximal after reported bedtime and prior to sleep onset. This reflected a timely rise in DPG, and shows that distal vasodilation precedes sleep onset in school aged children. The measures of Tskin and sleep were practical for children in their home settings, and the observed patterns were consistent across consecutive school nights. Environmental and behavioural strategies that manage skin temperature before and during sleep should be explored for their potential as valuable components of treatment of childhood insomnia.
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Affiliation(s)
- Susan M McCabe
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
| | - Catherine Elliott
- School of Occupational Therapy and Social Work, Curtin University, Bentley, Australia
| | - Katherine Langdon
- Department of Paediatric Rehabilitation, Princess Margaret Hospital, Subiaco, Australia
| | - Chris R Abbiss
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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Ko Y, Lee JY. Effects of feet warming using bed socks on sleep quality and thermoregulatory responses in a cool environment. J Physiol Anthropol 2018; 37:13. [PMID: 29699592 PMCID: PMC5921564 DOI: 10.1186/s40101-018-0172-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/09/2018] [Indexed: 11/24/2022] Open
Abstract
Background As a way of helping to sleep in winter, methods of warming the feet through footbaths or heating pads before bedtime are tried. In particular, bed socks are popular during winter sleeping in Korea, but scientific evidence about the physiological effects of bed socks on sleep quality is rarely reported. The purpose of this study was to evaluate the effect of feet warming using bed socks on sleep quality and thermoregulatory responses during sleep in a cool environment. Methods Six young males (22.7 ± 2.0 years in age, 175.6 ± 3.5 cm in height, and 73.1 ± 8.5 kg in body weight) participated in two experimental conditions (with and without feet warming) in a random order. The following variables on sleep quality using a wrist actigraphy were measured during a 7-h sleep at an air temperature of 23 °C with 50% RH: sleep-onset latency, sleep efficiency, total sleep time, number of awakenings, wake after sleep onset, average awakening length, movement index, and fragmentation index. Heart rate and rectal and skin temperatures were monitored during the 7-h sleep. Questionnaire on sleep quality was obtained after awakening in the morning. Results The results showed that sleep-onset latency was on average 7.5 min shorter, total sleep time was 32 min longer, the number of awakenings was 7.5 times smaller, and sleep efficiency was 7.6% higher for those wearing feet-warming bed socks during a 7-h sleep than control (no bed socks) (all P < 0.05). Also, their foot temperature was maintained on average 1.3 °C higher and the value in the distal-proximal skin temperature gradient was higher for those wearing feet warming bed socks when compared to the control condition (P < 0.05). However, there were no significant differences in heart rate, rectal and mean skin temperature, or in the questionnaire-based subjective evaluations between the two conditions. Conclusions Feet warming using bed socks during sleep in a cool environment had positive effects on sleep quality by shortened sleep onset, lengthened sleep time, and lessened awakenings during sleep but had no significant influence on core body temperature. These results imply that sleep quality could be improved by manipulation of the foot temperature throughout sleeping.
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Affiliation(s)
- Yelin Ko
- College of Human Ecology, Seoul National University, Seoul, South Korea
| | - Joo-Young Lee
- College of Human Ecology, Seoul National University, Seoul, South Korea. .,Research Institute of Human Ecology, Seoul National University, Seoul, South Korea. .,COM:FORT Laboratory, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea.
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33
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Costa CMA, Moreira DG, Sillero-Quintana M, Brito CJ, de Azambuja Pussieldi G, de Andrade Fernandes A, Cano SP, Bouzas Marins JC. Daily rhythm of skin temperature of women evaluated by infrared thermal imaging. J Therm Biol 2018; 72:1-9. [DOI: 10.1016/j.jtherbio.2017.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 01/05/2023]
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Herring WJ, Connor KM, Snyder E, Snavely DB, Zhang Y, Hutzelmann J, Matzura-Wolfe D, Benca RM, Krystal AD, Walsh JK, Lines C, Roth T, Michelson D. Suvorexant in Elderly Patients with Insomnia: Pooled Analyses of Data from Phase III Randomized Controlled Clinical Trials. Am J Geriatr Psychiatry 2017; 25:791-802. [PMID: 28427826 DOI: 10.1016/j.jagp.2017.03.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 03/06/2017] [Accepted: 03/06/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Suvorexant is an orexin receptor antagonist approved for treating insomnia at doses of 10-20 mg. Previously reported phase III results showed that suvorexant was effective and well-tolerated in a combined-age population (elderly and nonelderly adults). The present analysis evaluated the clinical profile of suvorexant specifically in the elderly. METHODS Prespecified subgroup analyses of pooled 3-month data from two (efficacy) and three (safety) randomized, double-blind, placebo-controlled, parallel-group trials. In each trial, elderly (≥65 years) patients with insomnia were randomized to suvorexant 30 mg, suvorexant 15 mg, and placebo. By design, fewer patients were randomized to 15 mg. Patient-reported and polysomnographic (subset of patients) sleep maintenance and onset endpoints were measured. RESULTS Suvorexant 30 mg (N = 319) was effective compared with placebo (N = 318) on patient-reported and polysomnographic sleep maintenance, and onset endpoints at Night 1 (polysomnographic endpoints)/Week 1 (patient-reported endpoints), Month 1, and Month 3. Suvorexant 15 mg (N = 202 treated) was also effective across these measures, although the onset effect was less evident at later time points. The percentages of patients discontinuing because of adverse events over 3 months were 6.4% for 30 mg (N = 627 treated), 3.5% for 15 mg (N = 202 treated), and 5.5% for placebo (N = 469 treated). Somnolence was the most common adverse event (8.8% for 30 mg, 5.4% for 15 mg, 3.2% for placebo). CONCLUSION Suvorexant generally improved sleep maintenance and onset over 3 months of nightly treatment and was well-tolerated in elderly patients with insomnia (clinicaltrials.gov; NCT01097616, NCT01097629, NCT01021813).
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Affiliation(s)
| | | | | | | | | | | | | | - Ruth M Benca
- Department of Psychiatry and Human Behavior, School of Medicine, University of California-Irvine, Irvine, CA
| | - Andrew D Krystal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - James K Walsh
- Sleep Medicine and Research Center, St. Luke's Hospital, St. Louis, MO
| | | | - Thomas Roth
- Henry Ford Hospital Sleep Center, Detroit, MI
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Steinberg JD, Vogel W, Vegt E. Factors influencing brown fat activation in FDG PET/CT: a retrospective analysis of 15,000+ cases. Br J Radiol 2017; 90:20170093. [PMID: 28590773 DOI: 10.1259/bjr.20170093] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Brown fat can exhibit high uptake of fluorine-18 fludeoxyglucose (18F-FDG) on positron emission tomography (PET) and interferes with interpretation of the scan. The goal of this study was to identify factors that may influence brown adipose tissue (BAT) activation. METHODS A retrospective study of 18F-FDG PET scans was performed using a database of 15,109 PET/CT reports. BAT activation reported by nuclear medicine physicians and factors influencing BAT activation were gathered. The data were analyzed using in-house software. RESULTS The total reported BAT activation was 3.6%. BAT activation was reported significantly more often in patients who were female (p < 0.0001), younger (p < 0.0001), with lower body mass index (p < 0.0001), with lower blood glucose levels (p = 0.01), indicated for breast cancer (p = 0.004), not administered chemotherapy recently before the scan (p < 0.0001) and shown to have BAT activation in a previous scan (p < 0.0001). BAT activation was also reported significantly more for lower outdoor temperatures (p < 0.0001) and for late morning scans than for afternoon (p = 0.005) and early morning (p = 0.001) scans. CONCLUSION This retrospective study of 15,109 scans highlights multiple factors contributing to BAT activation on 18F-FDG PET. The identification of new factors influencing BAT and confirmation of previously identified factors with a larger data set can be used to more accurately identify patients at risk for BAT activation so that prevention strategies can be implemented. Advances in knowledge: This study presents new factors associated with higher incidence of BAT activation, such as time of day, previous BAT activation and breast cancer. Conversely, recent chemotherapy was associated with reduced incidence of BAT activation.
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Affiliation(s)
- Jeffrey D Steinberg
- 1 Mouse Clinic for Cancer and Aging (MCCA) Imaging Unit, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Wouter Vogel
- 2 Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Erik Vegt
- 2 Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, Netherlands
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Radcliff Z, Baylor A, Rybarczyk B. Adopted youth and sleep difficulties. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2016; 7:165-175. [PMID: 29388635 PMCID: PMC5683292 DOI: 10.2147/phmt.s119958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Sleep is a critical component of healthy development for youth, with cascading effects on youth’s biological growth, psychological well-being, and overall functioning. Increased sleep difficulties are one of many disruptions that adopted youth may face throughout the adoption process. Sleep difficulties have been frequently cited as a major concern by adoptive parents and hypothesized in the literature as a problem that may affect multiple areas of development and functioning in adopted youth. However, there is limited research exploring this relationship. Using a biopsychosocial framework, this paper reviews the extant literature to explore the development, maintenance, and impact of sleep difficulties in adopted youth. Finally, implications for future research and clinical interventions are outlined.
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Affiliation(s)
- Zach Radcliff
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Allison Baylor
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Bruce Rybarczyk
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Low-dose Dexmedetomidine Improves Sleep Quality Pattern in Elderly Patients after Noncardiac Surgery in the Intensive Care Unit. Anesthesiology 2016; 125:979-991. [DOI: 10.1097/aln.0000000000001325] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Abstract
Background
Patients admitted to the intensive care unit (ICU) after surgery often develop sleep disturbances. The authors tested the hypothesis that low-dose dexmedetomidine infusion could improve sleep architecture in nonmechanically ventilated elderly patients in the ICU after surgery.
Methods
This was a pilot, randomized controlled trial. Seventy-six patients age 65 yr or older who were admitted to the ICU after noncardiac surgery and did not require mechanical ventilation were randomized to receive dexmedetomidine (continuous infusion at a rate of 0.1 μg kg−1 h−1; n = 38) or placebo (n = 38) for 15 h, i.e., from 5:00 pm on the day of surgery until 8:00 am on the first day after surgery. Polysomnogram was monitored during the period of study-drug infusion. The primary endpoint was the percentage of stage 2 non–rapid eye movement (stage N2) sleep.
Results
Complete polysomnogram recordings were obtained in 61 patients (30 in the placebo group and 31 in the dexmedetomidine group). Dexmedetomidine infusion increased the percentage of stage N2 sleep from median 15.8% (interquartile range, 1.3 to 62.8) with placebo to 43.5% (16.6 to 80.2) with dexmedetomidine (difference, 14.7%; 95% CI, 0.0 to 31.9; P = 0.048); it also prolonged the total sleep time, decreased the percentage of stage N1 sleep, increased the sleep efficiency, and improved the subjective sleep quality. Dexmedetomidine increased the incidence of hypotension without significant intervention.
Conclusions
In nonmechanically ventilated elderly patients who were admitted to the ICU after noncardiac surgery, the prophylactic low-dose dexmedetomidine infusion may improve overall sleep quality.
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Langsrud K, Vaaler AE, Kallestad H, Morken G. Sleep patterns as a predictor for length of stay in a psychiatric intensive care unit. Psychiatry Res 2016; 237:252-6. [PMID: 26805566 DOI: 10.1016/j.psychres.2016.01.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 11/13/2015] [Accepted: 01/15/2016] [Indexed: 11/28/2022]
Abstract
Systematic evaluations of the relationship between sleep patterns and length of stay in psychiatric intensive care units (PICUs) are lacking. The aims of the present study were to explore if sleep duration or night-to-night variations in sleep duration the first nights predict length of stay in a PICU. Consecutive patients admitted to a PICU were included (N=135) and the nurses registered the time patients were observed sleeping. In the three first nights, the mean sleep duration was 7.5 (±3.2)h. Sleep duration the first night correlated negatively with the length of stay for patients with schizophrenia. The mean difference in sleep duration from night one to night two were 3.3 (±3.0)h and correlated with length of stay for the whole group of patients, but especially for patients with schizophrenia. Patients of all diagnostic groups admitted to a PICU had pronounced intra-individual night-to-night variations in sleep duration. Stabilizing night-to-night variations of sleep duration might be a major goal in treatment.
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Affiliation(s)
- Knut Langsrud
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Arne E Vaaler
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Håvard Kallestad
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunnar Morken
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Kara B, Tenekeci EG. Sleep Quality and Associated Factors in Older Turkish Adults With Hypertension: A Pilot Study. J Transcult Nurs 2015; 28:296-305. [PMID: 26711885 DOI: 10.1177/1043659615623330] [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] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate sleep quality and to explore its associations with participant characteristics, anemia, excessive daytime sleepiness, and physical activity in older Turkish adults with hypertension. METHOD This cross-sectional study included 128 adults aged 60 years or older with hypertension. Data were collected by using a personal information form, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the International Physical Activity Questionnaire. Anemia was assessed by hemoglobin levels. RESULTS Eighty-one patients (63.3%) reported poor sleep quality. Anemia was present in 35.2% of the patients (defined as hemoglobin <13 g/dL for males and <12 g/dL for females). Female gender, the presence of anemia, and low levels of physical activity were associated with poor sleep quality. Conclusion/Implication: The majority of the participants had poor sleep quality. Better understanding of risk factors associated with poor sleep quality may contribute to more effective interventions to improve health and well-being.
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Abstract
BACKGROUND A substantial part of elderly persons with dementia show rest-activity rhythm disturbances. The rest-activity rhythm is important to study in people with early-onset dementia (EOD) for rest-activity rhythm disturbances are predictive of institutionalization, and caregivers of young patients suffer from high distress. OBJECTIVE The aim of this study was to study (1) whether EOD patients have more rest-activity rhythm disturbances compared with cognitively intact adults; and (2) which factors contribute to a disturbed rhythm. METHODS We included 61 patients with EOD [mean age 61.9 (4.9) y, 41 (67%) men] and 68 cognitively intact adults [mean age 61.6 (4.5) y, 28 (41%) men]. Rest-activity rhythm was assessed by actigraphy. RESULTS EOD patients tended to have higher intradaily variability [0.46 (0.16) and 0.39 (0.10), P=0.03]. EOD patients also lay for a longer time in bed [time in bed: 08:49 (0:51) h and 08:07 (0:47) h, P<0.001] and needed more time to fall asleep [sleep onset latency: 23 (22) min and 15 (15) min, P=0.02]. Disturbances in the rest-activity rhythm were predicted by a low level of physical activity, use of antidepressants and central nervous system neurological medications, and being male. CONCLUSIONS EOD patients showed more variability in the rest-activity rhythm compared with cognitively intact adults. The main predictor for rest-activity rhythm disturbances was a low level of physical activity.
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Alley JR, Mazzochi JW, Smith CJ, Morris DM, Collier SR. Effects of resistance exercise timing on sleep architecture and nocturnal blood pressure. J Strength Cond Res 2015; 29:1378-85. [PMID: 25426516 DOI: 10.1519/jsc.0000000000000750] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Short sleep duration and poor quality of sleep have been associated with health risks including cardiovascular disease, diabetes, and obesity. Prior research has suggested that regular aerobic exercise improves the quality of sleep; however, less is known regarding resistance exercise (RE) and how RE may affect sleep architecture. The purpose of this study was to investigate the acute effects of timing of RE on sleep architecture and nocturnal blood pressure. College-aged subjects engaged in 5 laboratory visits. Visits 1 (C) and 2 provided a non-RE control day and established the 10-repetition maximum on each of 9 RE machines, respectively. During visits 3-5, the subjects reported at 0700 hours (7A), 1300 hours (1P), and 1900 hours (7P) in a randomized order to perform 30 minutes of RE. Ambulatory blood pressure and sleep-monitoring devices were worn during sleep after C, 7A, 1P, and 7P. Time to fall asleep was significantly different between RE conditions 7A and 1P and between 7A and 7P. All exercise conditions exhibited significantly fewer times woken than the non-RE control day, with 7P resulting in significantly less time awake after initially falling asleep as compared with C. Although timing of RE does not seem to statistically impact sleep stages or nocturnal blood pressure, these data indicate that engaging in RE at any time of the day may improve quality of sleep as compared with no RE. Resistance exercise may offer additional benefits regarding the ability to fall asleep and stay asleep to populations with osteoporosis, sarcopenia, anxiety, or depression.
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Affiliation(s)
- Jessica R Alley
- Vascular Biology and Autonomic Studies Laboratory, Department of Health and Exercise Science, Appalachian State University, Boone, North Carolina
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Batinga H, Martinez-Nicolas A, Zornoza-Moreno M, Sánchez-Solis M, Larqué E, Mondéjar MT, Moreno-Casbas M, García FJ, Campos M, Rol MA, Madrid JA. Ontogeny and aging of the distal skin temperature rhythm in humans. AGE (DORDRECHT, NETHERLANDS) 2015; 37:29. [PMID: 25813804 PMCID: PMC4375132 DOI: 10.1007/s11357-015-9768-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 03/16/2015] [Indexed: 05/29/2023]
Abstract
In circadian terms, human ontogeny is characterized by the emergence of a daily pattern, from a previous ultradian pattern, for most variables during the first 6 months of life. Circadian aging in humans is characterized by a phase advance, accompanied by rhythm fragmentation and flattening. Despite an expanding body of literature focused on distal skin temperature, little information is available about the ontogeny and practically nothing about age-related changes in this rhythm. Thus, the aim was to evaluate the degree of maturation and aging of the circadian pattern of distal skin temperature to identify those parameters that are modified throughout life and could be used to differentiate subjects according to their age. For this, distal skin temperature was measured in 197 volunteers (55 % women), including babies aged 15 days (30 subjects), 1 month (28 subjects), 3 months (31 subjects), and 6 months (10 subjects); young adults aged 19 years (37 subjects); middle-aged persons aged 46 years (27 subjects); older people aged 72 (34 subjects). Circadian system maturation was associated with an increase in amplitude and a reduction in skin temperature during sleep. During adulthood, women showed a more robust pattern (lower fragmentation, and higher night-time temperature, amplitude, circadian function index, and first harmonic relative power); however, these differences were lost with aging, a period of life that was consistently associated with a phase advance of the rhythm. In summary, distal skin temperature pattern can be used as a robust variable to discern between different ages throughout the life.
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Affiliation(s)
- H. Batinga
- Chronobiology Laboratory, Department of Physiology, College of Biology, University of Murcia, IMIB-Arrixaca, Murcia, 30100 Spain
| | - A. Martinez-Nicolas
- Chronobiology Laboratory, Department of Physiology, College of Biology, University of Murcia, IMIB-Arrixaca, Murcia, 30100 Spain
| | - M. Zornoza-Moreno
- Department of Pediatrics, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - M. Sánchez-Solis
- Department of Pediatrics, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | - E. Larqué
- Chronobiology Laboratory, Department of Physiology, College of Biology, University of Murcia, IMIB-Arrixaca, Murcia, 30100 Spain
| | - M. T. Mondéjar
- Chronobiology Laboratory, Department of Physiology, College of Biology, University of Murcia, IMIB-Arrixaca, Murcia, 30100 Spain
| | - M. Moreno-Casbas
- Nursing and Healthcare Research Unit (Investén-isciii), Murcia, Spain
| | - F. J. García
- Geriatrics Section, Hospital Virgen del Valle, Toledo, Spain
| | - M. Campos
- Department of Computer Science and Systems, University of Murcia, IMIB-Arrixaca, Murcia, 30100 Spain
| | - M. A. Rol
- Chronobiology Laboratory, Department of Physiology, College of Biology, University of Murcia, IMIB-Arrixaca, Murcia, 30100 Spain
| | - J. A. Madrid
- Chronobiology Laboratory, Department of Physiology, College of Biology, University of Murcia, IMIB-Arrixaca, Murcia, 30100 Spain
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Camargo-Sanchez A, Niño CL, Sánchez L, Echeverri S, Gutiérrez DP, Duque AF, Pianeta O, Jaramillo-Gómez JA, Pilonieta MA, Cataño N, Arboleda H, Agostino PV, Alvarez-Baron CP, Vargas R. Theory of Inpatient Circadian Care (TICC): A Proposal for a Middle-Range Theory. Open Nurs J 2015; 9:1-9. [PMID: 25767632 PMCID: PMC4353124 DOI: 10.2174/1874434601509010001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/22/2014] [Accepted: 01/05/2015] [Indexed: 11/30/2022] Open
Abstract
The circadian system controls the daily rhythms of a variety of physiological processes. Most organisms show physiological, metabolic and behavioral rhythms that are coupled to environmental signals. In humans, the main synchronizer is the light/dark cycle, although non-photic cues such as food availability, noise, and work schedules are also involved. In a continuously operating hospital, the lack of rhythmicity in these elements can alter the patient’s biological rhythms and resilience. This paper presents a Theory of Inpatient Circadian Care (TICC) grounded in circadian principles. We conducted a literature search on biological rhythms, chronobiology, nursing care, and middle-range theories in the databases PubMed, SciELO Public Health, and Google Scholar. The search was performed considering a period of 6 decades from 1950 to 2013. Information was analyzed to look for links between chronobiology concepts and characteristics of inpatient care. TICC aims to integrate multidisciplinary knowledge of biomedical sciences and apply it to clinical practice in a formal way. The conceptual points of this theory are supported by abundant literature related to disease and altered biological rhythms. Our theory will be able to enrich current and future professional practice.
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Affiliation(s)
- Andrés Camargo-Sanchez
- Nursing School at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia
| | - Carmen L Niño
- Nursing School at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia
| | - Leonardo Sánchez
- Nursing School at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia
| | - Sonia Echeverri
- Nursing Department at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
| | - Diana P Gutiérrez
- Division of Internal Medicine at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
| | | | - Oscar Pianeta
- School of Medicine at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia
| | - Jenny A Jaramillo-Gómez
- Cell Death Group, School of Medicine and Institute of Genetics at the Universidad Nacional de Colombia, Bogotá, Colombia
| | - Martin A Pilonieta
- School of Medicine at the Universidad Nacional de Colombia, Bogotá, Colombia
| | - Nhora Cataño
- School of Nursing at the Universidad Nacional de Colombia, Bogotá, Colombia
| | - Humberto Arboleda
- Neurosciences Research Group, School of Medicine and Institute of Genetics at the Universidad Nacional de Colombia, Bogotá, Colombia
| | - Patricia V Agostino
- Laboratorio de Cronobiología, Departamento de Ciencia y Tecnología, Universidad Nacional de Quilmes/CONICET, Buenos Aires, Argentina
| | | | - Rafael Vargas
- School of Medicine at the Pontificia Universidad Javeriana, Bogotá, Colombia
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de Souza CM, Hidalgo MPL. The midpoint of sleep on working days: a measure for chronodisruption and its association to individuals' well-being. Chronobiol Int 2014; 32:341-8. [PMID: 25392279 DOI: 10.3109/07420528.2014.979941] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There is consistent evidence suggesting a relationship between individuals' sleep-wake rhythms and well-being. The indiscriminate demands from daily working routines, which do not respect this individual physiological rhythm, might be mediating this phenomenon. The aim of the present study was to evaluate the relationship between the characteristics of sleep routines during working days and psychological well-being. This was a cross-sectional study on 825 individuals from rural communities from southern Brazil. The study protocol included a questionnaire on demographic characteristics, working routines, health complaints, and habits; the Munich Chronotype Questionnaire for sleep-wake rhythm and; the WHO-Five well-being index. Since sex has been shown to affect sleep circadian rhythm and well-being, analysis was performed on men and women separately. In the proposed hierarchical regression models, different factors contributed to well-being according to sex. Among men, sleep-wake and work-related variables did not predict well-being scores. Among women, later midpoints of sleep on working days (B = -1.243, SE B = 0.315, β = -0.220), working more days per week (B = -1.507, SE B = 0.494, β = 0.150), having longer working journeys (B = -0.293, SE B = 0.105, β = -0.166), earlier working journey midpoints (B = 0.465, SE B = 0.222, β = 0.115), and being exposed to less sunlight (B = 0.140, SE B = 0.064, β = 0.103) predicted worse well-being. For the subgroup of women with days free from work, we have found a correlation between later midpoints of sleep during the week with worse well-being (Pearson's r = -0.159, p = 0.045) while the same relationship was not significantly observed with the midpoint of sleep on non-working days (Pearson's r = -0.153, p = 0.054). Considering WHO-Five as categorical, based on proposed clinical cut-offs, among women working 7-d/week, those with worst well-being (WHO-Five < 13) had the latest midpoint of sleep (F = 4.514, p = 0.012). Thus, the midpoint of sleep on working days represents the interaction between individuals' sleep-wake behavior and working routines. It plays an important role as a stress factor and may be a useful alternative variable related to chronodisruption.
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Higuchi S, Nagafuchi Y, Lee SI, Harada T. Influence of light at night on melatonin suppression in children. J Clin Endocrinol Metab 2014; 99:3298-303. [PMID: 24840814 DOI: 10.1210/jc.2014-1629] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT The sensitivity of melatonin to light suppression is expected to be higher in children because children have large pupils and pure crystal lenses. However, melatonin suppression by light in children remains unclear. OBJECTIVE We investigated whether light-induced melatonin suppression in children is larger than that in adults. METHODS Thirty-three healthy primary school children (mean age, 9.2 ± 1.5 y) and 29 healthy adults (mean age, 41.6 ± 4.7 y) participated in two experiments. In the first experiment, salivary melatonin concentrations in 13 children and 13 adults were measured at night under a dim light (<30 lux) and a moderately bright light (580 lux) in an experimental facility. Pupil diameters were also measured under dim light and bright light. In the second experiment, melatonin concentrations in 20 children and 16 adults were measured under dim light in the experimental facility and under room light at home (illuminance, 140.0 ± 82.7 lux). RESULTS In experiment 1, the melatonin concentration was significantly decreased by exposure to moderately bright light in both adults and children. Melatonin suppression was significantly larger in children (88.2%; n = 5) than in adults (46.3%; n = 6; P < .01), although the data for some participants were excluded because melatonin concentrations had not yet risen. In experiment 2, melatonin secretion was significantly suppressed by room light at home in children (n = 15; P < .05) but not in adults (n = 11). CONCLUSION We found that the percentage of melatonin suppression by light in children was almost twice that in adults, suggesting that melatonin is more sensitive to light in children than in adults at night.
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Affiliation(s)
- Shigekazu Higuchi
- Department of Human Science (S.H., Y.N., S.L.), Faculty of Design, Kyushu University, Fukuoka 815-8540, Japan; and Laboratory of Environmental Physiology (T.H.), Faculty of Education, Kochi University, Kochi 780-8520, Japan
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Innominato PF, Roche VP, Palesh OG, Ulusakarya A, Spiegel D, Lévi FA. The circadian timing system in clinical oncology. Ann Med 2014; 46:191-207. [PMID: 24915535 DOI: 10.3109/07853890.2014.916990] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The circadian timing system (CTS) controls several critical molecular pathways for cancer processes and treatment effects over the 24 hours, including drug metabolism, cell cycle, apoptosis, and DNA damage repair mechanisms. This results in the circadian time dependency of whole-body and cellular pharmacokinetics and pharmacodynamics of anticancer agents. However, CTS robustness and phase varies among cancer patients, based on circadian monitoring of rest- activity, body temperature, sleep, and/or hormonal secretion rhythms. Circadian disruption has been further found in up to 50% of patients with metastatic cancer. Such disruption was associated with poor outcomes, including fatigue, anorexia, sleep disorders, and short progression-free and overall survival. Novel, minimally invasive devices have enabled continuous CTS assessment in non-hospitalized cancer patients. They revealed up to 12-hour differences in individual circadian phase. Taken together, the data support the personalization of chronotherapy. This treatment method aims at the adjustment of cancer treatment delivery according to circadian rhythms, using programmable-in-time pumps or novel release formulations, in order to increase both efficacy and tolerability. A fixed oxaliplatin, 5-fluorouracil and leucovorin chronotherapy protocol prolonged median overall survival in men with metastatic colorectal cancer by 3.3 months as compared to conventional delivery, according to a meta-analysis (P=0.009). Further analyses revealed the need for the prevention of circadian disruption or the restoration of robust circadian function in patients on chronotherapy, in order to further optimize treatment effects. The strengthening of external synchronizers could meet such a goal, through programmed exercise, meal timing, light exposure, improved social support, sleep scheduling, and the properly timed administration of drugs that target circadian clocks. Chrono-rehabilitation warrants clinical testing for improving quality of life and survival in cancer patients.
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Affiliation(s)
- Pasquale F Innominato
- INSERM, UMRS 776 'Biological Rhythms and Cancers', Campus CNRS , 7 rue Guy Môquet, 94801 Villejuif Cedex , France
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Roche VP, Mohamad-Djafari A, Innominato PF, Karaboué A, Gorbach A, Lévi FA. Thoracic surface temperature rhythms as circadian biomarkers for cancer chronotherapy. Chronobiol Int 2014; 31:409-20. [PMID: 24397341 DOI: 10.3109/07420528.2013.864301] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The disruption of the temperature circadian rhythm has been associated with cancer progression, while its amplification resulted in cancer inhibition in experimental tumor models. The current study investigated the relevance of skin surface temperature rhythms as biomarkers of the Circadian Timing System (CTS) in order to optimize chronotherapy timing in individual cancer patients. Baseline skin surface temperature at four sites and wrist accelerations were measured every minute for 4 days in 16 patients with metastatic gastro-intestinal cancer before chronotherapy administration. Temperature and rest-activity were recorded, respectively, with wireless skin surface temperature patches (Respironics, Phillips) and an actigraph (Ambulatory Monitoring). Both variables were further monitored in 10 of these patients during and after a 4-day course of a fixed chronotherapy protocol. Collected at baseline, during and after therapy longitudinal data sets were processed using Fast Fourier Transform Cosinor and Linear Discriminant Analyses methods. A circadian rhythm was statistically validated with a period of 24 h (p < 0.05) for 49/61 temperature time series (80.3%), and 15/16 rest-activity patterns (93.7%) at baseline. However, individual circadian amplitudes varied from 0.04 °C to 2.86 °C for skin surface temperature (median, 0.72 °C), and from 16.6 to 146.1 acc/min for rest-activity (median, 88.9 acc/min). Thirty-nine pairs of baseline temperature and rest-activity time series (75%) were correlated (r > |0.7|; p < 0.05). Individual circadian acrophases at baseline were scattered from 15:18 to 6:05 for skin surface temperature, and from 12:19 to 15:18 for rest-activity, with respective median values of 01:10 (25-75% quartiles, 22:35-3:07) and 14:12 (13:14-14:31). The circadian patterns in skin surface temperature and rest-activity persisted or were amplified during and after fixed chronotherapy delivery for 5/10 patients. In contrast, transient or sustained disruption of these biomarkers was found for the five other patients, as indicated by the lack of any statistically significant dominant period in the circadian range. No consistent correlation (r < |0.7|, p ≥ 0.05) was found between paired rest-activity and temperature time series during fixed chronotherapy delivery. In conclusion, large inter-patient differences in circadian amplitudes and acrophases of skin surface temperature were demonstrated for the first time in cancer patients, despite rather similar rest-activity acrophases. The patient-dependent coupling between both CTS biomarkers, and its possible alteration on a fixed chronotherapy protocol, support the concept of personalized cancer chronotherapy.
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Abstract
Sleep pattern changes are considered normal as individuals age. However, changes in sleep patterns can ultimately affect the quality of life of many older adults. In addition, many sleep conditions are associated with an increase in morbidity and mortality. It is essential for clinicians to recognize sleep changes to lead to appropriate treatment. This article will focus on the assessment and interventions of sleep disorders in older adults.
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Soltani SS, Minaii B, Besharat M. Sleep and Wakefulness Correction in Different Seasons From Avicenna's Perspective. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:276-7. [PMID: 23984015 PMCID: PMC3745764 DOI: 10.5812/ircmj.7677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 11/10/2012] [Indexed: 11/16/2022]
Affiliation(s)
- Seyed Shahin Soltani
- Faculty of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Traditional Medicine and Material Medical Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Seyed Shahin Soltani, Faculty of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188773521, Fax: +98-2188795008, E-mail:
| | - Bagher Minaii
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
- Traditional Medicine Department, Faculty of Traditional Medicine of Tehran University of Medical sciences, Tehran, IR Iran
| | - Mehdi Besharat
- Loqman-e-Hakim Hospital, Department of Infectious Diseases, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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