1
|
Ma Y, Yu S, Li Q, Zhang H, Zeng R, Luo R, Lian Q, Leung FW, Duan C, Sha W, Chen H. Sleep patterns, genetic susceptibility, and digestive diseases: a large-scale longitudinal cohort study. Int J Surg 2024; 110:5471-5482. [PMID: 38781035 PMCID: PMC11392193 DOI: 10.1097/js9.0000000000001695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Sleep problems are prevalent. However, the impact of sleep patterns on digestive diseases remains uncertain. Moreover, the interaction between sleep patterns and genetic predisposition with digestive diseases has not been comprehensively explored. METHODS Four hundred ten thousand five hundred eighty-six participants from UK Biobank with complete sleep information were included in the analysis. Sleep patterns were measured by sleep scores as the primary exposure, based on five healthy sleep behaviors. Individual sleep behaviors were secondary exposures. Genetic risk of the digestive diseases was characterized by polygenic risk score. Primary outcome was incidence of 16 digestive diseases. RESULTS Healthy sleep scores showed dose-response associations with reduced risks of digestive diseases. Compared to participants scoring 0-1, those scoring 5 showed a 28% reduced risk of any digestive disease, including a 50% decrease in irritable bowel syndrome, 37% in non-alcoholic fatty liver disease, 35% in peptic ulcer, 34% in dyspepsia, 32% in gastroesophageal reflux disease, 28% in constipation, 25% in diverticulosis, 24% in severe liver disease, and 18% in gallbladder disease, whereas no correlation was observed with inflammatory bowel disease and pancreatic disease. Participants with poor sleep and high genetic risk exhibited approximately a 60% increase in the risk of digestive diseases. A healthy sleep pattern is linked to lower digestive disease risk in participants of all genetic risk levels. CONCLUSIONS In this large population-based cohort, a healthy sleep pattern was associated with a reduced risk of digestive diseases, regardless of genetic susceptibility. The authors' findings underscore the potential impact of healthy sleep traits in mitigating the risk of digestive diseases.
Collapse
Affiliation(s)
- Yuying Ma
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
| | - Shiyi Yu
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
- HKUMed Laboratory of Cellular Therapeutics, The University of Hong Kong
- Faculty of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen
| | - Qinming Li
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
| | - Haifeng Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
| | - Ruijie Zeng
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Shantou University Medical College, Shantou, Guangdong, China
| | - Ruibang Luo
- Department of Computer Science, The University of Hong Kong
| | - Qizhou Lian
- Cord Blood Bank, Guangzhou Institute of Eugenics and Perinatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou
- HKUMed Laboratory of Cellular Therapeutics, The University of Hong Kong
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong SAR
- Faculty of Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen
| | - Felix W Leung
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles
- Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System, North Hills, CA, USA
| | - Chongyang Duan
- Department of Biostatistics, School of Public Health, Southern Medical University
| | - Weihong Sha
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
- Shantou University Medical College, Shantou, Guangdong, China
| | - Hao Chen
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- The Second School of Clinical Medicine, Southern Medical University
- Shantou University Medical College, Shantou, Guangdong, China
| |
Collapse
|
2
|
Huang Y, Liu J, Xu L, Qi W, Dai J, Wang B, Tian J, Fu X, Yu Y. Exacerbation of symptoms, nocturnal acid reflux, and impaired autonomic function are associated with sleep disturbance in gastroesophageal reflux disease patients. Front Med (Lausanne) 2024; 11:1438698. [PMID: 39234038 PMCID: PMC11371777 DOI: 10.3389/fmed.2024.1438698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 08/07/2024] [Indexed: 09/06/2024] Open
Abstract
Background and aim Gastroesophageal reflux disease (GERD) patients often report sleep disturbance (SD); however, the relationship between GERD and SD is unknown. This study investigated whether SD affects symptoms, acid reflux, and autonomic function in GERD patients. Methods A total of 257 subjects (126 patients with SD and 99 patients without SD) participated in this survey from January 2020 to August 2022. Participants were required to complete questionnaires including the GERD impact scale (GIS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD). Esophageal mucosal injury, acid exposure, peristaltic function, and autonomic function were assessed by upper endoscopy, high-resolution esophageal manometry (HRAM), 24-h multichannel intraluminal impedance with pH (24 h-MII-pH), and electrocardiography (ECG). Results Gastroesophageal reflux disease patients with SD experienced a higher frequency of prolonged reflux (p < 0.001), longest reflux event (p < 0.001), acid exposure time (p < 0.001) during the recumbent period, and a higher incidence of erosive esophagitis (EE) (59.5 vs. 45.5%, p = 0.036) than those without SD. Pearson's correlation analysis showed that SD was positively correlated with GIS (r = 0.725, p < 0.001), HAMA (r = 0.680, p < 0.001), and HAMD (r = 0.323, p < 0.001) scores, and negatively correlated with parasympathetic or vagal nerve activity (r = -0.770, p < 0.001). Conclusion Gastroesophageal reflux disease patients with SD experience more severe reflux symptoms and nocturnal acid reflux, which may be related to autonomic dysfunction.
Collapse
Affiliation(s)
- Yizhou Huang
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Jie Liu
- Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Linsheng Xu
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Wu Qi
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Jie Dai
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Bo Wang
- Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jiashuang Tian
- Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xin Fu
- Department of Gastroenterology, The Anqing 116 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Anqing, Anhui, China
| | - Yue Yu
- Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| |
Collapse
|
3
|
Billey A, Saleem A, Zeeshan B, Dissanayake G, Zergaw MF, Elgendy M, Nassar ST. The Bidirectional Relationship Between Sleep Disturbance and Functional Dyspepsia: A Systematic Review to Understand Mechanisms and Implications on Management. Cureus 2024; 16:e66098. [PMID: 39229406 PMCID: PMC11370990 DOI: 10.7759/cureus.66098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2024] [Indexed: 09/05/2024] Open
Abstract
Functional dyspepsia (FD) is a prevalent chronic digestive disorder that significantly impacts patients' quality of life. Sleep disturbance (SD) is common among FD patients, yet the relationship between SD and FD remains poorly characterized. This systematic review explores the bidirectional relationship between FD and SD, investigating underlying mechanisms and implications for management. A rigorous and comprehensive systematic search was conducted across PubMed, PubMed Central (PMC), Google Scholar, Cochrane Library, and ScienceDirect using select keywords related to SD and FD. Only studies published in English from the past 10 years that met inclusion and exclusion criteria were included. Quality assessment tools specific to study types were employed to minimize bias. After applying inclusion and exclusion criteria and quality assessments, the review encompassed 30 studies. The key findings reveal that FD is frequently associated with SD, with a significant proportion of FD patients reporting poor sleep quality. The mechanisms linking SD and FD are complex, involving the circadian rhythm, visceral hypersensitivity, immune responses, and psychological factors. Nonpharmacological treatments like cognitive behavioral therapy (CBT), acupuncture, and pharmacological neuromodulators have shown promise in managing FD and SD, offering hope for improved patient outcomes. SD and FD share a significant bidirectional relationship, influenced by a complex interplay of physiological, psychological, and lifestyle factors. Addressing SD in FD patients may improve overall symptom management. Further research is crucial, as it should focus on isolating specific SD causes and their direct impacts on FD and other functional gastrointestinal disorders (FGIDs), opening up new avenues for understanding and treatment.
Collapse
Affiliation(s)
- Alvin Billey
- Internal Medicine and Gastroenterology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Asra Saleem
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Bushra Zeeshan
- Dermatology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Gayanthi Dissanayake
- Internal Medicine and Family Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Meaza F Zergaw
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Mohamed Elgendy
- Orthopaedics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Sondos T Nassar
- Medicine and Surgery, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| |
Collapse
|
4
|
Li FJ, Zhang RY, Li JY, Liu YN, Zhang ZX, Du L, Li YDY, Liu X, Zhang W, Cui GY, Xu CY. Pain, obesity, adenosine salvage disruption, and smoking behavior mediate the effect of gut microbiota on sleep disorders: results from network Mendelian randomization and 16S rDNA sequencing. Front Microbiol 2024; 15:1413218. [PMID: 39144232 PMCID: PMC11322093 DOI: 10.3389/fmicb.2024.1413218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 07/12/2024] [Indexed: 08/16/2024] Open
Abstract
Objectives The objective of this study is to investigate the indirect causalities between gut microbiota and sleep disorders. Methods In stage 1, we utilized 196 gut microbiota as the exposure factor and conducted a two-sample univariable Mendelian randomization (MR) analysis on five sleep disorders: insomnia, excessive daytime sleepiness (EDS), sleep-wake rhythm disorders (SWRD), obstructive sleep apnea (OSA), and isolated REM sleep behavior disorder (iRBD). In stage 2, we validated the MR findings by comparing fecal microbiota abundance between patients and healthy controls through 16S rDNA sequencing. In stage 3, we explored the indirect pathways by which the microbiota affects sleep, using 205 gut microbiota metabolic pathways and 9 common risk factors for sleep disorders as candidate mediators in a network MR analysis. Results In stage 1, the univariable MR analysis identified 14 microbiota potentially influencing five different sleep disorders. In stage 2, the results from our observational study validated four of these associations. In stage 3, the network MR analysis revealed that the Negativicutes class and Selenomonadales order might worsen insomnia by increasing pain [mediation: 12.43% (95% CI: 0.47, 24.39%)]. Oxalobacter could raise EDS by disrupting adenosine reuptake [25.39% (1.84, 48.95%)]. Allisonella may elevate OSA risk via obesity promotion [36.88% (17.23, 56.54%)], while the Eubacterium xylanophilum group may lower OSA risk by decreasing smoking behavior [7.70% (0.66, 14.74%)]. Conclusion Triangulation of evidence from the MR and observational study revealed indirect causal relationships between the microbiota and sleep disorders, offering fresh perspectives on how gut microbiota modulate sleep.
Collapse
Affiliation(s)
- Fu-Jia Li
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Ru-Yu Zhang
- Department of Pulmonary and Critical Care Medicine, First People’s Hospital of Zigong, Zigong, Sichuan, China
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jin-Yu Li
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yu-Ning Liu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zi-Xuan Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Li Du
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yang-Dan-Yu Li
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xu Liu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wei Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Gui-Yun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Chuan-Ying Xu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| |
Collapse
|
5
|
Akaishi T. Association Between Gastrointestinal and Sleep Problems in the General Population of Japan: A Cross-Sectional Community-Based Observational Study. Cureus 2024; 16:e65311. [PMID: 39071077 PMCID: PMC11279121 DOI: 10.7759/cureus.65311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 07/30/2024] Open
Abstract
Background and aim Poor sleep is known to be associated with functional gastrointestinal (GI) problems in the general population, but the exact mechanisms underlying the relationship remain unclear. Deeper insights into the exact mechanisms underlying the connection may benefit individuals suffering from these conditions without efficient treatments. Therefore, this study investigated the association between functional GI symptom levels and sleep-related characteristics in the general population of Japan. Methods In this cross-sectional questionnaire-based observational study, data including the self-reported level of poor sleep and functional GI symptoms in the last one month were collected from consecutive individuals who visited a hospital in Miyagi Prefecture, Japan, for regular medical checkups between April 2020 and March 2023. The levels of other physical and mental conditions, such as stress at home, fatigability, irritability, thermoregulatory problems, and edema in the limbs, were measured with an 11-point Numerical Rating Scale (NRS) between 0 and 10. Additional sleep-related specific information, such as sleep length, wake-up time, bedtime, trouble falling asleep, and nocturnal awakening, were further collected. Correlations with functional GI symptoms in these characteristics were evaluated by bivariate correlation analyses and generalized regression analyses. Results A total of 151 consecutive adults aged ≥18 years (77 males and 74 females) participated in this study. In bivariate correlation analyses, chronic GI symptom levels were significantly correlated with stress at home (p=0.0005), fatigability (p=0.0008), irritability (p=0.0022), edema in the limbs (p<0.0001), and sleep problem (p<0.0001). In the following generalized regression analysis, significant correlations with GI symptom levels were observed in sleep problems (p=0.0042) and edema in the limbs (p=0.0256). Further bivariate correlation analyses using sleep-related subscales revealed that trouble falling asleep in bed (p=0.0001), midnight awakening (p=0.0143), and wakeup time (p=0.0465) were correlated with GI symptom levels. In the following generalized regression analysis, a significant correlation with GI symptom levels was observed in trouble falling asleep (p=0.0239). Conclusion Functional GI symptoms in the general population of Japan were associated with poor sleep, even after adjusting for daily stress and irritability levels. Among the sleep-related characteristics, trouble falling asleep was associated with GI dysfunctions. Assessing sleep-related information and achieving good sleep quality with smooth sleep induction may be a clue to relieving GI dysfunctions with uncertain causes.
Collapse
Affiliation(s)
- Tetsuya Akaishi
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, JPN
| |
Collapse
|
6
|
Hama Y, Yamada S, Nishimura R, Yoshida M, Tsuga K, Morita E, Tamada Y, Kato Y, Kubo Y, Okada R, Nagayoshi M, Tamura T, Hishida A, Wakai K, Naito M. Association between dysphagia risk and sleep quality in community-dwelling older adults: A cross-sectional study. Heliyon 2024; 10:e32028. [PMID: 38882350 PMCID: PMC11180309 DOI: 10.1016/j.heliyon.2024.e32028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/26/2024] [Accepted: 05/27/2024] [Indexed: 06/18/2024] Open
Abstract
Objectives Exploring the effects of swallowing function on sleep quality could provide valuable insights into the potential impact of reduced swallowing function on sleep. However, pertinent studies are limited. Therefore, this study aimed to investigate the relationship between dysphagia risk and sleep health in community-dwelling older adults. Methods Data for this cross-sectional study were obtained from the Shizuoka and Daiko studies conducted as part of the Japan Multi-Institutional Collaborative Cohort Study. Information on demographics, overall lifestyle, dysphagia risk, as well as sleep quality, duration, satisfaction, and regularity, was obtained using a self-administered questionnaire. Dysphagia risk and sleep quality were assessed using the Dysphagia Risk Assessment Questionnaire for the Community-dwelling Elderly and the Japanese version of the Pittsburgh Sleep Questionnaire Index, respectively. Multivariate logistic regression, adjusted for covariates, was employed to assess the association between dysphagia risk and sleep health. Results Among the 3058 participants (1633 males, 1425 females) aged ≥60 years, 28.0 % exhibited dysphagia risk, and 19.1 % reported poor sleep quality. Those with dysphagia risk were more likely to experience poor sleep quality than those without dysphagia risk. In male participants, dysphagia was significantly associated with poor sleep quality, unsatisfactory sleep, and sleep irregularity, but was not significantly associated with unsatisfactory or irregular sleep in female participants. The Japanese version of the Pittsburgh Sleep Questionnaire Index components-subjective sleep quality, sleep latency, sleep disturbances, and daytime dysfunction-were associated with dysphagia risk in both sexes. Conclusions Dysphagia risk is associated with sleep quality in older individuals in Japan. Thus, preserving swallowing function may contribute to enhancing sleep quality.
Collapse
Affiliation(s)
- Yohko Hama
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Hiroshima Oral Health Center, Hiroshima, Japan
| | - Sachiko Yamada
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Rumi Nishimura
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Mitsuyoshi Yoshida
- Department of Dentistry and Oral-Maxillofacial Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Emi Morita
- International Institute for Integrative Sleep Medicine, University of Tsukuba, Japan
- Forestry and Forest Products Research Institute, Forest Research and Management Organization, Japan
| | - Yudai Tamada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Yasufumi Kato
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoko Kubo
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| |
Collapse
|
7
|
Hu KY, Tseng PH, Hsu WC, Lee PL, Tu CH, Chen CC, Lee YC, Chiu HM, Wu MS, Peng CK. Association of self-reported and objective sleep disturbance with the spectrum of gastroesophageal reflux disease. J Clin Sleep Med 2024; 20:911-920. [PMID: 38300823 PMCID: PMC11145051 DOI: 10.5664/jcsm.11028] [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: 08/30/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/03/2024]
Abstract
STUDY OBJECTIVES The relationship between obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) is complex. We aimed to determine the association of self-reported and objective sleep parameters with diverse manifestations of the GERD spectrum. METHODS We prospectively recruited 561 individuals who underwent an electrocardiogram-based cardiopulmonary coupling for OSA screening during a health check-up. All participants received the Reflux Disease Questionnaire and an upper endoscopy to determine the presence of troublesome reflux symptoms and erosive esophagitis (EE). Sleep quality was evaluated by the Pittsburgh Sleep Quality Index and sleep dysfunction was defined as a Pittsburgh Sleep Quality Index score > 5. OSA was defined as a cardiopulmonary coupling-derived apnea-hypopnea index exceeding 15 events/h. Comparisons were made between participants on the GERD spectrum with respect to their various self-reported and objective sleep parameters. RESULTS Among the 277 patients with GERD (49.4%), 198 (35.3%) had EE. Patients with GERD had higher PSQI scores (6.99 ± 3.97 vs 6.07 ± 3.73, P = .005) and a higher prevalence of sleep dysfunction (60.6% vs 49.6%, P = .009). Patients with EE had a higher prevalence of OSA (42.9% vs 33.9%, P = .034). Along the GERD spectrum, symptomatic patients with EE had the highest PSQI scores and prevalence of sleep dysfunction (70.7%), while asymptomatic patients with EE had the highest prevalence of OSA (44%). CONCLUSIONS Our findings indicate a high prevalence of sleep dysfunction among individuals with GERD. Furthermore, patients on the GERD spectrum are prone to experiencing a range of self-reported and objective sleep disturbances. CITATION Hu K-Y, Tseng P-H, Hsu W-C, et al. Association of self-reported and objective sleep disturbance with the spectrum of gastroesophageal reflux disease. J Clin Sleep Med. 2024;20(6):911-920.
Collapse
Affiliation(s)
- Kai-Yu Hu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Chung Hsu
- Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Lin Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Hung Tu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Chuan Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Chia Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung-Kang Peng
- Center for Dynamical Biomarkers, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
8
|
Li JN, Zheng QX, Jiang XM, Chen XQ, Huang L, Pan YQ, Liu RL, Zhu Y. Prevalence and bidirectional association of sleep quality and gut health among Chinese midwives: a large population, multi-center cross-sectional study. Front Public Health 2024; 12:1368178. [PMID: 38694975 PMCID: PMC11061365 DOI: 10.3389/fpubh.2024.1368178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/25/2024] [Indexed: 05/04/2024] Open
Abstract
Background Shift work can disrupt sleep quality and gut health. Nurses and midwives constitute approximately half of the global healthcare shift-working workforce. Our previous study revealed that most midwives were experiencing suboptimal health conditions, characterized by poor sleep quality and a high prevalence of gastrointestinal diseases. The gut-brain axis theory highlights the potential interplay between sleep quality and gut health. However, limited research focuses on this relationship among midwives. Methods A cross-sectional survey included 2041 midwives from 87 Chinese hospitals between March and October 2023. Participants completed standardized questionnaires assessing sleep quality, gut health, depression, anxiety, and work stress. Binary logistic regression analyzed factors associated with poor sleep, and multiple linear regression examined the influence of sleep quality on gut health. Results Over 60% of midwives reported poor sleep, with many experiencing gastrointestinal disorders. We observed a bidirectional relationship between sleep quality and gut health among midwives. After multivariable adjustments, midwives with higher gut health scores were more likely to experience poor sleep quality (odds ratio = 1.042, 95% confidence interval = 1.03-1.054). Conversely, midwives with higher sleep quality scores were also more likely to have poor gut health (β = 0.222, 95% confidence interval = 0.529-0.797). These associations remained robust across sensitivity analyses. Furthermore, depression, anxiety, and work stress significantly affected both sleep quality and gut health among midwives. Conclusion This study enhances our understanding of the intricate relationship between sleep quality and gut health among midwives. Poor gut health was associated with a higher risk of poor sleep, and vice versa. To improve the overall wellbeing of midwives, the findings emphasize the importance of addressing poor sleep quality and promoting gut health through maintaining a healthy diet, lifestyle, and good mental health. Further studies are needed to confirm our findings and clarify the underlying mechanisms.
Collapse
Affiliation(s)
- Jia-Ning Li
- School of Nursing, Fujian Medical University, Fuzhou, China
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Qing-Xiang Zheng
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Fujian Obstetrics and Gynecology Hospital, Fuzhou, China
| | - Xiu-Min Jiang
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Fujian Obstetrics and Gynecology Hospital, Fuzhou, China
| | - Xiao-Qian Chen
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Fujian Obstetrics and Gynecology Hospital, Fuzhou, China
| | - Ling Huang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yu-Qing Pan
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Fujian Obstetrics and Gynecology Hospital, Fuzhou, China
| | - Ru-Lin Liu
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Yu Zhu
- School of Nursing, Fujian Medical University, Fuzhou, China
| |
Collapse
|
9
|
Tan X, Wang S, Wu F, Zhu J. Bidirectional correlation between gastroesophageal reflux disease and sleep problems: a systematic review and meta-analysis. PeerJ 2024; 12:e17202. [PMID: 38646475 PMCID: PMC11027907 DOI: 10.7717/peerj.17202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/15/2024] [Indexed: 04/23/2024] Open
Abstract
Objectives Gastroesophageal reflux disease (GERD) and sleep problems are highly prevalent among the general population. Both them are associated with a variety of psychiatric disorders such as depression and anxiety, which is highlighting an underexplored connection between them. This meta-analysis aims to explore the association between sleep problems and GERD. Methods We conducted a comprehensive search on PubMed, Cochrane Library, Embase, and Web of Science, using Medical Subject Headings (MeSH) and keywords, covering articles from the inception of the databases until August 2023. Stata statistical software, version 14.0, was utilized for all statistical analyses. A fixed-effects model was applied when p > 0.1 and I2 ≤ 50%, while a random-effects model was employed for high heterogeneity (p < 0.1 and I2 > 50%). Funnel plots and Egger's test were used to assess publication bias. Results Involving 22 studies, our meta-analysis revealed that insomnia, sleep disturbance, or short sleep duration significantly increased the risk of GERD (OR = 2.02, 95% CI [1.64-2.49], p < 0.001; I2 = 66.4%; OR = 1.98, 95% CI [1.58-2.50], p < 0.001, I2 = 50.1%; OR = 2.66, 95% CI [2.02-3.15], p < 0.001; I2 = 62.5%, respectively). GERD was associated with an elevated risk of poor sleep quality (OR = 1.47, 95% CI [1.47-1.79], p < 0.001, I2 = 72.4%), sleep disturbance (OR = 1.47, 95% CI [1.24-1.74], p < 0.001, I2 = 71.6%), or short sleep duration (OR = 1.17, 95% CI [1.12-1.21], p < 0.001, I2 = 0). Conclusion This meta-analysis establishes a bidirectional relationship between four distinct types of sleep problems and GERD. The findings offer insights for the development of innovative approaches in the treatment of both GERD and sleep problems.
Collapse
Affiliation(s)
- Xiaolong Tan
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, Shandong Province, China
| | - Shasha Wang
- Department of Oncology, The People’s Hospital of Binzhou City, Binzhou, Shandong Province, China
| | - Fengjie Wu
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, Shandong Province, China
| | - Jun Zhu
- Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, Shandong Province, China
| |
Collapse
|
10
|
Wang X, Li Y, Wang X, Wang R, Hao Y, Ren F, Wang P, Fang B. Faecalibacterium prausnitzii Supplementation Prevents Intestinal Barrier Injury and Gut Microflora Dysbiosis Induced by Sleep Deprivation. Nutrients 2024; 16:1100. [PMID: 38674791 PMCID: PMC11054126 DOI: 10.3390/nu16081100] [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: 02/24/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Sleep deprivation (SD) leads to impaired intestinal barrier function and intestinal flora disorder, especially a reduction in the abundance of the next generation of probiotic Faecalibacterium prausnitzii (F. prausnitzii). However, it remains largely unclear whether F. prausnitzii can ameliorate SD-induced intestinal barrier damage. A 72 h SD mouse model was used in this research, with or without the addition of F. prausnitzii. The findings indicated that pre-colonization with F. prausnitzii could protect against tissue damage from SD, enhance goblet cell count and MUC2 levels in the colon, boost tight-junction protein expression, decrease macrophage infiltration, suppress pro-inflammatory cytokine expression, and reduce apoptosis. We found that the presence of F. prausnitzii helped to balance the gut microbiota in SD mice by reducing harmful bacteria like Klebsiella and Staphylococcus, while increasing beneficial bacteria such as Akkermansia. Ion chromatography analysis revealed that F. prausnitzii pretreatment increased the fecal butyrate level in SD mice. Overall, these results suggested that incorporating F. prausnitzii could help reduce gut damage caused by SD, potentially by enhancing the intestinal barrier and balancing gut microflora. This provides a foundation for utilizing probiotics to protect against intestinal illnesses.
Collapse
Affiliation(s)
- Xintong Wang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China; (X.W.); (Y.L.); (R.W.); (Y.H.); (F.R.)
| | - Yixuan Li
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China; (X.W.); (Y.L.); (R.W.); (Y.H.); (F.R.)
| | - Xifan Wang
- Department of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA;
| | - Ran Wang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China; (X.W.); (Y.L.); (R.W.); (Y.H.); (F.R.)
| | - Yanling Hao
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China; (X.W.); (Y.L.); (R.W.); (Y.H.); (F.R.)
| | - Fazheng Ren
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China; (X.W.); (Y.L.); (R.W.); (Y.H.); (F.R.)
- Food Laboratory of Zhongyuan, Luohe 462000, China
| | - Pengjie Wang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China; (X.W.); (Y.L.); (R.W.); (Y.H.); (F.R.)
- Food Laboratory of Zhongyuan, Luohe 462000, China
| | - Bing Fang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China; (X.W.); (Y.L.); (R.W.); (Y.H.); (F.R.)
| |
Collapse
|
11
|
Ashktorab H, Challa SR, Singh G, Nanduri S, Ibrahim M, Martirosyan Z, Whitsell P, Chirumamilla LG, Shayegh N, Watson K, Smith T, Ogwo V, Kolawole O, Littleton M, Morrison N, Nair V, Byer D, Dawodu DO, Lexima P, Rashid M, Deverapalli M, Atluri SM, Nezamloo A, Nasrin F, Kim RJA, Sherif Z, Oskrochi G, Carethers JM, Brim H. Gastrointestinal Manifestations and Their Association with Neurologic and Sleep Problems in Long COVID-19 Minority Patients: A Prospective Follow-Up Study. Dig Dis Sci 2024; 69:562-569. [PMID: 38135813 PMCID: PMC11070273 DOI: 10.1007/s10620-023-08176-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/29/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Long-COVID is a condition post SARS-CoV-2 infection with persistent or recurring symptoms affecting multiple organs, and may involve viral persistence, changes to the microbiome, coagulopathies, and alterations to neuro-immune interactions. These factors can disrupt the Gut-Brain Axis, which is a complex system involving bidirectional communication between the central nervous system and the gastrointestinal (GI) system. As a result of these disruptions, individuals with long-COVID may develop post-infectious functional GI disorders, which can cause a range of symptoms affecting the digestive system. AIM To understand frequency of GI manifestations of Long-COVID and to determine association with sleep or neurological symptoms in a predominantly minority population. METHODS We included patients with positive SARS-CoV-2 PCR (n = 747) who were hospitalized from Feb. 2020 to May 2021 at Howard University Hospital and followed between 6 and 12 months from discharge. GI, sleep, and neurological symptoms (via the Montreal Cognitive Assessment (MoCA) scoring system) were assessed using a standardized questionnaire. Linear regression analysis, χ2 and Fisher's exact test were utilized to determine the statistical significance of correlations of GI/Neuro/COVID. RESULTS The mean age of patients was 58, with 51.6% females and a predominant African American ethnicity (73.6%, n = 550). A total of 108 patients died during their initial hospital stay, with the remaining 639 patients followed-up. Three hundred fifty (350) patients responded to the questionnaire (57 patients died during the follow-up period). Overall, 39 (13.3%) patients reported GI-related symptoms, out of which 19 (6.4%) had persistent symptoms and 20 (6.8%) developed new onset GI symptoms. Nausea and vomiting were the most common 24/39 (61.5%), followed by abdominal pain 7/39 (18%), diarrhea 5/39 (12.8%), and others 3/39 (7.6%). Patients who presented with vomiting during acute SARS-CoV-2 infection were more likely to have Long-COVID GI manifestations (P = 0.023). Use of ACE inhibitors, abnormal lymphocyte count and elevated ferritin are other variables that showed significant associations with Long-COVID GI manifestations (P = 0.03, 0.006 and 0.03, respectively). During follow-up, a total of 28 (9.5%) patients reported difficulty with sleep and 79 (27%) patients had abnormal MoCA assessment. With further analysis, there was a trend between presentation of GI symptoms on admission with abnormal MoCA assessment, and an association between abnormal LFTs and history of liver disease during hospitalization with subsequent sleep problems. Baseline characteristics, clinical comorbidities, other laboratory values, hospital length of stay, mechanical ventilation, medications during hospitalization, re-admission and Flu or COVID-19 vaccination have not shown any association with Long-COVID GI symptoms in our cohort. CONCLUSION Dyspeptic symptoms were common GI manifestations in the acute and post COVID periods. GI symptoms, abnormal LFTs and a history of liver disease during the acute infectious phase associates with abnormal MoCA and sleep problems during follow-up. Further large population studies are needed to determine if COVID-19 leads to a GI symptoms-associated Long-COVID phenotypes and other symptoms through the Gut-Brain-Axis.
Collapse
Affiliation(s)
- Hassan Ashktorab
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA.
- Howard University College of Medicine, 2041 Georgia Avenue, N.W., Washington, DC, 20060, USA.
| | | | - Gagan Singh
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Sumant Nanduri
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Malika Ibrahim
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Zara Martirosyan
- Howard University College of Medicine, 2041 Georgia Avenue, N.W., Washington, DC, 20060, USA
| | - Peter Whitsell
- Howard University College of Medicine, 2041 Georgia Avenue, N.W., Washington, DC, 20060, USA
| | - Lakshmi G Chirumamilla
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Nader Shayegh
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Kyra Watson
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Tori Smith
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Valarie Ogwo
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
- Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington, DC, USA
- College of Engineering and Technology, American University of the Middle East, Egaila, Kuwait
- Division of Gastroenterology & Hepatology, Department of Medicine and Moores Cancer Center, UC San Diego, San Diego, USA
- Department of Pathology and Cancer Center, Howard University College of Medicine, Washington, DC, USA
- Department of Pathology and Cancer Center, Howard University College of Medicine, Washington, DC, USA
| | - Oluwapelumi Kolawole
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Megan Littleton
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Nicole Morrison
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Vaisakh Nair
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Danae Byer
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Dideolu O Dawodu
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Patrice Lexima
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Mudasir Rashid
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Mrinalini Deverapalli
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Swetha Mynedi Atluri
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Ali Nezamloo
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Farjana Nasrin
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Rachel Ji-Aeh Kim
- GI Division, Department of Medicine, Cancer Center, Howard University Hospital, Washington, DC, USA
| | - Zaki Sherif
- Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington, DC, USA
| | - Gholamreza Oskrochi
- College of Engineering and Technology, American University of the Middle East, Egaila, Kuwait
| | - John M Carethers
- Division of Gastroenterology & Hepatology, Department of Medicine and Moores Cancer Center, UC San Diego, San Diego, USA
| | - H Brim
- Department of Pathology and Cancer Center, Howard University College of Medicine, Washington, DC, USA
| |
Collapse
|
12
|
Kazemian N, Zhou T, Chalasani N, Narayan A, Cedeño Laurent JG, Olvera Alvarez HA, Pakpour S. Long-Term Impact of Childhood Adversity on the Gut Microbiome of Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:68. [PMID: 38248533 PMCID: PMC10815413 DOI: 10.3390/ijerph21010068] [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: 11/16/2023] [Revised: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
Adverse childhood experiences (ACEs) encompass negative, stressful, and potentially traumatic events during childhood, impacting physical and mental health outcomes in adulthood. Limited studies suggest ACEs can have short-term effects on children's gut microbiomes and adult cognitive performance under stress. Nevertheless, the long-term effects of ACEs experienced during adulthood remain unexplored. Thus, this study aimed to assess the long-term effects of ACEs on the gut microbiota of adult nursing students. We employed a multidimensional approach, combining 16S rRNA sequencing, bioinformatics tools, and machine learning to predict functional capabilities. High-ACE individuals had an increased abundance of Butyricimonas spp. and Prevotella spp. and decreased levels of Clostridiales, and Lachnospira spp. Prevotella abundance correlated negatively with L-glutamate and L-glutamine biosynthesis, potentially impacting intestinal tissue integrity. While nursing students with high ACE reported increased depression, evidence for a direct gut microbiota-depression relationship was inconclusive. High-ACE individuals also experienced a higher prevalence of diarrhea. These findings highlight the long-lasting impact of ACEs on the gut microbiota and its functions in adulthood, particularly among nursing students. Further research is warranted to develop targeted interventions and strategies for healthcare professionals, optimizing overall health outcomes.
Collapse
Affiliation(s)
- Negin Kazemian
- School of Engineering, University of British Columbia, Kelowna, BC V1V 1V7, Canada;
| | - Tony Zhou
- Department of Computer Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada; (T.Z.); (N.C.); (A.N.)
| | - Naveen Chalasani
- Department of Computer Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada; (T.Z.); (N.C.); (A.N.)
| | - Apurva Narayan
- Department of Computer Science, University of British Columbia, Kelowna, BC V1V 1V7, Canada; (T.Z.); (N.C.); (A.N.)
- Department of Computer Science, University of Western Ontario, 1151 Richmond St., London, ON N6A 3K7, Canada
- Department of Electrical and Computer Engineering, University of Western Ontario, 1151 Richmond St., London, ON N6A 3K7, Canada
| | - Jose Guillermo Cedeño Laurent
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | | | - Sepideh Pakpour
- School of Engineering, University of British Columbia, Kelowna, BC V1V 1V7, Canada;
| |
Collapse
|
13
|
Simadibrata DM, Lesmana E, Amangku BR, Wardoyo MP, Simadibrata M. Left lateral decubitus sleeping position is associated with improved gastroesophageal reflux disease symptoms: A systematic review and meta-analysis. World J Clin Cases 2023; 11:7329-7336. [PMID: 37969463 PMCID: PMC10643078 DOI: 10.12998/wjcc.v11.i30.7329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/24/2023] [Accepted: 10/08/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND A limited number of studies have demonstrated that sleeping in the left lateral decubitus (LLD) decreases nocturnal reflux in patients with gastroesophageal reflux disease (GERD) compared to right lateral decubitus (RLD) and supine. AIM This systematic review summarizes the association between sleeping in the LLD position and nocturnal reflux in patients with GERD. METHODS Studies published up to July 17, 2023, in MEDLINE, EMBASE, and CENTRAL were searched. Eligible studies were randomized and nonrandomized studies assessing the effect of sleeping in LLD compared to RLD and supine in reducing nocturnal reflux in GERD patients. Outcomes include the acid exposure time (AET) (% time in pH<4), acid clearance time (ACT) (in sec/episode), number of reflux episodes, and improvement in N-GSSIQ scores. RESULTS Two nonrandomized studies showed decreased AET and ACT in LLD sleep position in comparison to RLD (mean difference [MD] -2.03 [95%CI: -3.62 to -0.45]; -81.84 [95%CI: -127.48 to -36.20], respectively) and supine position (MD -2.71 [95%CI: -4.34 to -1.09]; -74.47 [95%CI: -116.26 to -32.69], respectively). There was no difference in AET and ACT between RLD sleep position and supine. Furthermore, one randomized controlled trial investigating the use of electronic sleep positional therapy, which increased the duration of LLD sleep and decreased the duration of RLD sleep compared to sham, showed nocturnal symptoms improvement (improved N-GSSIQ score, increased reflux-free nights, and resolution of nocturnal reflux symptoms). CONCLUSION Current evidence suggests that sleeping on the left side could reduce nocturnal reflux and improve GERD-related quality of life, therefore warranting interventions that promote LLD sleep position.
Collapse
Affiliation(s)
- Daniel Martin Simadibrata
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
| | - Elvira Lesmana
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia
| | - Bagus Ramasha Amangku
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia
| | - Muhammad Prasetio Wardoyo
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia
| | - Marcellus Simadibrata
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia
| |
Collapse
|
14
|
Gagliardi M, Iovino P, Gargano D, Zulli C, Fortino L, Santonicola A. Can esophageal symptoms be associated with sleep disorders in esophageal rare diseases? A prospective case-control study across achalasia, eosinophilic esophagitis and gastroesophageal reflux disease. Minerva Gastroenterol (Torino) 2023; 69:365-373. [PMID: 37642600 DOI: 10.23736/s2724-5985.21.03002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND The association between sleep disorders and gastroesophageal reflux disease (GERD) has been the subject of several studies; however, quality of sleep has been under investigated in adult patients with eosinophilic esophagitis (EoE) and achalasia (Ach). This study aims to evaluate the prevalence of sleep disturbances in patients with EoE and Ach compared to GERD patients and their associations with esophageal symptoms. METHODS Thirty Ach patients and 20 EoE patients were consecutively enrolled and compared to a control group of 46 GERD patients. All patients underwent a standardized questionnaire investigating the intensity-frequency scores (from 0 to 6) of esophageal symptoms, Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess sleep quality, a SF-36 survey to investigate health-related quality of life (both physical (PCS) and mental (MCS) component scales), Beck Depression Inventory-II (BDI-II) and State Trait Anxiety Inventory (STAI) to assess the presence of depression and anxiety. RESULTS The prevalence of sleep disturbances was 66.7% in Ach, 50% in EoE, and 60% in GERD patients (P=0.5). PCS and MCS significantly correlated with depression and anxiety levels. Ach patients showed significantly higher intensity-frequency scores of dysphagia for solids (Scheffè P<0.001) and liquids (Scheffè P<0.001) than EoE and GERD patients. No differences were found in the intensity-frequency scores of the esophageal symptoms among the three groups. There was a significant association between worst quality of sleep and higher intensity-frequency scores of regurgitation. CONCLUSIONS Sleep disturbances are common with Ach and EoE, similar to GERD patients. Moreover, there is a significant association between regurgitation, a typical GERD symptom, and poor quality of sleep, independent from diagnosis.
Collapse
Affiliation(s)
- Mario Gagliardi
- Unit of Gastroenterology, Scuola Medica Salernitana Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy -
| | - Paola Iovino
- Unit of Gastroenterology, Scuola Medica Salernitana Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | | | - Claudio Zulli
- Division of Gastroenterology, G. Fucito Hospital, AOU Ruggi d'Aragona, Salerno, Italy
| | - Luigi Fortino
- Unit of Gastroenterology, Scuola Medica Salernitana Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | - Antonella Santonicola
- Unit of Gastroenterology, Scuola Medica Salernitana Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| |
Collapse
|
15
|
Gundogdu D, Urgancı N, Usta M. Relationship between disease activity index and sleep disorders in children with inflammatory bowel diseases. Eur J Pediatr 2023; 182:4095-4102. [PMID: 37405508 DOI: 10.1007/s00431-023-05081-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/06/2023]
Abstract
The aim of the study was to assess the prevalence of sleep disturbance in pediatric IBD patients and evaluate the relationship between clinical features of IBD, disease activity, inflammatory markers and quality of sleep. A total of 99 patients who were followed-up with the diagnosis of IBD (44 Crohn's disease (CD), 55 Ulcerative colitis (UC)) between 2015-2020 and 80 healthy controls were enrolled in the study. The clinical and demographic characteristics, laboratory parameters and disease activities were obtained from medical reports retrospectively. Pittsburgh sleep quality index (PSQI) was administered to all participants. PSQI score was significantly higher in patient group than the control group (P < 0.001). The sleep time of patient group, especially patients with UC was later than the control group (P = 0.008). Sleep duration was longer in control group than the patient group (P < 0.001). A positive strong correlation was obtained in disease activity index (r = 0.886; P < 0.001) and abdominal pain (r = 0.781; P < 0.001) with PSQI scores of CD patients. Disease activity index, rectal bleeding, diarrhea and number of stool had statistically significant positive strong correlation with PSQI scores of UC patients (P < 0.001). Pediatric Crohn's disease activity index and Pediatric ulcerative colitis activity index were the only independent risk factors affecting sleep disturbances (80% sensitivity and 91.67% specificity, 93.1% sensitivity and %96.15 specificity, respectively). Conclusion: Increased disease activity has adverse effects on sleep quality. PSQI and PCDAI were strong tests for predicting sleep disorders in pediatric patients with IBD. What is Known: • Sleep disturbances are common complaint in inflammatory bowel disease (IBD), even in clinical remission. • Pittsburgh sleep quality index (PSQI) was used to evaluate the subjective sleep quality of patients. What is New: • PSQI and Pediatric Crohn Disease Activity index (PCDAI) were strong tests for predicting sleep disorders in pediatric patients with IBD. • PSQI and PCDAI scores correlated significantly with the severity of the sleep disturbances.
Collapse
Affiliation(s)
- Dilsat Gundogdu
- Pediatrics, SBU Sisli Hamidiye Etfal Training and Research Hospital, MD, Istanbul, Turkey
| | - Nafiye Urgancı
- Division of Pediatric Gastroenterology, SBU Sisli Hamidiye Etfal Training and Research Hospital, Kazim Karabekir Pasa, Bahcekoy No: 62 Sariyer, Istanbul, Turkey.
| | - Merve Usta
- Division of Pediatric Gastroenterology, SBU Sisli Hamidiye Etfal Training and Research Hospital, Kazim Karabekir Pasa, Bahcekoy No: 62 Sariyer, Istanbul, Turkey
| |
Collapse
|
16
|
Hibberd TJ, Ramsay S, Spencer-Merris P, Dinning PG, Zagorodnyuk VP, Spencer NJ. Circadian rhythms in colonic function. Front Physiol 2023; 14:1239278. [PMID: 37711458 PMCID: PMC10498548 DOI: 10.3389/fphys.2023.1239278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
A rhythmic expression of clock genes occurs within the cells of multiple organs and tissues throughout the body, termed "peripheral clocks." Peripheral clocks are subject to entrainment by a multitude of factors, many of which are directly or indirectly controlled by the light-entrainable clock located in the suprachiasmatic nucleus of the hypothalamus. Peripheral clocks occur in the gastrointestinal tract, notably the epithelia whose functions include regulation of absorption, permeability, and secretion of hormones; and in the myenteric plexus, which is the intrinsic neural network principally responsible for the coordination of muscular activity in the gut. This review focuses on the physiological circadian variation of major colonic functions and their entraining mechanisms, including colonic motility, absorption, hormone secretion, permeability, and pain signalling. Pathophysiological states such as irritable bowel syndrome and ulcerative colitis and their interactions with circadian rhythmicity are also described. Finally, the classic circadian hormone melatonin is discussed, which is expressed in the gut in greater quantities than the pineal gland, and whose exogenous use has been of therapeutic interest in treating colonic pathophysiological states, including those exacerbated by chronic circadian disruption.
Collapse
Affiliation(s)
- Timothy J. Hibberd
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Stewart Ramsay
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | | | - Phil G. Dinning
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Colorectal Surgical Unit, Division of Surgery, Flinders Medical Centre, Adelaide, SA, Australia
| | | | - Nick J. Spencer
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
17
|
Post Z, Manfready RA, Keshavarzian A. Overview of the Gut-Brain Axis: From Gut to Brain and Back Again. Semin Neurol 2023; 43:506-517. [PMID: 37562457 DOI: 10.1055/s-0043-1771464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
The gut-brain axis refers to a bidirectional communication pathway linking the gastrointestinal system to the central nervous system. The hardware of this multifaceted pathway takes many forms, at once structural (neurons, microglia, intestinal epithelial cell barrier), chemical (neurotransmitters, enteroendocrine hormones, bacterial metabolites), and cellular (immune signaling, inflammatory pathways). The gut-brain axis is exquisitely influenced by our environment, diet, and behaviors. Here, we will describe recent progress in understanding the gut-brain axis in neurological disease, using Parkinson's disease as a guide. We will see that each component of the gut-brain axis is heavily mediated by intestinal microbiota and learn how gut-brain communication can go awry in microbial dysbiosis.
Collapse
Affiliation(s)
- Zoë Post
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Richard A Manfready
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois
- Departments of Physiology and Anatomy & Cell Biology, Rush University Medical Center, Chicago, Illinois
| | - Ali Keshavarzian
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
- Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois
- Departments of Physiology and Anatomy & Cell Biology, Rush University Medical Center, Chicago, Illinois
| |
Collapse
|
18
|
Sircu V, Colesnic SI, Covantsev S, Corlateanu O, Sukhotko A, Popovici C, Corlateanu A. The Burden of Comorbidities in Obstructive Sleep Apnea and the Pathophysiologic Mechanisms and Effects of CPAP. Clocks Sleep 2023; 5:333-349. [PMID: 37366660 DOI: 10.3390/clockssleep5020025] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/22/2023] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Micro-arousals and the repeated desaturation of oxyhemoglobin, which are typical in obstructive sleep apnea syndrome (OSAS), have adverse effects on the health of patients, leading to a wide range of complications such as cardiovascular (arterial hypertension, pulmonary hypertension, chronic heart failure, arrhythmias, myocardial infarction), cerebrovascular (strokes), metabolic (insulin resistance, obesity, diabetes mellitus, metabolic syndrome), gastrointestinal (non-alcoholic liver disease), urinary (chronic renal failure), and neuropsychiatric complications as well as a wide range of malignancies. These, in turn, have multilateral effects on familial, occupational, and social life, as well as increasing the risks of road traffic accidents and accidents at the workplace. Awareness, timely screening, and the prevention of complications play important roles in diagnosing and treating comorbid conditions. This review focuses on comorbidities in OSAS and the effect of Continuous Positive Airway Pressure (CPAP) therapy on their prognoses.
Collapse
Affiliation(s)
- Victoria Sircu
- Division of Pneumology and Allergology, Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova
| | - Silvia-Iaroslava Colesnic
- Division of Pneumology and Allergology, Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova
| | - Serghei Covantsev
- Department of Clinical Research and Development, Botkin Hospital, 125284 Moscow, Russia
- Department of Emergency Medicine № 76, Botkin Hospital, 125284 Moscow, Russia
| | - Olga Corlateanu
- Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova
| | - Anna Sukhotko
- Department of General Oncology № 71, Botkin Hospital, 125284 Moscow, Russia
| | - Cristian Popovici
- Division of Pneumology and Allergology, Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova
| | - Alexandru Corlateanu
- Division of Pneumology and Allergology, Department of Internal Medicine, State University of Medicine and Pharmacy Nicolae Testemitanu, MD-2004 Chisinau, Moldova
| |
Collapse
|
19
|
Liu W, Ma R, Sun C, Xu Y, Liu Y, Hu J, Ma Y, Wang D, Wen D, Yu Y. Implications from proteomic studies investigating circadian rhythm disorder-regulated neurodegenerative disease pathology. Sleep Med Rev 2023; 70:101789. [PMID: 37253318 DOI: 10.1016/j.smrv.2023.101789] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 06/01/2023]
Abstract
Neurodegenerative diseases (NDs) affect 15% of the world's population and are becoming an increasingly common cause of morbidity and mortality worldwide. Circadian rhythm disorders (CRDs) have been reported to be involved in the pathogenic regulation of various neurologic diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease, multiple sclerosis and amyotrophic lateral sclerosis. Proteomic technology is helpful to explore treatment targets for CRDs in patients with NDs. Here, we review the key differentially expressed (DE) proteins identified in previous proteomic studies investigating NDs, CRDs and associated models and the related pathways identified by enrichment analysis. Furthermore, we summarize the advantages and disadvantages of the above studies and propose new proteomic technologies for the precise study of circadian disorder-mediated regulation of ND pathology. This review provides a theoretical and technical reference for the precise study of circadian disorder-mediated regulation of ND pathology.
Collapse
Affiliation(s)
- Weiwei Liu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China
| | - Ruze Ma
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China; Department of Gerontology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, China
| | - Chen Sun
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China; Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Yingxi Xu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China
| | - Yang Liu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China
| | - Jiajin Hu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China
| | - Yanan Ma
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China; Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110122, Liaoning, China
| | - Difei Wang
- Department of Gerontology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, China
| | - Deliang Wen
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China.
| | - Yang Yu
- Health Sciences Institute, Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, Shenyang 110122, Liaoning, China.
| |
Collapse
|
20
|
Liu J, Wang W, Tian J, Lv C, Fu Y, Fass R, Song G, Yu Y. Sleep Deficiency Is Associated With Exacerbation of Symptoms and Impairment of Anorectal and Autonomic Functions in Patients With Functional Constipation. Front Neurosci 2022; 16:912442. [PMID: 35873821 PMCID: PMC9301120 DOI: 10.3389/fnins.2022.912442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Sleep deficiency (SD) is commonly seen in patients with functional constipation (FC). Our aim was to determine whether the presence of SD would influence symptoms, anorectal motility, sensation, and autonomic function in FC patients. Materials and Methods A total of 85 FC patients with SD and 193 FC patients without SD underwent high-resolution anorectal manometry. SD was assessed by using the Pittsburgh Sleep Quality Index (PSQI) score. Participants were required to fill in the entire questionnaires, including Patients' Constipation-symptoms, State-Trait Anxiety Inventory, and Hamilton Depression Scale. Autonomic dysfunction was studied by recording the heart rate variability. Multiple logistic regression was performed to explore the potential risk factors for anorectal function. Results Functional constipation patients with SD had a higher total score of constipation symptom (P < 0.001), in comparison with those without SD. FC patients with SD demonstrated significantly lower threshold volume for first sensation (P < 0.001) and urge (P < 0.001), as compared to those without SD. The PSQI score positively correlated with constipation symptom total score (P < 0.001), and negatively correlated with threshold volume for first sensation (P < 0.001) and urge (P < 0.001). FC patients with SD had a reduced vagal activity (P = 0.016) and a higher sympathetic activity as compared to those without SD (P = 0.003). Multivariate logistic regression revealed that SD, anxiety and depression were independent risk factors for anorectal function, with SD exhibiting the highest degree of association with first sensation (OR: 4.235). Conclusion Sleep deficiency is associated with worse constipation related symptoms, altered anorectal function and perception, and impaired autonomic function in FC patients.
Collapse
Affiliation(s)
- Jie Liu
- Department of Gastroenterology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - Wei Wang
- Department of Gastroenterology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - Jiashuang Tian
- Department of Gastroenterology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, China
| | - Chaolan Lv
- Division of Life Sciences and Medicine, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China (USTC), University of Science and Technology of China, Hefei, China
| | - Yuhan Fu
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | - Ronnie Fass
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | - Gengqing Song
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | - Yue Yu
- Department of Gastroenterology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, China
- Division of Life Sciences and Medicine, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China (USTC), University of Science and Technology of China, Hefei, China
| |
Collapse
|
21
|
Taherpour M, Mirzaei-Alavijeh M, Khazaie H, Nasrollah Hosseini S, Fatahi M, Karimi N, Jalilian F. Socio-cognitive Determinants of Healthy Sleep Behaviors Among Iranian Elderly: Application of the Theory of Planned Behavior. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2022. [DOI: 10.34172/jech.2022.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Sleep quality and quantity disorders are among the most important problems in old age. Healthy sleep behaviors are among the best ways to deal with sleep disorders among the elderly. This study aimed to determine the socio-cognitive determinants predicting healthy sleep behaviors among the elderly who had been referred to the retirement centers in Hamadan, Iran. Methods: This cross-sectional study was performed among 288 elderly people who had been referred to the retirement centers in Hamadan, Iran in 2020, and were selected through stratified random sampling. Data were collected online using a self-administered questionnaire with items on demographic characteristics and the theory of planned behavior (TPB) constructs. Data were analyzed by SPSS software (version 16) using Pearson correlation, independent t test, one-way ANOVA, and linear regression tests at the significance level of 0.05. Results: The mean (±standard deviation) age of respondents in this study was 67.2 (±6.3) years. Perceived behavior control (β=0.409), attitude (β=0.251), and subjective norms (β=0.205) were stronger predictors of healthy sleep behavior intention among the elderly, respectively; collectively, they accounted for 28.5% of the variation in sleep health behavior intention. Behavioral intention (β=0.429) and perceived behavioral control (β=0.167) were also predictors of healthy sleep behaviors among the elderly. There was a statistically significant relationship between the educational level and healthy sleep behaviors (P<0.05). Conclusion: It seems that the development and implementation of educational programs based on the TPB for the improvement of attitudes, subjective norms, and perceived behavior control can play an effective role in promoting healthy sleep behaviors and sleep quality among the elderly.
Collapse
Affiliation(s)
- Mahshad Taherpour
- Department of Health Education and Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Mohammad Fatahi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Negar Karimi
- Sleep Disorders Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Instructor, Cognitive Science Research Group, Academic Center for Education, Culture and Research, Alborz Branch, Alborz, Iran
| | - Farzad Jalilian
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
22
|
Fowler S, Hoedt EC, Talley NJ, Keely S, Burns GL. Circadian Rhythms and Melatonin Metabolism in Patients With Disorders of Gut-Brain Interactions. Front Neurosci 2022; 16:825246. [PMID: 35356051 PMCID: PMC8959415 DOI: 10.3389/fnins.2022.825246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/08/2022] [Indexed: 12/12/2022] Open
Abstract
Circadian rhythms are cyclic patterns of physiological, behavioural and molecular events that occur over a 24-h period. They are controlled by the suprachiasmatic nucleus (SCN), the brain’s master pacemaker which governs peripheral clocks and melatonin release. While circadian systems are endogenous, there are external factors that synchronise the SCN to the ambient environment including light/dark cycles, fasting/fed state, temperature and physical activity. Circadian rhythms also provide internal temporal organisation which ensures that any internal changes that take place are centrally coordinated. Melatonin synchronises peripheral clocks to the external time and circadian rhythms are regulated by gene expression to control physiological function. Synchronisation of the circadian system with the external environment is vital for the health and survival of an organism and as circadian rhythms play a pivotal role in regulating GI physiology, disruption may lead to gastrointestinal (GI) dysfunction. Disorders of gut-brain interactions (DGBIs), also known as functional gastrointestinal disorders (FGIDs), are a group of diseases where patients experience reoccurring gastrointestinal symptoms which cannot be explained by obvious structural abnormalities and include functional dyspepsia (FD) and irritable bowel syndrome (IBS). Food timing impacts on the production of melatonin and given the correlation between food intake and symptom onset reported by patients with DGBIs, chronodisruption may be a feature of these conditions. Recent advances in immunology implicate circadian rhythms in the regulation of immune responses, and DGBI patients report fatigue and disordered sleep, suggesting circadian disruption. Further, melatonin treatment has been demonstrated to improve symptom burden in IBS patients, however, the mechanisms underlying this efficacy are unclear. Given the influence of circadian rhythms on gastrointestinal physiology and the immune system, modulation of these rhythms may be a potential therapeutic option for reducing symptom burden in these patients.
Collapse
Affiliation(s)
- Sophie Fowler
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia
- NHMRC Centre of Research Excellence in Digestive Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Emily C. Hoedt
- NHMRC Centre of Research Excellence in Digestive Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia
| | - Nicholas J. Talley
- NHMRC Centre of Research Excellence in Digestive Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia
| | - Simon Keely
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia
- NHMRC Centre of Research Excellence in Digestive Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Grace L. Burns
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia
- NHMRC Centre of Research Excellence in Digestive Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- *Correspondence: Grace L. Burns,
| |
Collapse
|
23
|
Beigrezaei S, Mazidi M, Davies IG, Salehi-Abargouei A, Ghayour-Mobarhan M, Khayyatzadeh SS. The association between dietary behaviors and insomnia among adolescent girls in Iran. Sleep Health 2022; 8:195-199. [DOI: 10.1016/j.sleh.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 11/18/2021] [Accepted: 12/03/2021] [Indexed: 11/28/2022]
|
24
|
Hyun MK. How fatigue level is related to sleep disturbances: A large cross-sectional community study. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.102097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
25
|
Teimouri A, Amra B. Association between Sleep Quality and Gastroesophageal Reflux in Medical Students. Middle East J Dig Dis 2021; 13:139-144. [PMID: 34712452 PMCID: PMC8531919 DOI: 10.34172/mejdd.2021.217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/19/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Due to stressful occupational conditions, irregular dietary and sleep schedules, medical students are at increased risk of developing gastrointestinal disorders, gastroesophageal reflux (GERD) in particular, as well as sleep disturbances. Therefore, for the first time, we aimed to assess the correlation between GERD and sleep disturbances among medical students. METHODS The current cross-sectional study was done on 290 medical students at different study periods in Iran during 2018-2019. Age, sex, stage of studying, residence, and body mass index were gathered. The frequency scale for the symptoms of gastroesophageal reflux (FSSG) was utilized to assess gastrointestinal symptoms among them and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Eventually, the association of sleep disturbances with demographic factors and gastrointestinal symptoms was evaluated. RESULTS Living in the dormitory (p = 0.048; OR: 1.73; 95%CI: 1.01-2.99) and being overweight (p < 0.001; OR: 3.09; 95%CI: 1.58-6.06) were independently correlated with impaired sleep quality. GERD presented either by heartburn (p < 0.001) or regurgitation (p < 0.001) was associated with a lower quality of life. CONCLUSION GERD was correlated with poor sleep quality among medical students. In addition, residence in dormitory and being overweight were correlated with poor sleep quality.
Collapse
Affiliation(s)
- Azam Teimouri
- Assistant Professor of Gastroenterology, Department of Gasteroenterology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Babak Amra
- Professor of Pulmonology, Department of Pulmonology, Bamdad Respiratory Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
26
|
Fujiwara Y, Okuyama M, Nagami Y, Taira K, Ishizu H, Takaishi O, Sato H, Watanabe T. Heartburn, Functional Dyspepsia, Anxiety/Depression, and Sleep Disturbances Are Associated With Clinically Significant Belching. J Neurogastroenterol Motil 2021; 27:581-587. [PMID: 34642278 PMCID: PMC8521483 DOI: 10.5056/jnm20225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/29/2020] [Accepted: 02/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background/Aims Belching is the act of expelling gas from the stomach or esophagus noisily through the oral cavity. Although it is a physiological phenomenon, belching may also be a symptom of upper gastrointestinal diseases such as reflux esophagitis and functional dyspepsia (FD). A detailed epidemiology of belching has not yet been reported. The aim of this study is to examine the prevalence and clinical characteristics of clinically significant belching (CSB) in adults. Methods We analyzed 1998 subjects who visited the hospital for annual health checkups. Belching was evaluated by a simple question “Do you burp a lot?” and scored as 0 (never), 1 (occasionally), 2 (sometimes), 3 (often), or 4 (always). Subjects with CSB were defined as having scores ≥ 3. We also collected the clinical parameters, endoscopic findings, and data according to the Athens Insomnia Scale, Rome IV questionnaire, and Hospital Anxiety and Depression Scale (HADS). Results Of the 1998 subjects, 121 (6.1%) had CSB. Subjects with CSB had FD more commonly than reflux esophagitis, but presence of heartburn was high (10.7% vs 3.1%). In addition, the HADS and Athens Insomnia Scale scores in subjects with CSB were significantly higher than those in subjects without CSB. Presence of heartburn (OR, 2.07; 95% CI, 1.05-4.09), presence of FD (OR, 2.12; 95% CI, 1.33-3.36), anxiety/depression (OR, 2.29; 95% CI 1.51-3.45), and sleep disturbances (OR, 1.73; 95% CI, 1.14-2.61) were significantly associated with CSB. Conclusion The detailed epidemiology of belching in the general adult population was clarified.
Collapse
Affiliation(s)
- Yasuhiro Fujiwara
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masatsugu Okuyama
- Department of Gastroenterology, Kashiwara Municipal Hospital, Kashiwara, Japan
| | - Yasuaki Nagami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Koichi Taira
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hirotaka Ishizu
- Department of Gastroenterology, Kashiwara Municipal Hospital, Kashiwara, Japan
| | - Osamu Takaishi
- Department of Gastroenterology, Kashiwara Municipal Hospital, Kashiwara, Japan
| | - Hiroshi Sato
- Department of Gastroenterology, Kashiwara Municipal Hospital, Kashiwara, Japan
| | - Toshio Watanabe
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
27
|
Cox SD, Benoit JS, Brohard CL, McIntyre TM. Evaluation of sleep quality among nursing faculty: Application of the Pittsburgh Sleep Quality Index-A descriptive correlational study. Nurs Open 2021; 9:339-348. [PMID: 34569173 PMCID: PMC8685842 DOI: 10.1002/nop2.1067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/24/2021] [Accepted: 09/02/2021] [Indexed: 12/11/2022] Open
Abstract
AIM The aim of this study was to describe the overall sleep quality, sleep patterns and severity of sleep difficulties among nursing faculty using the Pittsburgh Sleep Quality Index (PSQI). DESIGN Cross-sectional descriptive and correlational study. METHODS A survey of faculty recruited from Texas Board of Nursing approved colleges/schools was used. A purposive, convenience sample of 105 faculty completed the PSQI, a reliable and valid instrument, in an online setting. Data was collected from January 2019 through April 2019. RESULTS Nursing faculty reported sleep difficulty across all components, with more problems in sleep latency, sleep disturbances and subjective sleep quality. Overall, 70.5% of participants were reportedly "poor" sleepers, a salient finding. Faculty experienced poor sleep quality across all academic ranks and age groups. Sleep latency and subjective sleep quality were components that presented higher in severity for the youngest faculty.
Collapse
Affiliation(s)
- Sonya D Cox
- College of Nursing, University of Houston, Sugar Land, TX, USA
| | - Julia S Benoit
- College of Optometry and Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
| | | | | |
Collapse
|
28
|
Abstract
INTRODUCTION Sleep quality may be impaired in systemic scleroderma (SSc) patients and contribute to loss of life quality. AIM The aims of this study were to study the prevalence of sleep disturbance in SSc patients and its possible association with epidemiological, clinical and laboratory data, treatment used, and depression, and to verify the association of sleep disturbance and quality of life in this group of patients. METHODS This is a cross-sectional study including 60 SSc patients. Epidemiological, clinical, laboratory, and treatment data were extracted from the medical records. To evaluate sleep quality, the PSQI (Pittsburgh Sleep Quality Index) was used; to evaluate depression, the CES-D (Center for Epidemiological Scale-Depression) was used; and to evaluate quality of life, SF-12 (12-Item Short-Form Health Survey) was used. Disease severity was evaluated by the Medsger index and the degree of cutaneous involvement by the modified Rodnan index. RESULTS The prevalence of patients with sleep disturbance was 73.3%. Sleep disturbance was associated with esophageal involvement (p = 0.03), Medsger index with higher disease severity (p = 0.01), and more depressive mood (p = 0.002). Patients with poor quality of sleep had worse quality of life by the SF-12 in mental (p = 0.001) and physical domains (p = 0.0008). No associations were found with epidemiological, serological, and treatment variables (all P's = nonsignificant). CONCLUSIONS There is a high prevalence of sleep disturbance in patients with SSc that is associated with esophageal involvement, severity of disease, depression, and worse quality of life.
Collapse
|
29
|
Sen P, Molinero-Perez A, O'Riordan KJ, McCafferty CP, O'Halloran KD, Cryan JF. Microbiota and sleep: awakening the gut feeling. Trends Mol Med 2021; 27:935-945. [PMID: 34364787 DOI: 10.1016/j.molmed.2021.07.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/05/2021] [Accepted: 07/05/2021] [Indexed: 02/07/2023]
Abstract
Various lifestyle and environmental factors are known to influence sleep. Increasingly, evidence points to a role for the microbiota in regulating brain and behaviour. This article explores how the microbiota-gut-brain axis affects sleep directly and indirectly. We summarize the possible molecular mechanisms underlying sleep-microbiome interactions and discuss how various factors interact with the gut microbiota to influence sleep. Furthermore, we present the current evidence of alterations of the microbiota-gut-brain axis in various sleep disorders and pathologies where comorbid sleep disturbances are common. Since manipulating the gut microbiota could potentially improve sleep, we outline ways in which this can be achieved.
Collapse
Affiliation(s)
- Paromita Sen
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | | | | | - Cian P McCafferty
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Ken D O'Halloran
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Physiology, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
| |
Collapse
|
30
|
Kurin M, Shibli F, Kitayama Y, Kim Y, Fass R. Sorting out the Relationship between Gastroesophageal Reflux Disease and Sleep. Curr Gastroenterol Rep 2021; 23:15. [PMID: 34338891 DOI: 10.1007/s11894-021-00815-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Gastroesophageal reflux disease is one of the most common conditions encountered by primary care physicians, gastroenterologists, foregut surgeons and otolaryngologists. While approximately 50% of patients experience nocturnal reflux symptoms, the relationship between gastroesophageal reflux disease and sleep is often overlooked. The aim of this review is to provide an update on the current understanding of this relationship and its clinical implications. Recent studies pertaining to the association between GERD and sleep with focus on sleep disturbances, obstructive sleep apnea, extraesophageal manifestations of GERD and treatment are discussed. RECENT FINDINGS There is a close relationship between GERD and sleep disturbances, but the nature of this relationship remains to be elucidated. Similarly, new data supports the association between GERD and obstructive sleep apnea, but whether this association is independent of confounding risk factors remains unresolved. Extraesophageal manifestations due to nocturnal GERD are primarily respiratory and can be explained by microaspiration and vagally-induced bronchospasm. Treatment of nocturnal GERD, both pharmacologically and surgically, improves sleep quality. Conversely, pharmacologic treatment of sleep disorders can improve nocturnal GERD symptoms. There is a bi-directional relationship between GERD and sleep. GERD is associated with various sleep disturbances. Sleep deficiency can exacerbate GERD. There is an association between extraesophageal manifestations and nocturnal GERD. Treatment directed towards GERD can improve sleep experience, and treatment directed to improve sleep can improve GERD symptoms.
Collapse
Affiliation(s)
- Michael Kurin
- Digestive Health Institute, Division of Gastroenterology and Hepatology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Fahmi Shibli
- The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA
| | - Yoshitaka Kitayama
- The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA
| | - Yeseong Kim
- The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA
| | - Ronnie Fass
- The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA.
| |
Collapse
|
31
|
Yan R, Murphy M, Genoni A, Marlow E, Dunican IC, Lo J, Andrew L, Devine A, Christophersen CT. Does Fibre-fix provided to people with irritable bowel syndrome who are consuming a low FODMAP diet improve their gut health, gut microbiome, sleep and mental health? A double-blinded, randomised controlled trial. BMJ Open Gastroenterol 2021; 7:bmjgast-2020-000448. [PMID: 32816830 PMCID: PMC7437697 DOI: 10.1136/bmjgast-2020-000448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction A diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) is an effective way to reduce gut symptoms in people with irritable bowel syndrome (IBS). This diet reduces the intake of fermentable fibres, leading to changes of the gut microbiota and insufficient fermentation in the large bowel, resulting in reduced production of short-chain fatty acids (SCFAs), such as butyrate, which has unfavourable implications for gut health, sleep and mental health. This study will examine the effect of Fibre-fix, a supplement containing a mix of dietary fibres, on the human gut microbiome composition, fermentative capacity, sleep, quality of life (QOL) and mental health of people with IBS who consume a low FODMAP diet (LFD). Methods and analysis A randomised, double-blind, placebo-controlled, study design is proposed to examine whether Fibre-fix added to an existing LFD may help modulate gastrointestinal function, improve markers of sleep, mental health and promote QOL in patients with IBS. Participants will provide stool and blood samples, daily bowel symptoms diaries and 3-day diet records. Additionally, they will complete validated questionnaires relating to FODMAP intake, sleep, mental health and QOL before and after a 3-week intervention. Gut health will be assessed via faecal microbiome composition, faecal pH and SCFA levels. Alteration of sleep will be recorded using an actigraphy device worn by all participants over the whole study. Multivariate analysis will be used to examine the gut microbiome and repeated measures Analysis of variance (ANOVA) will be used for dependent variables from questionnaires related to bowel symptoms, stool type, sleep, mental health and QOL to assess the differences between intervention and control groups after adjustment for confounding variables. Ethics and dissemination Ethics approval was obtained from the Human Research Ethics Committee of Edith Cowan University (2019-00619-YAN). Results will be disseminated in peer-review journal publications, and conference presentations. Participants will be provided with a summary of findings once the study is completed. If Fibre-fix is shown to result in favourable changes in gut microbial composition, SCFA production, sleep and mental well-being without exacerbating symptoms, this will provide additional dietary management options for those with IBS following an LFD. Trial registration number ACTRN12620000032954.
Collapse
Affiliation(s)
- Ran Yan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Mandy Murphy
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Angela Genoni
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Evania Marlow
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Ian C Dunican
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lesley Andrew
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Claus T Christophersen
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,WA Human Microbiome Collaboration Centre, School of Molecular & Life Sciences, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
32
|
de Rijk MG, van Eekelen APJ, Kaldenberg E, Boesveldt S, Te Woerd W, Holwerda T, Lansink CJM, Feskens EJM, de Vries JHM. The association between eating frequency with alertness and gastrointestinal complaints in nurses during the night shift. J Sleep Res 2021; 30:e13306. [PMID: 33622018 PMCID: PMC8518800 DOI: 10.1111/jsr.13306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/14/2020] [Accepted: 01/20/2021] [Indexed: 12/05/2022]
Abstract
We investigated the association of the number of eating occasions and energy intake with alertness and gastrointestinal (GI) complaints in nurses during their night shift. During this observational study we collected data on anthropometrics and demographics, eating frequency, energy intake, alertness and GI complaints in 118 healthy female nurses, aged 20 to 61 years. Nurses completed an alertness test (psychomotor vigilance task) during the night shift and a 24‐hr dietary recall and a questionnaire about GI complaints after the night shift. This was repeated three times, always on the first night shift in a night shift series. The number of eating occasions during the night shift was negatively associated with reaction times (β = −4.81 ms, 95% confidence interval [CI] −9.14 to −0.48; p = .030), and number of lapses (β = −0.04, 95% CI −0.07 to −0.00; p = .030). However, the number of eating occasions was not associated with subjective alertness and GI complaints. Energy intake during the night shift was not associated with objective or subjective alertness or with GI complaints. These associations were independent of caffeine intake, age, body mass index and dependence among the repeated measurements. The present study showed that eating frequency was positively associated with objectively measured alertness levels in female nurses during the night shift. The results need to be confirmed in an intervention study, where also timing, size and composition of the meal will be taken into account. In practice, optimising nutritional guidelines on these aspects could lead to faster responses, less (medical) errors, and a better wellbeing of night shift workers.
Collapse
Affiliation(s)
- Mariëlle G de Rijk
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | | | | | - Sanne Boesveldt
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | | | | | | | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Jeanne H M de Vries
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| |
Collapse
|
33
|
Jeon M, Dimitriou D, Halstead EJ. A Systematic Review on Cross-Cultural Comparative Studies of Sleep in Young Populations: The Roles of Cultural Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042005. [PMID: 33669583 PMCID: PMC7922907 DOI: 10.3390/ijerph18042005] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 01/21/2023]
Abstract
Recent studies have shown that sleep is influenced and shaped by cultural factors, including cultural values, beliefs and practices. However, a systematic understanding of how cultural factors in countries may influence sleep duration and sleep disturbances is still lacking. Therefore, we focused on a comparison of sleep duration and disturbances in young populations between countries. We report cross-cultural differences between the child, parent and environmental factors, and their association with sleep duration and disturbances. The review is based on literature searches of seven databases published until December 2020. Studies were included if they investigated sleep duration and disturbances of individuals up to 18 years across at least two or more countries. The results of this review have shown that sleep duration and disturbances vary between countries and regions and certain factors (e.g., bedtime routines, sleeping arrangement, physical activity and psychological functioning) have been associated with sleep duration or disturbances. This review also demonstrates that certain factors which were associated with sleep duration or disturbances in one country, were not shown in other countries, suggesting a need for recommendations for age-related sleep duration and sleep interventions to consider cultural differences that influence sleep duration or disturbances in individual countries or regions.
Collapse
|
34
|
Li X, Zhao H. Automated feature extraction from population wearable device data identified novel loci associated with sleep and circadian rhythms. PLoS Genet 2020; 16:e1009089. [PMID: 33075057 PMCID: PMC7595622 DOI: 10.1371/journal.pgen.1009089] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 10/29/2020] [Accepted: 08/31/2020] [Indexed: 12/12/2022] Open
Abstract
Wearable devices have been increasingly used in research to provide continuous physical activity monitoring, but how to effectively extract features remains challenging for researchers. To analyze the generated actigraphy data in large-scale population studies, we developed computationally efficient methods to derive sleep and activity features through a Hidden Markov Model-based sleep/wake identification algorithm, and circadian rhythm features through a Penalized Multi-band Learning approach adapted from machine learning. Unsupervised feature extraction is useful when labeled data are unavailable, especially in large-scale population studies. We applied these two methods to the UK Biobank wearable device data and used the derived sleep and circadian features as phenotypes in genome-wide association studies. We identified 53 genetic loci with p<5×10-8 including genes known to be associated with sleep disorders and circadian rhythms as well as novel loci associated with Body Mass Index, mental diseases and neurological disorders, which suggest shared genetic factors of sleep and circadian rhythms with physical and mental health. Further cross-tissue enrichment analysis highlights the important role of the central nervous system and the shared genetic architecture with metabolism-related traits and the metabolic system. Our study demonstrates the effectiveness of our unsupervised methods for wearable device data when additional training data cannot be easily acquired, and our study further expands the application of wearable devices in population studies and genetic studies to provide novel biological insights.
Collapse
Affiliation(s)
- Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States of America
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, CT, United States of America
- Department of Genetics, Yale University School of Medicine, New Haven, CT, United States of America
| |
Collapse
|
35
|
Nocturnal Gastroesophageal Reflux Disease (GERD) and Sleep: An Important Relationship That Is Commonly Overlooked. J Clin Gastroenterol 2020; 54:663-674. [PMID: 32657961 DOI: 10.1097/mcg.0000000000001382] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gastroesophageal reflux disease (GERD) is a prevalent, chronic medical condition that affects 13% of the adult population globally at least once a week. Sleep disturbances are frequently encountered in up to 25% of the GERD patients, likely due to nocturnal gastroesophageal reflux (GER). With advance in diagnostic techniques allowing for an improved understanding of involved physiological mechanisms of nocturnal reflux, there is growing evidence of a bidirectional relationship between GERD and sleep disturbances. Furthermore, nocturnal GER is associated with more complicated GERD. Obstructive sleep apnea (OSA) and GERD also have been linked, but to what degree remains controversial. Treatment of nocturnal GER has been shown to improve both subjective and objective sleep measures. The therapeutic approach includes lifestyle modifications and medication individualization and optimization with proton-pump inhibitors serving as the mainstay of treatment. Antireflux surgery and newer endoscopic procedures have been demonstrated to control nocturnal GER.
Collapse
|
36
|
Briguglio M, Vitale JA, Galentino R, Banfi G, Zanaboni Dina C, Bona A, Panzica G, Porta M, Dell'Osso B, Glick ID. Healthy Eating, Physical Activity, and Sleep Hygiene (HEPAS) as the Winning Triad for Sustaining Physical and Mental Health in Patients at Risk for or with Neuropsychiatric Disorders: Considerations for Clinical Practice. Neuropsychiatr Dis Treat 2020; 16:55-70. [PMID: 32021199 PMCID: PMC6955623 DOI: 10.2147/ndt.s229206] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/17/2019] [Indexed: 12/17/2022] Open
Abstract
Neuropsychiatric disorders stem from gene-environment interaction and their development can be, at least in some cases, prevented by the adoption of healthy and protective lifestyles. Once full blown, neuropsychiatric disorders are prevalent conditions that patients live with a great burden of disability. Indeed, the determinants that increase the affliction of neuropsychiatric disorders are various, with unhealthy lifestyles providing a significant contribution in the interplay between genetic, epigenetic, and environmental factors that ultimately represent the pathophysiological basis of these impairing conditions. On one hand, the adoption of Healthy Eating education, Physical Activity programs, and Sleep hygiene promotion (HEPAS) has the potential to become one of the most suitable interventions to reduce the risk to develop neuropsychiatric disorders, while, on the other hand, its integration with pharmacological and psychological therapies seems to be essential in the overall management of neuropsychiatric disorders in order to reduce the disability and improve the quality of life of affected patients. We present an overview of the current evidence in relation to HEPAS components in the prevention and management of neuropsychiatric disorders and provide suggestions for clinical practice.
Collapse
Affiliation(s)
- Matteo Briguglio
- IRCCS Orthopedic Institute Galeazzi, Scientific Direction, Milan, Italy
| | | | - Roberta Galentino
- IRCCS Orthopedic Institute Galeazzi, Tourette's Syndrome and Movement Disorders Centre, Milan, Italy
| | - Giuseppe Banfi
- IRCCS Orthopedic Institute Galeazzi, Scientific Direction, Milan, Italy.,Department of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Alberto Bona
- Neurosurgery Department, ICCS Istituto Clinico Città Studi, Milan, Italy
| | - Giancarlo Panzica
- Department of Neuroscience, Rita Levi Montalcini, University of Turin, Turin, Italy
| | - Mauro Porta
- IRCCS Orthopedic Institute Galeazzi, Tourette's Syndrome and Movement Disorders Centre, Milan, Italy
| | - Bernardo Dell'Osso
- University of Milan, Department of Clinical and Biomedical Sciences Luigi Sacco, ASST Fatebenefratelli-Sacco, Ospedale Sacco Polo Universitario, Milan, Italy.,"Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Ira David Glick
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|