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Chen P, Wang W, Ban W, Zhang K, Dai Y, Yang Z, You Y. Deciphering Post-Stroke Sleep Disorders: Unveiling Neurological Mechanisms in the Realm of Brain Science. Brain Sci 2024; 14:307. [PMID: 38671959 PMCID: PMC11047862 DOI: 10.3390/brainsci14040307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 04/28/2024] Open
Abstract
Sleep disorders are the most widespread mental disorders after stroke and hurt survivors' functional prognosis, response to restoration, and quality of life. This review will address an overview of the progress of research on the biological mechanisms associated with stroke-complicating sleep disorders. Extensive research has investigated the negative impact of stroke on sleep. However, a bidirectional association between sleep disorders and stroke exists; while stroke elevates the risk of sleep disorders, these disorders also independently contribute as a risk factor for stroke. This review aims to elucidate the mechanisms of stroke-induced sleep disorders. Possible influences were examined, including functional changes in brain regions, cerebrovascular hemodynamics, neurological deficits, sleep ion regulation, neurotransmitters, and inflammation. The results provide valuable insights into the mechanisms of stroke complicating sleep disorders.
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Affiliation(s)
- Pinqiu Chen
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (P.C.)
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Wenyan Wang
- Key Laboratory of Molecular Pharmacology and Drug Evaluation, Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, School of Pharmacy, Yantai University, Yantai 264005, China; (P.C.)
| | - Weikang Ban
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Kecan Zhang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Yanan Dai
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Zhihong Yang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Yuyang You
- School of Automation, Beijing Institute of Technology, Beijing 100081, China
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Xiao X, Feng H, Liao Y, Tang H, Li L, Li K, Hu F. Identification of key circadian rhythm genes in skin aging based on bioinformatics and machine learning. Aging (Albany NY) 2023; 15:11672-11689. [PMID: 37905958 PMCID: PMC10637791 DOI: 10.18632/aging.205155] [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: 05/17/2023] [Accepted: 09/26/2023] [Indexed: 11/02/2023]
Abstract
Skin aging is often accompanied by disruption of circadian rhythm and abnormal expression of circadian rhythm-related genes. In this study, we downloaded skin aging expression datasets from the GEO database and utilized bioinformatics and machine learning methods to explore circadian rhythm genes and pathways involved in skin aging, revealing the pathological and molecular mechanisms of skin aging. Results showed that 39 circadian rhythm-related genes (CRGs) were identified in skin aging, and these CRGs were enriched in signaling pathways such as glucagon signaling pathway, insulin resistance, thyroid hormone signaling pathway, and adipocytokine signaling pathway. Three key skin aging-related CRGs, SIRT1, ARNTL, and ATF4, were identified based on machine learning. Additionally, we found that skin aging was associated with infiltration of immune cells including NK cells activated, Macrophages M1, Mast cells resting, T cells CD4 memory activated, and Macrophages M2, and the expression of the three key skin aging-related CRGs was correlated with these immune cells. Finally, SIRT1, ARNTL, and ATF4 were all down-regulated in skin aging and had a good ability to distinguish young skin tissue from aging skin tissue. In conclusion, three key CRGs, including SIRT1, ARNTL, and ATF4, which are closely related to skin aging, were obtained based on bioinformatics and machine learning technology screening. These three key CRGs were potential risk genes for skin aging and also associated with changes in the immune microenvironment in skin aging. The language used in this paragraph follows the guidelines for scientific writing specified by SCI, making it clear and concise.
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Affiliation(s)
- Xiao Xiao
- Department of Dermatology, Hunan Provincial People’s Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410002, China
| | - Hao Feng
- Department of Dermatology, Hunan Provincial People’s Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410002, China
| | - Yangying Liao
- Department of Dermatology, Hunan Provincial People’s Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410002, China
| | - Hua Tang
- Department of Dermatology, Hunan Provincial People’s Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410002, China
| | - Lan Li
- Department of Dermatology, Hunan Provincial People’s Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410002, China
| | - Ke Li
- Department of Dermatology, Hunan Provincial People’s Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410002, China
| | - Feng Hu
- Department of Dermatology, Hunan Provincial People’s Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410002, China
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3
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Zhao W, Mao L, He C, Ding D, Hu N, Song X, Long D. Effects of low dose radiation on behavior rhythm of zebrafish (Danio rerio). ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 255:114779. [PMID: 36924557 DOI: 10.1016/j.ecoenv.2023.114779] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/02/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
Biological rhythm refers to the internal regulation of various life activities of an organism, which are determined by the specific time structure sequences of each individual. Behavior rhythm is the most intuitive embodiment of biological rhythm. To study the effect of low dose radiation on behavioral rhythm, zebrafish (Danio rerio) was used as a model organism in this study. The early embryos of zebrafish were irradiated at doses of 0.01, 0.1, and 1 Gy to observe the changes in zebrafish development, circadian rhythm, key clock genes, related RNA and protein expression, and melatonin. The results revealed that 0.1 and 1 Gy radiation could lead to different degrees of telencephalic nerve cell apoptosis and the formation of vacuolar structures. 0.1 and 1 Gy radiation could reduce the hatching rate of zebrafish embryos at 72 hpf and delay embryo hatching. The analysis of circadian behavior at 120 hpf demonstrated that 1 Gy dose of radiation altered the circadian rhythm of zebrafish, as well as decreased the distance, amplitude, and phase of movement. RT-PCR analysis of the key clock genes (bmal1b, clock1a, per1b, per2, cry2, and nr1d1) involved in regulating circadian rhythm was performed. The results showed that 1 Gy radiation could interfere with the expression of clock genes in zebrafish embryos and upregulate bmal1b, clock1a, and per1b. Western blot experiments further verified the protein expression of key clock genes, bmal1b and clock. Detection of melatonin secretion at different time points over 24 h showed that radiation doses of 0.1 and 1 Gy could increase melatonin secretion. Based on these findings, it is speculated that a certain dose of radiation may affect melatonin secretion, which impacts the telencephalon structure and ontogeny of zebrafish, delays hatching, and changes the circadian rhythm. This effect is thought to be achieved through upregulating the expression of circadian rhythm genes, clock1a and per1b and related proteins, which may be responsible for the abnormal circadian rhythm caused by radiation.
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Affiliation(s)
- Weichao Zhao
- School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, PR China; Hunan Province Key Laboratory of Typical Evironmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang 421001, PR China
| | - Liang Mao
- School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, PR China; Hunan Province Key Laboratory of Typical Evironmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang 421001, PR China
| | - Chuqi He
- School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, PR China; Hunan Province Key Laboratory of Typical Evironmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang 421001, PR China
| | - Dexin Ding
- Key Discipline Laboratory for National Defence for Biotechnology in Uranium Mining and Hydrometallurgy,University of South China, Hengyang, Hunan 421001, PR China
| | - Nan Hu
- Key Discipline Laboratory for National Defence for Biotechnology in Uranium Mining and Hydrometallurgy,University of South China, Hengyang, Hunan 421001, PR China
| | - Xiaohua Song
- School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, PR China; Hunan Province Key Laboratory of Typical Evironmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang 421001, PR China
| | - Dingxin Long
- School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, PR China; Hunan Province Key Laboratory of Typical Evironmental Pollution and Health Hazards, Hengyang Medical School, University of South China, Hengyang 421001, PR China.
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Mentzelou M, Papadopoulou SK, Papandreou D, Spanoudaki M, Dakanalis A, Vasios GK, Voulgaridou G, Pavlidou E, Mantzorou M, Giaginis C. Evaluating the Relationship between Circadian Rhythms and Sleep, Metabolic and Cardiovascular Disorders: Current Clinical Evidence in Human Studies. Metabolites 2023; 13:370. [PMID: 36984810 PMCID: PMC10057970 DOI: 10.3390/metabo13030370] [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: 02/01/2023] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Circadian rhythms are generated by the circadian clock, a self-sustained internal timing system that exhibits 24-h rhythms in the body. Many metabolic, cellular, behavioral and physiological processes are regulated by the circadian clock in coordination with environmental cues. The present study is a comprehensive review of the currently existing evidence concerning the relationship between circadian rhythms and sleep, metabolic, and cardiovascular disorders. We thoroughly searched the online databases PubMed, Scopus, and Web of Science to find the existing clinical studies from the last twenty-three years (2000-2023). Circadian misalignment was found to be associated with an increase in the risk of metabolic disorders, cardiovascular diseases, and obesity, as well as inadequate sleep quality. In this review article, all the included studies had a strength protocol design and all of them were conducted on humans. However, the most common limitations of them were the small sample size and the short time of the intervention. In conclusion, managing the factors that disrupt the optimal function of central and peripheral clocks can help to reduce the risk of metabolic and cardiovascular diseases, improving also sleep quality. Future studies should further explore the underlying mechanisms of the interconnections between circadian clocks and sleep, metabolic, and cardiovascular disorders. This may provide new opportunities for advance chronotherapy approach.
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Affiliation(s)
- Maria Mentzelou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Lemnos, Greece
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Dimitrios Papandreou
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates
| | - Maria Spanoudaki
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
- Clinical Dietetics & Nutrition Department of 424 General Military Hospital, New Efkarpia Ring Road, 56429 Thessaloniki, Greece
| | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy
| | - Georgios K. Vasios
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Lemnos, Greece
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Lemnos, Greece
| | - Maria Mantzorou
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Lemnos, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Lemnos, Greece
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Abstract
SUMMARY Circadian sleep-wake disorders are common. Because they represent conflict between the timing of the patient's endogenous rhythms and desired timing of sleep, the presenting complaints may include both difficulty of sleep initiation or maintenance and undesired or unplanned daytime or early evening sleepiness. Therefore, circadian disorders may be misdiagnosed as either a primary insomnia or a hypersomnia disorder, depending on which complaint is more troublesome for the patient. Objective information about sleep and wake patterns over long periods is crucial for accurate diagnosis. Actigraphy provides long-term information about the rest/activity pattern about an individual. However, caution should be applied in interpretation of the results because the information provided only includes information of movements, and activity is only an indirect circadian phase marker. Timing of light and melatonin therapy is critical for successful treatment of circadian rhythm disorders. Therefore, results of actigraphy are useful and should be used in conjunction with additional measurements, including 24 hours sleep-wake history, sleep log, and melatonin measurements.
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Affiliation(s)
- Alessandra Giordano
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston Massachusetts, U.S.A
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Sun SY, Chen GH. Treatment of Circadian Rhythm Sleep-Wake Disorders. Curr Neuropharmacol 2022; 20:1022-1034. [PMID: 34493186 PMCID: PMC9886819 DOI: 10.2174/1570159x19666210907122933] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/09/2021] [Accepted: 09/05/2021] [Indexed: 11/22/2022] Open
Abstract
Circadian rhythm sleep-wake disorders (CRSWDs) are a distinct class of sleep disorders caused by alterations to the circadian time-keeping system, its entrainment mechanisms, or a mismatch between the endogenous circadian rhythm and the external environment. The main clinical manifestations are insomnia and excessive daytime sleepiness that often lead to clinically meaningful distress or cause mental, physical, social, occupational, educational, or other functional impairment. CRSWDs are easily mistaken for insomnia or early waking up, resulting in inappropriate treatment. CRSWDs can be roughly divided into two categories, namely, intrinsic CRSWDs, in which sleep disturbances are caused by alterations to the endogenous circadian rhythm system due to chronic changes in the regulation or capture mechanism of the biological clock, and extrinsic circadian rhythm sleep-wake disorders, in which sleep disorders, such as jet lag or shift-work disorder, result from environmental changes that cause a mismatch between sleep-wakefulness times and internal circadian rhythms. Sleep diaries, actigraphy, and determination of day and night phase markers (dim light melatonin onset and core body temperature minimum) have all become routine diagnostic methods for CRSWDs. Common treatments for CRSWD currently include sleep health education, time therapy, light therapy, melatonin, and hypnotic drug therapy. Here, we review the progress in the epidemiology, etiology, diagnostic evaluation, diagnostic criteria, and treatment of intrinsic CRSWD, with emphasis on the latter, in the hope of bolstering the clinical diagnosis and treatment of CRSWDs.
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Affiliation(s)
- Shi-Yu Sun
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan, Huainan 232007, Anhui, People's Republic of China
| | - Gui-Hai Chen
- Department of Neurology (Sleep Disorders), the Affiliated Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, P.R. China;,Address correspondence to this author at the Department of Neurology (Sleep Disorders), the Affiliated Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, P.R. China; Tel/Fax:+86-551-82324252; E-mail:
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Fiorito TM, Krilov LR. Diurnal Temperature Variation: Addressing Once-Daily Nighttime Fevers in the Era of COVID-19. Pediatr Ann 2022; 51:e202-e205. [PMID: 35575539 DOI: 10.3928/19382359-20220314-03] [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: 11/20/2022]
Abstract
Pediatric patients with "once-daily" fevers are often referred to pediatric infectious disease specialists for evaluation. Often, these fevers occur at nighttime in the absence of additional symptoms and come to the caregiver's attention after a viral illness. It is crucial for caregivers and providers to be able to define and measure fever accurately when trying to ascertain the true etiology of this clinical picture. Fever education is critical in providing reassurance to parents, and fever diaries should be encouraged. In a well-appearing child without any additional symptoms, at least a percentage of these fevers can be explained by normal diurnal variation of temperature. [Pediatr Ann. 2022;51(5):e202-e205.].
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Hsu NW, Chou KC, Wang YTT, Hung CL, Kuo CF, Tsai SY. Building a model for predicting metabolic syndrome using artificial intelligence based on an investigation of whole-genome sequencing. J Transl Med 2022; 20:190. [PMID: 35484552 PMCID: PMC9052619 DOI: 10.1186/s12967-022-03379-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/04/2022] [Indexed: 12/02/2022] Open
Abstract
Background The circadian system is responsible for regulating various physiological activities and behaviors and has been gaining recognition. The circadian rhythm is adjusted in a 24-h cycle and has transcriptional–translational feedback loops. When the circadian rhythm is interrupted, affecting the expression of circadian genes, the phenotypes of diseases could amplify. For example, the importance of maintaining the internal temporal homeostasis conferred by the circadian system is revealed as mutations in genes coding for core components of the clock result in diseases. This study will investigate the association between circadian genes and metabolic syndromes in a Taiwanese population. Methods We performed analysis using whole-genome sequencing, read vcf files and set target circadian genes to determine if there were variants on target genes. In this study, we have investigated genetic contribution of circadian-related diseases using population-based next generation whole genome sequencing. We also used significant SNPs to create a metabolic syndrome prediction model. Logistic regression, random forest, adaboost, and neural network were used to predict metabolic syndrome. In addition, we used random forest model variables importance matrix to select 40 more significant SNPs, which were subsequently incorporated to create new prediction models and to compare with previous models. The data was then utilized for training set and testing set using five-fold cross validation. Each model was evaluated with the following criteria: area under the receiver operating characteristics curve (AUC), precision, F1 score, and average precision (the area under the precision recall curve). Results After searching significant variants, we used Chi-Square tests to find some variants. We found 186 significant SNPs, and four predicting models which used 186 SNPs (logistic regression, random forest, adaboost and neural network), AUC were 0.68, 0.8, 0.82, 0.81 respectively. The F1 scores were 0.412, 0.078, 0.295, 0.552, respectively. The other three models which used the 40 SNPs (logistic regression, adaboost and neural network), AUC were 0.82, 0.81, 0.81 respectively. The F1 scores were 0.584, 0.395, 0.574, respectively. Conclusions Circadian gene defect may also contribute to metabolic syndrome. Our study found several related genes and building a simple model to predict metabolic syndrome. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03379-7.
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Affiliation(s)
- Nai-Wei Hsu
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Kai-Chen Chou
- Department of Laboratory Medicine, MacKay Memorial Hospital, Taipei City, Taiwan
| | - Yu-Ting Tina Wang
- Department of Laboratory Medicine, MacKay Memorial Hospital, Taipei City, Taiwan
| | - Chung-Lieh Hung
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan
| | - Chien-Feng Kuo
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Department of Nursing, MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan.,Division of Infectious Diseases, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shin-Yi Tsai
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan. .,Department of Laboratory Medicine, MacKay Memorial Hospital, Taipei City, Taiwan. .,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, 21205, USA. .,Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan. .,Institute of Long-Term Care, Mackay Medical College, New Taipei City, Taiwan.
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Roles of Neuropeptides in Sleep-Wake Regulation. Int J Mol Sci 2022; 23:ijms23094599. [PMID: 35562990 PMCID: PMC9103574 DOI: 10.3390/ijms23094599] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/31/2022] [Accepted: 04/19/2022] [Indexed: 12/04/2022] Open
Abstract
Sleep and wakefulness are basic behavioral states that require coordination between several brain regions, and they involve multiple neurochemical systems, including neuropeptides. Neuropeptides are a group of peptides produced by neurons and neuroendocrine cells of the central nervous system. Like traditional neurotransmitters, neuropeptides can bind to specific surface receptors and subsequently regulate neuronal activities. For example, orexin is a crucial component for the maintenance of wakefulness and the suppression of rapid eye movement (REM) sleep. In addition to orexin, melanin-concentrating hormone, and galanin may promote REM sleep. These results suggest that neuropeptides play an important role in sleep–wake regulation. These neuropeptides can be divided into three categories according to their effects on sleep–wake behaviors in rodents and humans. (i) Galanin, melanin-concentrating hormone, and vasoactive intestinal polypeptide are sleep-promoting peptides. It is also noticeable that vasoactive intestinal polypeptide particularly increases REM sleep. (ii) Orexin and neuropeptide S have been shown to induce wakefulness. (iii) Neuropeptide Y and substance P may have a bidirectional function as they can produce both arousal and sleep-inducing effects. This review will introduce the distribution of various neuropeptides in the brain and summarize the roles of different neuropeptides in sleep–wake regulation. We aim to lay the foundation for future studies to uncover the mechanisms that underlie the initiation, maintenance, and end of sleep–wake states.
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Liu S, Cheng Y, Wang S, Liu H. Circadian Clock Genes Modulate Immune, Cell Cycle and Apoptosis in the Diagnosis and Prognosis of Pan-Renal Cell Carcinoma. Front Mol Biosci 2022; 8:747629. [PMID: 34977153 PMCID: PMC8717949 DOI: 10.3389/fmolb.2021.747629] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/10/2021] [Indexed: 01/20/2023] Open
Abstract
Background: Pan-renal cell carcinoma (pan-RCC) is mainly divided into renal clear cell carcinoma (KIRC), renal papillary cell carcinoma (KIRP), and chromophobe cell carcinoma (KICH). Pan-RCC is a common malignant neoplasm with a high incidence and poor prognosis. Several studies have demonstrated a close association between cancer development and circadian rhythms; however, the clinical significance and molecular mechanism of the clock gene remain unclear in pan-RCC. Methods: In this study, we systematically characterized the alterations of 15 well-known clock genes of three types of kidney cancer. Bioinformatics methods, including differential expression analysis, survival analysis, signing pathway analysis, co-expression network analysis, and drug sensitivity analysis were used to study the diagnosis, prognostic role, and mechanism of clock genes. Results: Thirteen rhythmic genes fluctuated in circadian rhythm in the kidney tissue of mice, and the opposite trend of these rhythm phases was also found in baboons. There are twelve clock genes that were differentially expressed in at least two types of RCC, of which NR1D1, DBP, BHLHE40, CRY1, and CLOCK had the same trend in RCC. Changes in clock control genes may be regulated through methylation, copy number, and mutations. Five rhythmic genes, including PER2, DBP, PER3, CRY2, and RORA, have significant prognostic role in patient survival in at least two types of kidney cancer. Immune infiltration analysis showed that the expression of these rhythmic genes related to prognosis was positively correlated with the infiltration levels of CD4 and CD8 T cells. Pathway analysis suggests that the clock genes is widely related to cancer-related signaling pathways, such as apoptosis, cell cycle, and other pathways. The PPI network showed that circadian genes are closely linked to cancer-related genes such as HIF-1A, TP53, and ERBB2. Moreover, clock gene expression is correlated with the sensitivity of anticancer drugs such as bleomycin and methotrexate in pan-RCC. Conclusion: Taken together, the abnormal expression of biological clock genes plays an important role in the clinical prognosis of RCC through immunity, cell cycle, and apoptosis. These findings provide a reliable basis for the diagnosis, prognosis, and drug guidance for RCC.
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Affiliation(s)
- Shuwen Liu
- Institute for Inheritance-Based Innovation of Chinese Medicine, School of Pharmaceutical Sciences, Health Science Center, Shenzhen University, Shenzhen, China.,College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen, China.,Guangdong Key Laboratory for Functional Substances in Medicinal Edible Resources and Healthcare Products, School of Life Sciences and Food Engineering, Hanshan Normal University, Chaozhou, China
| | - Yongxian Cheng
- Institute for Inheritance-Based Innovation of Chinese Medicine, School of Pharmaceutical Sciences, Health Science Center, Shenzhen University, Shenzhen, China.,Guangdong Key Laboratory for Functional Substances in Medicinal Edible Resources and Healthcare Products, School of Life Sciences and Food Engineering, Hanshan Normal University, Chaozhou, China
| | - Shaoxiang Wang
- Institute for Inheritance-Based Innovation of Chinese Medicine, School of Pharmaceutical Sciences, Health Science Center, Shenzhen University, Shenzhen, China
| | - Huiyu Liu
- Institute for Inheritance-Based Innovation of Chinese Medicine, School of Pharmaceutical Sciences, Health Science Center, Shenzhen University, Shenzhen, China
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Yin W, Zhang J, Guo Y, Wu Z, Diao C, Sun J. Melatonin for premenstrual syndrome: A potential remedy but not ready. Front Endocrinol (Lausanne) 2022; 13:1084249. [PMID: 36699021 PMCID: PMC9868742 DOI: 10.3389/fendo.2022.1084249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Premenstrual syndrome (PMS), a recurrent and moderate disorder that occurs during the luteal phase of the menstrual cycle and quickly resolves after menstruation, is characterized by somatic and emotional discomfort that can be severe enough to impair daily activities. Current therapeutic drugs for PMS such as selective serotonin reuptake inhibitors are not very satisfying. As a critical pineal hormone, melatonin has increasingly been suggested to modulate PMS symptoms. In this review, we update the latest progress on PMS-induced sleep disturbance, mood changes, and cognitive impairment and provide possible pathways by which melatonin attenuates these symptoms. Moreover, we focus on the role of melatonin in PMS molecular mechanisms. Herein, we show that melatonin can regulate ovarian estrogen and progesterone, of which cyclic fluctuations contribute to PMS pathogenesis. Melatonin also modulates gamma-aminobutyric acid and the brain-derived neurotrophic factor system in PMS. Interpreting the role of melatonin in PMS is not only informative to clarify PMS etiology but also instructive to melatonin and its receptor agonist application to promote female health. As a safe interaction, melatonin treatment can be effective in alleviating symptoms of PMS. However, symptoms such as sleep disturbance, depressive mood, cognitive impairment are not specific and can be easily misdiagnosed. Connections between melatonin receptor, ovarian steroid dysfunction, and PMS are not consistent among past studies. Before final conclusions are drawn, more well-organized and rigorous studies are recommended.
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Affiliation(s)
- Wei Yin
- Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Neurobiology, Shandong University, Jinan, Shandong, China
| | - Jie Zhang
- Department of Neurosurgery, Laizhou City People’s Hospital, Laizhou, Shandong, China
| | - Yao Guo
- Department of Psychiatry, Shandong Provincial Mental Health Center, Jinan, Shandong, China
| | - Zhibing Wu
- Department of Anatomy, Changzhi Medical College, Changzhi, Shanxi, China
| | - Can Diao
- School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jinhao Sun
- Shandong Key Laboratory of Mental Disorders, Department of Anatomy and Neurobiology, Shandong University, Jinan, Shandong, China
- *Correspondence: Jinhao Sun,
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Bonilla-Jaime H, Zeleke H, Rojas A, Espinosa-Garcia C. Sleep Disruption Worsens Seizures: Neuroinflammation as a Potential Mechanistic Link. Int J Mol Sci 2021; 22:12531. [PMID: 34830412 PMCID: PMC8617844 DOI: 10.3390/ijms222212531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
Sleep disturbances, such as insomnia, obstructive sleep apnea, and daytime sleepiness, are common in people diagnosed with epilepsy. These disturbances can be attributed to nocturnal seizures, psychosocial factors, and/or the use of anti-epileptic drugs with sleep-modifying side effects. Epilepsy patients with poor sleep quality have intensified seizure frequency and disease progression compared to their well-rested counterparts. A better understanding of the complex relationship between sleep and epilepsy is needed, since approximately 20% of seizures and more than 90% of sudden unexpected deaths in epilepsy occur during sleep. Emerging studies suggest that neuroinflammation, (e.g., the CNS immune response characterized by the change in expression of inflammatory mediators and glial activation) may be a potential link between sleep deprivation and seizures. Here, we review the mechanisms by which sleep deprivation induces neuroinflammation and propose that neuroinflammation synergizes with seizure activity to worsen neurodegeneration in the epileptic brain. Additionally, we highlight the relevance of sleep interventions, often overlooked by physicians, to manage seizures, prevent epilepsy-related mortality, and improve quality of life.
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Affiliation(s)
- Herlinda Bonilla-Jaime
- Departamento de Biología de la Reproducción, Área de Biología Conductual y Reproductiva, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de Mexico CP 09340, Mexico;
| | - Helena Zeleke
- Neuroscience and Behavioral Biology Program, College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA;
| | - Asheebo Rojas
- Department of Pharmacology and Chemical Biology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Claudia Espinosa-Garcia
- Department of Pharmacology and Chemical Biology, School of Medicine, Emory University, Atlanta, GA 30322, USA
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13
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Lin CH, Lin YH, Tzeng IS, Kuo CY. An Association Rule Analysis of the Acupressure Effect on Sleep Quality. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:1399258. [PMID: 34630604 PMCID: PMC8494578 DOI: 10.1155/2021/1399258] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/09/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sleep is recognized as an all-important physiological process, which also contributes to maintaining several bodily functions and systems. According to the Pittsburgh Sleep Quality Index (PSQI), also known as the most widely used tool in the field of subjective assessment of self-perceived sleep quality, a combination of acupoints could be more effective than single acupoint treatment in improving sleep quality. METHODS The present study was based on the extracted eligible studies rooted in a previous meta-analysis that worked on the basis of association rule mining and examined the potential kernel acupoint combinations for improving sleep quality. RESULTS Depending on the Apriori algorithm, we summarized 26 acupoints as binary data from the 32 eligible studies based on a previous meta-analysis and analyzed them. The top 10 most frequently selected acupoints were HT7, SP6, PC6, KI1, GV20, EM5, EX-HN3, EX-HN16, KI3, and MA-TF1. Furthermore, as deduced from 21 association rules, the primary relevant rules in the combination of acupoints are (EX-HN3, EX-HN16)=>(GV20) and (HT7, KI1)=>(PC6). CONCLUSIONS In order to use acupuncture to improve sleep quality, integrating (EX-HN3, EX-HN16, GV20) with (HT7, KI1, PC6) acupoints could be deemed as the kernel acupoint combination.
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Affiliation(s)
- Chih-Hung Lin
- Respiratory Care and Chest Medicine, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Ya-Hsuan Lin
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
- Department of Statistics, National Taipei University, Taipei, Taiwan
| | - Chan-Yen Kuo
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
- Department of Nursing, Cardinal Tien College of Healthcare and Management, New Taipei, Taiwan
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14
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Juliatte TDPR, Costa PD, Canaan JDR, Fonseca DC, Serra-Negra JM, Andrade EF, Castelo PM, Pereira LJ. Circadian preference and its relationship with possible sleep and awake bruxism in adults assisted by the public health system. Chronobiol Int 2021; 39:68-76. [PMID: 34517733 DOI: 10.1080/07420528.2021.1973487] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Modern lifestyle and social demands induce changes in sleep routines that may not meet individual circadian preferences (chronotype). Such changes may be associated with the development of unhealthy lifestyles and the emergence of diseases relevant to public health services, such as obesity, hypertension, and diabetes mellitus, as well as sleep bruxism (SB) and awake bruxism (AB). The present study aimed to assess the relationship between the evening, morning or intermediate chronotypes with the report of possible SB and AB in adult individuals assisted by the Family Health Strategy (FHS). The selection of participants was performed through probabilistic cluster analysis. The sample size (n = 384) was calculated to include a representative sample of the 52,628 adults registered in the FHS of a countryside city located in the Southeast Region of Brazil. The Morningness-Eveningness Questionnaire (MEQ) was used to determine the chronotype, and Questionnaire-Based Self-Reported Bruxism was used for identifying possible SB and AB. The following clinical and social-behavioral variables were also evaluated: age, sex, BMI, income, physical activity, schooling, alcohol consumption and smoking, chronic diseases and depression. Two logistic regression models were used: one for SB and one for AB. Possible SB was associated with female sex, lack of physical activity and income above 2 minimum wages. Regarding chronotype, a 19% reduction in the chance of possible SB was observed in morning individuals compared to evening individuals (p = .017). Possible AB was associated with younger individuals, smoking and depression. In conclusion, compared with the evening circadian preference, the morning circadian preference was associated with greater protection against possible SB in an adult population assisted by the FHS.
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Affiliation(s)
| | | | | | | | | | | | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Universidade Federal De São Paulo (Unifesp), Diadema, Brazil
| | - Luciano José Pereira
- Health Sciences Department, Universidade Federal de Lavras (Ufla), Lavras, Brazil
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15
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A Feasibility Study on Smart Mattresses to Improve Sleep Quality. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6127894. [PMID: 34394894 PMCID: PMC8356017 DOI: 10.1155/2021/6127894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 12/05/2022]
Abstract
Good sleep quality is essential, especially for clinical users. Sleep disorders not only impair the success rate of treatment but also delay recovery. They can seriously interfere with treatment outcomes and even endanger a user's life. In this study, we created a smart mattress containing 10 × 18 air packs and control units. Each air pack contains a set of pressure and height sensors and two air valves. Each row control unit can detect and adjust the pressure and height of each air bag in the row. When the bed body is turned on, it automatically initializes, adjusts the state of each air bag to the same height and pressure, and enters a slow scanning state. When perceived objects or people are lying on the bed, the bed automatically perceives the human body structure and body pressure matrix, increases the scanning speed for more timely and accurate measurements of the digital matrix and forming pressure by matrix-normalized processing, and then uses local pressure variance detection to automatically adjust to the sleeping position of the human body and thus achieve a uniform force distribution and a comfortable state. Finally, pressure matrix binarization was used to match sleeping position templates to identify the best template for automatic recognition of the sleeping position. The experimental results show that the sleeping position recognition method has high accuracy, recall, and precision. Our mattress is designed with interfaces for external devices. In future research, the smart mattress can connect to an auxiliary part of a smart ecosystem consisting of a smart pill box, a smart lighting system, and a microclimate system, which is expected to yield a more comprehensive intelligent ward to explore the possibility of improving sleep quality.
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16
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Zhang X, Molsberry SA, Pavlova M, Schwarzschild MA, Ascherio A, Gao X. Association of Sleepwalking and REM Sleep Behavior Disorder With Parkinson Disease in Men. JAMA Netw Open 2021; 4:e215713. [PMID: 33847749 PMCID: PMC8044732 DOI: 10.1001/jamanetworkopen.2021.5713] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Previous studies conducted among patients with Parkinson disease (PD) reported that parasomnias other than rapid eye movement (REM) sleep behavior disorder (RBD), particularly sleepwalking (SW), are associated with PD severity. However, it remains unclear whether the presence of SW is associated with altered odds of having PD in a population-based study. OBJECTIVE To evaluate whether probable SW, either alone or co-occurring with probable RBD, is associated with higher odds of PD in men. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included 25 694 men from the Health Professionals Follow-up Study, a population-based cohort of male health professionals in the US with information on probable SW and probable RBD. Data collection took place between January 2012 and June 2018, and data analysis took place from July 2020 to October 2020. EXPOSURES Probable SW and probable RBD were measured by questions adapted from the Mayo Sleep Questionnaire in 2012. MAIN OUTCOMES AND MEASURES PD, confirmed after review of medical records by a movement disorder specialist. RESULTS Of the 25 694 studied men (mean [SD] age, 75.6 [7.4] years), 223 (0.9%) had probable SW, 2720 (10.6%) had probable RBD, and 257 (1.0%) had PD. After adjusting for potential confounders (eg, age, smoking, caffeine intake, chronic disease status, and other sleep disorders), compared with individuals without probable SW and probable RBD, participants with probable SW, probable RBD, and both probable SW and probable RBD had higher odds of PD, (probable SW: odds ratio [OR], 4.80; 95% CI, 1.61-14.26; probable RBD: OR, 6.36; 95% CI, 4.83-8.37; both probable SW and probable RBD: OR, 8.44; 95% CI, 3.90-18.27). CONCLUSIONS AND RELEVANCE In this cross-sectional study of a male population, probable sleep parasomnias, including both SW and RBD, were associated with higher odds of having PD. PD-related neurodegeneration may impair arousal regulation during sleep.
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Affiliation(s)
- Xinyuan Zhang
- Department of Nutritional Sciences, The Pennsylvania State University, University Park
| | - Samantha A. Molsberry
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Milena Pavlova
- Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Alberto Ascherio
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park
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17
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Zhang C, Yang L, Liu S, Xu Y, Zheng H, Zhang B. One-Week Self-Guided Internet Cognitive Behavioral Treatments for Insomnia in Adults With Situational Insomnia During the COVID-19 Outbreak. Front Neurosci 2021; 14:622749. [PMID: 33551732 PMCID: PMC7859353 DOI: 10.3389/fnins.2020.622749] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/14/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: In the current global home confinement due to COVID-19, most individuals are facing unprecedented stress which can induce situational insomnia. We explored the efficacy of self-guided online cognitive behavioral treatment for insomnia (CBTI) on situational insomnia during the COVID-19 outbreak. Methods: Participants were recruited from March to April in 2020 in Guangzhou, China. A 1-week Internet CBTI intervention was performed for all individuals with situational insomnia. The Pre-sleep Arousal Scale (PSAS), Insomnia Severity Index (ISI), and Hospital Anxiety and Depression Scale (HADS) were measured before and after the intervention and compared between individuals who completed the intervention and those who did not. Results: One hundred and ninety-four individuals with situational insomnia were included. For PSAS score, significant group effects were found on total score (p = 0.003), somatic score (p = 0.014), and cognitive score (p = 0.009). Time effect was significant on total score (p = 0.004) and cognitive score (p < 0.001). There was a significant group × time effect of the somatic score (p = 0.025). For ISI total score, there were significant time effect (p < 0.001) and group × time effect (p = 0.024). For the HADS score, a significant group effect was found on the anxiety score (p = 0.045). The HADS had significant time effects for anxiety and depressive symptoms (all p < 0.001). Conclusion: Our study suggests good efficacy of CBTI on situational insomnia during COVID-19 for adults in the community, as well as on pre-sleep somatic hyperarousal symptom. The CBTI intervention is not applied to improve pre-sleep cognitive hyperarousal, depression, and anxiety symptoms.
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Affiliation(s)
- Chenxi Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
| | - Lulu Yang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
| | - Shuai Liu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
| | - Yan Xu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
| | - Huirong Zheng
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Affliated School of Medicine of South China University of Technology, Guangzhou, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China
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18
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Pavkovic IM, Kothare SV. Migraine and Sleep in Children: A Bidirectional Relationship. Pediatr Neurol 2020; 109:20-27. [PMID: 32165029 DOI: 10.1016/j.pediatrneurol.2019.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/05/2019] [Accepted: 12/24/2019] [Indexed: 01/03/2023]
Abstract
Migraine and sleep disorders in children exhibit a bidirectional relationship. This relationship is based on shared pathophysiology. Migraine involves activation of the trigeminal vascular system. Nociceptive neurons that innervate the dura release various vasoactive peptides. Calcitonin gene-related peptide is the most active of these peptides. Neural pathways that are involved in sleep generation are divided into those responsible for circadian rhythm, wake promotion, non-rapid eye movement, and rapid eye movement sleep activation. Sleep state switches are a critical component of these systems. The cerebral structures, networks, and neurochemical systems that are involved in migraine align closely with those responsible for the regulation of sleep. Neurochemical systems that are involved with both the pathogenesis of migraine and regulation of sleep include adenosine, melatonin, orexin, and calcitonin gene-related peptide. Sleep disorders represent the most common comorbidity with migraine in childhood. The prevalence of parasomnias, obstructive sleep apnea, and sleep-related movement disorders is significantly greater in children migraineurs. Infantile colic is a precursor of childhood migraine. Treatment of comorbid sleep disorders is important for the appropriate management of children with migraine. Sleep-based behavioral interventions can be of substantial benefit. These interventions are particularly important in children due to limited evidence for effective migraine pharmacotherapy.
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Affiliation(s)
- Ivan M Pavkovic
- Division of Pediatric Neurology, Department of Pediatrics, Cohen Children's Medical Center, Lake Success, New York; Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Sanjeev V Kothare
- Divison of Pediatric Neurology, Department of Pediatircs, Cohen Children's Medical Center, Lake Success, New York; Pediatric Sleep Program (Neurology), Department of Pediatircs, Cohen Children's Medical Center, Lake Success, New York; Pediatric Neurology Service Line for Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Pediatrics & Neurology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
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19
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Cash RE, Beverly Hery CM, Panchal AR, Bower JK. Association Between Sleep Duration and Ideal Cardiovascular Health Among US Adults, National Health and Nutrition Examination Survey, 2013-2016. Prev Chronic Dis 2020; 17:E43. [PMID: 32530395 PMCID: PMC7316418 DOI: 10.5888/pcd17.190424] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction Short or long sleep duration is a risk factor for cardiovascular disease, but the association between sleep duration and cardiovascular health is unclear. Our objective was to quantify the association between sleep duration and ideal cardiovascular health (CVH) in US adults. We hypothesized that very short (<6 h) and very long (≥9 h) sleep duration were associated with poorer CVH compared with sleep lasting 7 to <8 hours. Methods We conducted a cross-sectional evaluation of the nationally representative National Health and Nutrition Examination Survey in 2 cycles (2013–2014 and 2015–2016). Participants were 7,784 cardiovascular disease–free US adults aged 20 to 75. Self-reported sleep duration was categorized as <6 hours, 6 to <7 hours, 7 to <8 hours, 8 to <9 hours, and ≥9 hours. The American Heart Association’s ideal CVH metrics were used to determine the number of ideal CVH components, dichotomized as ideal (5–7 components) or not ideal (0–4 components). Survey-weighted logistic and linear regression models were used to determine the association between sleep duration and ideal CVH. Results The weighted prevalences of those who slept 7 to <8 hours were 30.4%, very short sleep duration (<6 h), 9.0%, and very long duration (≥9 h), 13.5%. Only 21.3% of the population had ideal CVH. Compared with 7 to <8 hours, very short duration (OR = 0.65; 95% confidence interval [CI], 0.47–0.90) and very long duration (OR = 0.72; 95% CI, 0.55–0.94) were associated with decreased odds of ideal CVH. We confirmed findings by using linear regression. Conclusions Very short and very long sleep duration were associated with decreased odds of ideal CVH and lower mean CVH scores. Future research should focus on clarifying causal associations between sleep duration and ideal CVH.
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Affiliation(s)
- Rebecca E Cash
- The Ohio State University College of Public Health, Division of Epidemiology, Columbus, Ohio.,National Registry of Emergency Medical Technicians, Columbus, Ohio.,Massachusetts General Hospital, Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua St, Ste 920, Boston, MA 02114.
| | - Chloe M Beverly Hery
- The Ohio State University College of Public Health, Division of Epidemiology, Columbus, Ohio
| | - Ashish R Panchal
- The Ohio State University College of Public Health, Division of Epidemiology, Columbus, Ohio.,National Registry of Emergency Medical Technicians, Columbus, Ohio.,The Ohio State University Wexner Medical Center, Department of Emergency Medicine, Columbus, Ohio
| | - Julie K Bower
- The Ohio State University College of Public Health, Division of Epidemiology, Columbus, Ohio
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20
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Bjørklund G, Rajib SA, Saffoon N, Pen JJ, Chirumbolo S. Insights on Melatonin as an Active Pharmacological Molecule in Cancer Prevention: What's New? Curr Med Chem 2019; 26:6304-6320. [PMID: 29714136 DOI: 10.2174/0929867325666180501094850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/10/2018] [Accepted: 04/18/2018] [Indexed: 12/12/2022]
Abstract
Along with playing an important role in circadian rhythm, melatonin is thought to play a significant role in preventing cells from damage, as well as in the inhibition of growth and in triggering apoptosis in malignant cells. Its relationship with circadian rhythms, energetic homeostasis, diet, and metabolism, is fundamental to achieve a better comprehension of how melatonin has been considered a chemopreventive molecule, though very few papers dealing with this issue. In this article, we tried to review the most recent evidence regarding the protective as well as the antitumoral mechanisms of melatonin, as related to diet and metabolic balance. From different studies, it was evident that an intracellular antioxidant defense mechanism is activated by upregulating an antioxidant gene battery in the presence of high-dose melatonin in malignant cells. Like other broad-spectrum antioxidant molecules, melatonin plays a vital role in killing tumor cells, preventing metastasis, and simultaneously keeping normal cells protected from oxidative stress and other types of tissue damage.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | | | - Nadia Saffoon
- Department of Pharmacy and Forensic Science, Faculty of Life Science and Medicine, King's College London, London, United Kingdom
| | - Joeri J Pen
- Diabetes Clinic, Department of Internal Medicine, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Nutrition, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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21
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Caumo W, Hidalgo MP, Souza A, Torres ILS, Antunes LC. Melatonin is a biomarker of circadian dysregulation and is correlated with major depression and fibromyalgia symptom severity. J Pain Res 2019; 12:545-556. [PMID: 30787633 PMCID: PMC6365222 DOI: 10.2147/jpr.s176857] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE This study compared urinary 6-sulfatoxymelatonin (aMT6s) over 24 hours among fibromyalgia (FM), major depression disorder (MDD), and healthy control (HC) groups, and examined whether rhythm is correlated with depressive symptoms. To answer this question we compared the rhythm of urinary aMT6s secretion among each group in four time series: morning (06:00-12:00 hours), afternoon (12:00-18:00 hours), evening (18:00-24:00 hours), and night (24:00-06:00 hours). In the FM subjects, we assessed if the rhythm of urinary aMT6s secretion is associated with pain severity, sleep quality, number of trigger points (NTPs), and the pain pressure threshold (PPT). PATIENTS AND METHODS We included 54 women, aged 18-60 years with diagnosis of FM (n=18), MDD (n=19), and HC (n =17). The 24-hour urinary aMT6s was evaluated according to four standardized periods. The assessment instruments were the Hamilton Depression Rating Scale (HDRS), Pittsburgh Sleep Quality Index, and Fibromyalgia Impact Questionnaire. RESULTS A generalized estimating equation revealed no difference in the daily load of aMT6s secretion among the three groups (P=0.49). However, at the daily time (06:00-18:00 hours), the load secretion of aMT6s reached 41.54% and 60.71% in the FM and MDD, respectively, as compared to 20.73% in the HC (P<0.05). A higher score in the HDRS was positively correlated with the amount of aMT6s secretion during daytime (06:00-18:00 hours). Also, multivariate linear regression revealed that in FM subjects, the aMT6s secretion during daytime (06:00-18:00 hours) was negatively correlated with the PPTlog (partial η2=0.531, P=0.001). However, it was positively correlated with depressive symptoms (partial η2=0.317, P=0.01); PQSI (partial η2=0.306, P=0.017), and NTPs (partial η2=0.23, P=0.04). CONCLUSION A more significant load of aMT6s secretion during daytime hours was observed in MDD and FM subjects compared to HC. These findings help to comprehend the biological basis of these disorders and show how disruption in melatonin secretion is positively correlated with clinical symptoms.
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Affiliation(s)
- Wolnei Caumo
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil,
- Pain and Palliative Care Service at Hospital de Clínicas de Porto Alegre (HCPA), Laboratory of Pain and Neuromodulation at UFRGS, Porto Alegre, Brazil,
- Pain and Anesthesia in Surgery Department, School of Medicine, UFRGS, Porto Alegre, Brazil,
| | - Maria Paz Hidalgo
- Psychiatry Department, School of Medicine, UFRGS, Porto Alegre, Brazil
- Laboratorio de Cronobiologia e Sono do Hospital de Clinicas de Porto Alegre; Porto Alegre, Brazil
| | - Andressa Souza
- Postgraduate Program in Health and Human Development, La Salle Universitary Center, Canoas, Brazil
| | - Iraci L S Torres
- School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil,
- Pharmacology Department, Instituto de Ciências Básicas da Saúde, UFRGS, Porto Alegre, Brazil
| | - Luciana C Antunes
- Centro de Ciências da Saúde - Departamento de Nutrição da Universidade Federal De Santa Catarina, Florianopolis, Brazil
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Abstract
Sleep is a phenomenon in animal behavior as enigmatic as it is ubiquitous, and one deeply tied to endocrine function. Though there are still many unanswered questions about the neurochemical basis of sleep and its functions, extensive interactions have been identified between sleep and the endocrine system, in both the endocrine system's effect on sleep and sleep's effect on the endocrine system. Unfortunately, until recent years, much research on sleep behavior largely disregarded its connections with the endocrine system. Use of both clinical studies and rodent models to investigate interactions between neuroendocrine function, including biological sex, and sleep therefore presents a promising area of further exploration. Further investigation of the neurobiological and neuroendocrine basis of sleep could have wide impact on a number of clinical and basic science fields. In this review, we summarize the state of basic sleep biology and its connections to the field of neuroendocrine biology, as well as suggest key future directions for the neuroendocrine regulation of sleep that may significantly impact new therapies for sleep disorders in women and men.
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Affiliation(s)
- Philip C Smith
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Jessica A Mong
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, USA
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23
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Kinnunen KM, Rapaport P, Webster L, Barber J, Kyle SD, Hallam B, Cooper C, Horsley R, Pickett JA, Vikhanova A, Espie CA, Livingston G. A manual-based intervention for carers of people with dementia and sleep disturbances: an acceptability and feasibility RCT. Health Technol Assess 2018; 22:1-408. [PMID: 30538021 DOI: 10.3310/hta22710] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND It has been estimated that between 25% and 40% of people living with dementia suffer from sleep disturbances, and there are currently no known effective treatments. Sleep disturbances may be the direct result of dementia or due to other comorbidities, such as pain and limited mobility. If carers' sleep is also disturbed, carers too can become tired and stressed, and this sometimes results in the breakdown of care in the home. OBJECTIVES To design an evidence-based manualised non-pharmacological therapy for sleep disturbances and test it for feasibility and acceptability. DESIGN A single-blind, randomised, parallel-group feasibility trial, with participants randomised 2 : 1 to intervention or treatment as usual (TAU). SETTING Five memory services in two London NHS trusts and Join Dementia Research (JDR). PARTICIPANTS The study recruited people with dementia and sleep disturbances (who scored ≥ 4 on at least one question on the Sleep Disorders Inventory) and their primary family carers. INTERVENTION All participants were given an Actiwatch (CamNtech Ltd, Cambridge, UK) to wear to record their sleep patterns for 2 weeks before randomisation. The intervention group received Dementia RElAted Manual for Sleep; STrAtegies for RelaTives (DREAMS START). This was designed as a six-session, manual-based intervention for carers of people with dementia, delivered by trained and clinically supervised psychology graduates, based on evidence about managing sleep disturbance in people with dementia. It uses the structure of a previous manual-based treatment, STrAtegies for RelaTives (START). Family carers were consulted about structure, content and design. Sessions were interactive, and each involved techniques, tasks to practise between sessions, relaxation and a recapitulation on the previous session. The sessions covered understanding sleep and dementia, making a plan (incorporating information from Actiwatch read-outs and a light box to increase light), daytime activity and routine, difficult night-time behaviours, taking care of your own (carer's) sleep and using the strategies in the future. Carers kept their own manual, light box and relaxation recordings post intervention. RANDOMISATION AND BLINDING A statistician created an electronic randomisation list, stratified by site, using random permuted blocks. Those assessing the outcome were blinded to allocation; participants were not blinded. MAIN OUTCOME MEASURES Outcomes were assessed at 3 months. (1) Feasibility, defined as the percentage of eligible people who consented to the study recruitment, with an expected value of 50% [95% confidence interval (CI) 41% to 59%]. (2) Acceptability, defined as the percentage of intervention group participants attending ≥ 4 intervention sessions, with an expected value of 75% (95% CI 59% to 87%). The predetermined criterion for progression to the main trial was acceptability of ≥ 70%. RESULTS Of 95 eligible patients referred, 63 (66%, 95% CI 56% to 76%) consented between 4 August 2016 and 24 March 2017: 61 from memory clinics and two from JDR. Of these, 62 participants (65%, 95% CI 55% to 75%) were randomised: 42 to the intervention arm and 20 to the TAU arm. Thirty-seven out of 42 participants (88%, 95% CI 75% to 96%) adhered to the intervention. CONCLUSIONS The results show that the randomised controlled trial is feasible and that the intervention is acceptable. A higher than expected proportion of eligible patients referred consented to the study and adhered to the intervention. LIMITATIONS Participants were not blinded and were recruited only in London. FUTURE WORK The results of this trial indicate that a future efficacy trial is warranted. TRIAL REGISTRATION Current Controlled Trials ISCTRN36983298. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 71. See the NIHR Journals Library website for further project information. Funding was also provided by Camden and Islington NHS Foundation Trust and Barnet, Enfield and Haringey Mental Health NHS Trust to pay for excess treatment costs from therapist training and supervision and intervention delivery.
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Affiliation(s)
- Kirsi M Kinnunen
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Penny Rapaport
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Lucy Webster
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Julie Barber
- Department of Statistical Science, Faculty of Mathematical & Physical Sciences, University College London, London, UK
| | - Simon D Kyle
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Brendan Hallam
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Claudia Cooper
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.,Services for Ageing and Mental Health, Camden and Islington NHS Foundation Trust, London, UK
| | | | | | - Anastasia Vikhanova
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Colin A Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Gill Livingston
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.,Services for Ageing and Mental Health, Camden and Islington NHS Foundation Trust, London, UK
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Abstract
PURPOSE OF REVIEW Sleep disorders in dementia cause distress and may lead to families being unable to care for someone with dementia at home. Recent Cochrane reviews found no interventions of proven effectiveness. There was no effect of light therapy and moderate evidence that melatonin was ineffective both given without knowledge of the patient's circadian rhythm. The current article updates this review by considering newer publications on interventions for sleep disorders or abnormalities of the sleep-wake cycle in people with dementia living in the community. RECENT FINDINGS We searched electronically for new primary research, reviews and meta-analyses and identified 258 articles published between 15/12/2015 and 14/06/2017 on sleep and dementia; 43 of them on nonpharmacological or pharmacological treatments. Fifteen articles reported on the management of sleep disturbances in people with dementia, living at home. Those using pharmacological treatments (melatonin, psychotropic medications, donepezil, memantine) encompassed a meta-analysis, two double-blind RCTs, two uncontrolled trials, two population-based studies, and one case report. The studies of behavioural interventions comprised five uncontrolled trials, one case series, and one qualitative study. We also included three recent reviews on the management of sleep disturbances in Alzheimer's disease; pharmacotherapies for sleep disturbances in dementia, and dementia prevention, intervention and care. None of these found a treatment that showed definitive effectiveness, although there is preliminary work about nonpharmacological interventions, which can be built on. SUMMARY Clinically effective, safe treatment of sleep disturbances in dementia remains an unresolved challenge. Given the importance of sleep and the many consequences of its disruption, well designed controlled trials are needed to determine acceptable and cost-effective treatment strategies that work for sleep disturbances.
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