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Kusters CDJ, Klopack ET, Crimmins EM, Seeman TE, Cole S, Carroll JE. Short Sleep and Insomnia Are Associated With Accelerated Epigenetic Age. Psychosom Med 2024; 86:453-462. [PMID: 37594243 PMCID: PMC10879461 DOI: 10.1097/psy.0000000000001243] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Short sleep and insomnia are each associated with a greater risk of age-related disease, which suggests that insufficient sleep may accelerate biological aging. We examine whether short sleep and insomnia alone or together relates to epigenetic age among older adults. METHODS A total of 3795 men (46.3%) and women aged 56 to 100 years from the Health and Retirement Study were included. Insomnia was defined as reporting at least one insomnia symptom (difficulty falling asleep, waking up at night, or waking up too early in the morning) and feeling unrested when waking up most of the time. Those reporting <6 hours of bedtime were categorized as short sleepers. Three second- or third-generation epigenetic age acceleration clocks were derived from the 2016 Health and Retirement Study Venous Blood Study. The linear regression analysis was adjusted for age, sex, race/ethnicity, education, and obesity status. RESULTS Insomnia and short sleep were associated with acceleration of GrimAge of 0.49 (95% confidence interval [CI] = 0.03-0.94 years; p = .04) and 1.29 (95% CI = 0.52-2.07 years; p = .002) years, respectively, as well as a faster pace of aging (DunedinPACE; 0.018 [95% CI = 0.004-0.033; p = .02] and 0.022 [95% CI = -0.004 to 0.048; p = .11]). Compared with healthy sleepers, individuals with the combination of short sleep and insomnia had an accelerated GrimAge (0.97 years; 95% CI = 0.07-1.87 years, p = .04) and a greater DunedinPACE (0.032; 95% CI = 0.003-0.060, p = .04). CONCLUSIONS Our findings indicate that short sleep, insomnia, and the combination of the two are linked to epigenetic age acceleration, suggesting that these individuals have an older biological age that may contribute to risk of comorbidity and mortality.
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Affiliation(s)
- Cynthia D J Kusters
- From the Department of Epidemiology (Kusters, Seeman), Fielding School of Public Health, UCLA; Davis School of Gerontology (Klopack, Crimmins), and Leonard Davis School of Gerontology, USC; Department of Geriatrics (Seeman), and Cousins Center for Psychoneuroimmunology (Cole, Carroll), Jane & Terry Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, California
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Zeng Y, Guo Z, Wu M, Chen F, Chen L. Circadian rhythm regulates the function of immune cells and participates in the development of tumors. Cell Death Discov 2024; 10:199. [PMID: 38678017 PMCID: PMC11055927 DOI: 10.1038/s41420-024-01960-1] [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: 01/16/2024] [Revised: 04/02/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
Circadian rhythms are present in almost all cells and play a crucial role in regulating various biological processes. Maintaining a stable circadian rhythm is essential for overall health. Disruption of this rhythm can alter the expression of clock genes and cancer-related genes, and affect many metabolic pathways and factors, thereby affecting the function of the immune system and contributing to the occurrence and progression of tumors. This paper aims to elucidate the regulatory effects of BMAL1, clock and other clock genes on immune cells, and reveal the molecular mechanism of circadian rhythm's involvement in tumor and its microenvironment regulation. A deeper understanding of circadian rhythms has the potential to provide new strategies for the treatment of cancer and other immune-related diseases.
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Affiliation(s)
- Yuen Zeng
- Department of Immunology, School of Basic Medical Sciences, Air Force Medical University, Xi'an, China
| | - Zichan Guo
- Faculty of Life Sciences, Northwest University, Xi'an, China
| | - Mengqi Wu
- Department of Immunology, School of Basic Medical Sciences, Air Force Medical University, Xi'an, China
| | - Fulin Chen
- Faculty of Life Sciences, Northwest University, Xi'an, China
| | - Lihua Chen
- Department of Immunology, School of Basic Medical Sciences, Air Force Medical University, Xi'an, China.
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Tao MH, Drake CL, Lin CH. Association of sleep duration, chronotype, social jetlag, and sleep disturbance with phenotypic age acceleration: A cross-sectional analysis. Sleep Health 2024; 10:122-128. [PMID: 38238123 DOI: 10.1016/j.sleh.2023.11.015] [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: 08/09/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 03/01/2024]
Abstract
OBJECTIVE Sleep is a critical health-related behavior; research evidence has shown that sleep duration, poor sleep quality and insomnia are associated with aging and relevant age-related diseases. However, the associations between sleep duration, chronotype, sleep disturbance, and biological age have not been comprehensively assessed. This study aimed to examine sleep characteristics with biological age. METHODS The study included 6534 participants aged 20 years and older from the National Health and Nutrition Examination Survey between 2017 and March 2020. Sleep questionnaires were used to collect information on sleep duration and wake behavior on workdays and workfree days and sleep disturbance. Phenotypic age acceleration (PhenoAgeAccel) was estimated as a biological age measure using 9 blood chemistry biomarkers. RESULTS Long sleep (>9 hours) and extremely short sleep (≤4 hours) on workdays were positively associated with PhenoAgeAccel, compared with optimal sleep duration (7-8 hours). Similar positive associations with PhenoAgeAccel were observed for sleep duration on workfree days and across the whole week. Both slightly evening and evening chronotypes were associated with faster PhenoAgeAccel compared to morning chronotype. Social jetlag and sleep disturbance were not associated with PhenoAgeAccel, while long corrected social jetlag was associated with faster PhenoAgeAccel. The associations of sleep duration, chronotype, and corrected social jetlag with PhenoAgeAccel appeared stronger among females than among males. CONCLUSIONS Findings suggest a U-shape relationship between sleep duration and biological aging; slightly evening and evening chronotypes may be risk factors for aging. Further studies are needed to confirm these findings.
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Affiliation(s)
- Meng-Hua Tao
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA.
| | - Christopher L Drake
- Department of Medicine, Division of Sleep Medicine, Henry Ford Health System, Novi, Michigan, USA
| | - Chun-Hui Lin
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
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Etindele Sosso FA, Torres Silva F, Queiroz Rodrigues R, Carvalho MM, Zoukal S, Zarate GC. Prevalence of Sleep Disturbances in Latin American Populations and Its Association with Their Socioeconomic Status-A Systematic Review and a Meta-Analysis. J Clin Med 2023; 12:7508. [PMID: 38137577 PMCID: PMC10743597 DOI: 10.3390/jcm12247508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The worldwide increase in the prevalence and incidence of sleep disturbances represents a major public health issue. Among multiple determinants affecting sleep health, an individual's socioeconomic status (SES) is the most ignored and underestimated throughout the literature. No systematic review on the relation between SES and sleep health has been previously conducted in Latin America. METHODS PRISMA guidelines were used. RESULTS Twenty articles were included in the final sample (all cross-sectional studies), and twelve among them were rated as fair or poor quality. Among these studies, 80.0% (n = 16) were performed in Brazil, 10.0% (n = 2) were performed in Peru, 5.0% (n = 1) were performed in Chile, and 5.0% (n = 1) were multicentric (11 countries). The combined total number of participants was N = 128.455, comprising 3.7% (n = 4693) children, 16.0% (n = 20,586) adolescents, and 80.3% (n = 103,176) adults. The results show the following: (1) The sleep outcomes analyzed were sleep duration, sleep quality/sleep disturbance, insomnia, excessive daytime sleepiness (EDS), obstructive sleep apnea (OSA)/sleep-disordered breathing (SDB) symptoms, and bruxism. (2) The most used determinants were income, education level, employment status/occupation, wealth/assets, and composite indices. (3) Higher SES was associated with shorter sleep duration. (4) Lower SES was associated with a decrease in sleep quality, less frequent snoring, more prevalent EDS, and sleep bruxism. (5) Lower education was associated with insomnia. (6) Higher education was associated with more sleep bruxism. (7) The pooled prevalence using a meta-analysis of the random effects model was 24.73% (95%CI, 19.98-30.19), with high heterogeneity (I2 = 100%). (8) The prevalence of sleep disturbances decreased with high education (OR, 0.83; 95%CI, [0.69-0.99]; I2 = 79%), while it increased with low income (OR, 1.26; 95%CI, [1.12-1.42]; I2 = 59%), unemployment (OR, 2.84; 95%CI, [2.14-3.76]; I2 = 0%), and being a housewife (OR, 1.72; 95%CI, [1.19-2.48]; I2 = 55%). DISCUSSION This meta-analysis shows that lower SES (education, income, and work) was associated with sleep disturbances in Latin America. Therefore, sleep disturbance management should be addressed with a multidimensional approach, and a significant investment in targeted public health programs to reduce sleep disparities and support research should be made by the government before the situation becomes uncontrollable.
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Affiliation(s)
- F. A. Etindele Sosso
- Department of Global Health and Ecoepidemiology, Redavi Institute, Montréal, QC H4J 1C5, Canada
| | - Filipa Torres Silva
- Pneumonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal; (F.T.S.); (R.Q.R.); (M.M.C.)
| | - Rita Queiroz Rodrigues
- Pneumonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal; (F.T.S.); (R.Q.R.); (M.M.C.)
| | - Margarida M. Carvalho
- Pneumonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal; (F.T.S.); (R.Q.R.); (M.M.C.)
| | - Sofia Zoukal
- Laboratory of Epidemiology, Faculty of Medicine and Pharmacy of Casablanca, University Hassan II, Casablanca 20250, Morocco;
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Åkerstedt T, Olsson T, Alfredsson L, Hedström AK. Insufficient sleep during adolescence and risk of multiple sclerosis: results from a Swedish case-control study. J Neurol Neurosurg Psychiatry 2023; 94:331-336. [PMID: 36690431 PMCID: PMC10176406 DOI: 10.1136/jnnp-2022-330123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/04/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Shift work, which often results in sleep deprivation and circadian desynchrony, has been associated with increased risk of multiple sclerosis (MS). We aimed at studying the impact of sleep duration, circadian disruption and sleep quality on MS risk. METHODS We used a Swedish population-based case-control study (2075 cases, 3164 controls). Aspects of sleep were associated with MS risk by calculating OR with 95% CIs using logistic regression models. RESULTS Compared with sleeping 7-9 hours/night during adolescence, short sleep (<7 hours/night) was associated with increased risk of developing MS (OR 1.4, 95% OR 1.1-1.7). Similarly, subjective low sleep quality during adolescence increased the risk of subsequently developing MS (OR 1.5, 95% CI 1.3 to 1.9), whereas phase shift did not significantly influence the risk. Our findings remained similar when those who worked shifts were excluded. CONCLUSIONS Insufficient sleep and low sleep quality during adolescence seem to increase the risk of subsequently developing MS. Sufficient restorative sleep at young age, needed for adequate immune functioning, may be a preventive factor against MS.
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Affiliation(s)
- Torbjörn Åkerstedt
- Stress Research, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Stockholm, Sweden
| | - Lars Alfredsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Karin Hedström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden .,Karolinska University Hospital, Stockholm, Sweden
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Beese S, Postma J, Graves JM. Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192417006. [PMID: 36554888 PMCID: PMC9779615 DOI: 10.3390/ijerph192417006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Neighborhoods are critical to understanding how environments influence health outcomes. Prolonged environmental stressors, such as a lack of green spaces and neighborhood socioeconomic disadvantage, have been associated with higher allostatic load levels. Since allostatic load levels experienced earlier in life have stronger associations with mortality risk, neighborhoods may be uniquely suited to monitor and mitigate the impacts of environmental stressors. Researchers often study allostatic load in neighborhoods by utilizing administrative boundaries within publicly accessible databases as proxies for neighborhoods. METHODS This systematic review of reviews aims to identify commonly used biomarkers in the measurement of allostatic load, compare measurement approaches, inventory databases to study allostatic load, and spotlight considerations referenced in the literature where allostatic load is studied in neighborhoods. The review was conducted using the search term "allostatic load" in the MEDLINE, CINAHL, and PsychINFO databases. The search results were filtered to include reviews. RESULTS The search returned 499 articles after deduplication. Overall, 18 synthesis reviews met the inclusion criteria and were retained for extraction. The synthesis reviews analyzed represented 238 studies published from 1995 to 2020. The original ten biomarkers were most often used to measure allostatic load. More recently, body mass index and C-reactive protein have additionally been frequently used to measure allostatic load burden. CONCLUSIONS The scientific contributions of this study are that we have identified a clear gap in geographic considerations when studying allostatic load. The implication of this study is that we have highlighted geographic concepts when conducting neighborhood-level research using administrative databases as a neighborhood proxy and outlined emerging future trends that can enable future study of allostatic load in the neighborhood context.
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Affiliation(s)
- Shawna Beese
- College of Agricultural, Human, and Natural Resources Sciences, Washington State University, Pullman, WA 99164, USA
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Julie Postma
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Janessa M. Graves
- College of Nursing, Washington State University, Spokane, WA 99202, USA
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Pilot Test of “NIOSH Training for Law Enforcement on Shift Work and Long Work Hours”. J Occup Environ Med 2022; 64:599-606. [DOI: 10.1097/jom.0000000000002534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Christensen DS, Zachariae R, Amidi A, Wu LM. Sleep and allostatic load: A systematic review and meta-analysis. Sleep Med Rev 2022; 64:101650. [DOI: 10.1016/j.smrv.2022.101650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 04/21/2022] [Accepted: 05/21/2022] [Indexed: 11/27/2022]
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Siew RVK, Nabe-Nielsen K, Turner AI, Bujtor M, Torres SJ. The role of combined modifiable lifestyle behaviors in the association between exposure to stressors and allostatic load: A systematic review of observational studies. Psychoneuroendocrinology 2022; 138:105668. [PMID: 35066347 DOI: 10.1016/j.psyneuen.2022.105668] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/10/2021] [Accepted: 01/10/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Exposure to stressors can evoke psychological, physiological, and behavioral stress responses, which may lead to the adoption of health-damaging behaviors that dysregulate multiple biological systems contributing to a high allostatic load. This review explored the role of combined modifiable lifestyle behaviors in the relationship between stressors and allostatic load among healthy adults. METHODS A systematic search was conducted in Medline Complete, PsycINFO, CINAHL, and Embase databases up to September 2021. The PRISMA guidelines guided reporting and study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist. RESULTS Database searches identified 319 papers. Eight cross-sectional and two longitudinal studies met our inclusion criteria. Among the ten studies, combined modifiable lifestyle behaviors partly explained the association between exposure to stressors and elevated allostatic load in four cross-sectional and two longitudinal studies. CONCLUSION Some evidence suggests that combined modifiable lifestyle behaviors may help explain the relationship between stressors and an elevated allostatic load. Further longitudinal studies with mediation analyses would strengthen these findings and help to confirm the mechanistic role of combined modifiable lifestyle behaviors underlying the relationship between stress exposure and allostatic load.
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Affiliation(s)
- Raymond Vooi Khong Siew
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Vic, Australia; Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark.
| | - Kirsten Nabe-Nielsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark
| | - Anne I Turner
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Vic, Australia
| | - Melissa Bujtor
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Vic, Australia
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Vic, Australia
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Caraballo C, Mahajan S, Valero-Elizondo J, Massey D, Lu Y, Roy B, Riley C, Annapureddy AR, Murugiah K, Elumn J, Nasir K, Nunez-Smith M, Forman HP, Jackson CL, Herrin J, Krumholz HM. Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018. JAMA Netw Open 2022; 5:e226385. [PMID: 35389500 PMCID: PMC8990329 DOI: 10.1001/jamanetworkopen.2022.6385] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
IMPORTANCE Historically marginalized racial and ethnic groups are generally more likely to experience sleep deficiencies. It is unclear how these sleep duration disparities have changed during recent years. OBJECTIVE To evaluate 15-year trends in racial and ethnic differences in self-reported sleep duration among adults in the US. DESIGN, SETTING, AND PARTICIPANTS This serial cross-sectional study used US population-based National Health Interview Survey data collected from 2004 to 2018. A total of 429 195 noninstitutionalized adults were included in the analysis, which was performed from July 26, 2021, to February 10, 2022. EXPOSURES Self-reported race, ethnicity, household income, and sex. MAIN OUTCOMES AND MEASURES Temporal trends and racial and ethnic differences in short (<7 hours in 24 hours) and long (>9 hours in 24 hours) sleep duration and racial and ethnic differences in the association between sleep duration and age. RESULTS The study sample consisted of 429 195 individuals (median [IQR] age, 46 [31-60] years; 51.7% women), of whom 5.1% identified as Asian, 11.8% identified as Black, 14.7% identified as Hispanic or Latino, and 68.5% identified as White. In 2004, the adjusted estimated prevalence of short and long sleep duration were 31.4% and 2.5%, respectively, among Asian individuals; 35.3% and 6.4%, respectively, among Black individuals; 27.0% and 4.6%, respectively, among Hispanic or Latino individuals; and 27.8% and 3.5%, respectively, among White individuals. During the study period, there was a significant increase in short sleep prevalence among Black (6.39 [95% CI, 3.32-9.46] percentage points), Hispanic or Latino (6.61 [95% CI, 4.03-9.20] percentage points), and White (3.22 [95% CI, 2.06-4.38] percentage points) individuals (P < .001 for each), whereas prevalence of long sleep changed significantly only among Hispanic or Latino individuals (-1.42 [95% CI, -2.52 to -0.32] percentage points; P = .01). In 2018, compared with White individuals, short sleep prevalence among Black and Hispanic or Latino individuals was higher by 10.68 (95% CI, 8.12-13.24; P < .001) and 2.44 (95% CI, 0.23-4.65; P = .03) percentage points, respectively, and long sleep prevalence was higher only among Black individuals (1.44 [95% CI, 0.39-2.48] percentage points; P = .007). The short sleep disparities were greatest among women and among those with middle or high household income. In addition, across age groups, Black individuals had a higher short and long sleep duration prevalence compared with White individuals of the same age. CONCLUSIONS AND RELEVANCE The findings of this cross-sectional study suggest that from 2004 to 2018, the prevalence of short and long sleep duration was persistently higher among Black individuals in the US. The disparities in short sleep duration appear to be highest among women, individuals who had middle or high income, and young or middle-aged adults, which may be associated with health disparities.
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Affiliation(s)
- César Caraballo
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Shiwani Mahajan
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
- Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Javier Valero-Elizondo
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas
| | - Daisy Massey
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
| | - Yuan Lu
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Brita Roy
- Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Carley Riley
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Amarnath R. Annapureddy
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Karthik Murugiah
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Johanna Elumn
- SEICHE Center for Health and Justice, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas
| | - Marcella Nunez-Smith
- Equity Research and Innovation Center, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Howard P. Forman
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Chandra L. Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
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Korpics J, Altman L, Feinglass J, Stillerman A. Prevalence and Impact of Adverse Childhood Experiences on Chicago Public School Students in the Youth Risk Behavior Survey. THE JOURNAL OF SCHOOL HEALTH 2021; 91:802-812. [PMID: 34426968 DOI: 10.1111/josh.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 03/03/2021] [Accepted: 04/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) can impair health and other outcomes. To obtain district-level data about the prevalence and impact of ACEs in Chicago Public Schools (CPS), we advocated for CPS to add a short ACE screener to the 2017 Youth Risk Behavior Survey (YRBS) and analyzed the results. METHODS Responses to the screener were scored zero, one, or two ACEs. Student scores for violence and victimization, substance use, sexual health risk, mental health, housing insecurity, physical health, grades, and multiple risk/high vulnerability (those students in the top 20% of affirmative responses) were correlated with ACE scores for categories and individual items. RESULTS Among 1883 student respondents (response rate 73%), there were 17.8% affirmative responses for experiencing physical abuse and 19.8% for witnessing domestic violence; 20% reported at least one ACE and 8% both. A significant dose-response was found for behaviors, experiences, and sleep by ACE scores. CONCLUSIONS ACEs were common among CPS high school students and associated with many negative behavior and health-related outcomes. Increased awareness of ACEs and their impact among all school personnel can inform and strengthen the development of safer, more supportive, and trauma-informed schools that help all students and families thrive.
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Affiliation(s)
- Jacqueline Korpics
- Cook County Health and Northwestern Feinberg School of Medicine, 1950 W Polk St, Chicago, IL, 60612
| | - Lara Altman
- Illinois ACE Response Collaborative, PhD Candidate, School of Education and Social Policy, Northwestern University, Walter Annenberg Hall, 2120 Campus Drive, Evanston, IL, 60208
| | - Joseph Feinglass
- Division of General Internal Medicine, Northwestern University, 750 N Lakeshore Dr. 10th Floor, Chicago, IL, 60611
| | - Audrey Stillerman
- School Health Centers, Clinical Assistant Professor of Family Medicine, Office of Community Engagement and Neighborhood Health Partnerships, University of Illinois at Chicago, 818 S. Wolcott, Rm 809, Chicago, IL, 60612
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Yu EYT, Yeung CHN, Wan EYF, Tang EHM, Wong CKH, Cheung BMY, Lam CLK. Association between health behaviours and cardiometabolic dysregulation: a population-based survey among healthy adults in Hong Kong. BMJ Open 2021; 11:e043503. [PMID: 34244247 PMCID: PMC8273464 DOI: 10.1136/bmjopen-2020-043503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 06/02/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To explore the association between cardiometabolic dysregulation, an integral component of allostatic load, and health risk behaviours (HRBs) of the Hong Kong healthy adult population. DESIGN Secondary analysis of cross-sectional anonymous data. SETTING Data on sociodemographics, self-reported health status, HRBs and biomarkers were extracted from the Hong Kong Population Health Survey 2014/2015. PARTICIPANTS One thousand five hundred and fifty-one participants aged 18-64 years without self-reported diagnoses of hypertension, diabetes mellitus, hyperlipidaemia, cardiovascular disease, cognitive impairment or cancer. PRIMARY OUTCOME MEASURES Cardiometabolic dysregulation index (CMDI), ranging from 0 to 6, was calculated by counting the number of biomarkers including systolic blood pressure, diastolic blood pressure, waist to hip ratio, glycated haemoglobin, total cholesterol to high-density lipoprotein cholesterol ratio, and triglycerides that were above the respective normal level suggested by international guidelines and literature. HRBs including smoking, dietary habits and sleeping hours were collected by self-report questionnaire. Alcohol consumption was assessed by the 10-item Alcohol Use Disorders Identification Test, while physical activity level was measured using the Global Physical Activity Questionnaire. A composite HRB score, ranging from 0 to 5, was calculated as the cumulative number of HRBs. The effect of HRB on CMDI was evaluated by negative binomial regression with adjustment for socioeconomic status, health awareness and comorbidities of the participants. RESULTS The mean CMDI of the studied population was 1.6; 29.5% had a CMDI of 0, whereas 1.5% had a CMDI of 6. Significant difference was observed in mean CMDI between gender and different age groups. Sleeping less than 6 hours (incidence rate ratio (IRR)=1.26, p<0.001), smoking (IRR=1.15, p=0.027), insufficient physical activity (IRR=1.12, p=0.007) and higher composite HRB score (IRR=1.12, 95% CI 1.06 to 1.18) were significantly associated with higher CMDI. CONCLUSION Smoking, physical inactivity and inadequate sleep-an essential yet often overlooked health behaviour-were associated with higher CMDI in the Hong Kong healthy adult population.
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Affiliation(s)
- Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | | | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Eric Ho Man Tang
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | | | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
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13
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Carroll JE, Ross KM, Horvath S, Okun M, Hobel C, Rentscher KE, Coussons-Read M, Schetter CD. Postpartum sleep loss and accelerated epigenetic aging. Sleep Health 2021; 7:362-367. [PMID: 33903077 PMCID: PMC10027398 DOI: 10.1016/j.sleh.2021.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Insufficient sleep has been linked to accelerated biological aging in adults, providing a possible mechanism through which sleep may influence disease risk. In the current paper, we test the hypothesis that short sleep in postpartum would predict older biological age in women one year post birth, as indicated by accelerated epigenetic aging. METHODS As part of a larger study of pregnancy and postpartum health (Healthy Babies Before Birth, HB3), 33 mothers provided blood samples for epigenetic aging clock estimates. intrinsic epigenetic age acceleration (IEAA), extrinsic apigenetic age acceleration, phenotypic epigenetic age acceleration (PEAA), GrimAge, DNAmPAI-1, and DNAm telomere length (TL) were calculated using established protocols. Sleep duration was categorized as insufficient sleep (<7 hours per night) or healthy sleep duration (7+ hours per night). Sleep quality was determined using the Pittsburgh Sleep Quality Index (Global score >5). RESULTS Maternal postpartum sleep duration at 6 months, but not 12 months, following a birth was predictive of older 12-month IEAA, B (SE) = 3.0 (1.2), P = .02, PEAA, B (SE) = 7.3 (2.0), P = .002, and DNAmTL, B (SE) = -0.18 (0.07), P = .01, but not other indices, all P> .127. Self-reported poor sleep quality at 6 and 12 months was not significantly related to epigenetic age. CONCLUSIONS These findings suggest that insufficient sleep duration during the early postpartum period is associated with accelerated biological aging. As the sample size is small, additional research is warranted with a larger sample size to replicate these findings.
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Affiliation(s)
- Judith E Carroll
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA.
| | - Kharah M Ross
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Steve Horvath
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, California, USA
| | - Michele Okun
- Department of Psychology, University of Colorado, Colorado Springs, Colorado Springs, Colorado, USA
| | - Calvin Hobel
- Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Kelly E Rentscher
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Mary Coussons-Read
- Department of Psychology, University of Colorado, Colorado Springs, Colorado Springs, Colorado, USA
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14
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Che T, Yan C, Tian D, Zhang X, Liu X, Wu Z. The Association Between Sleep and Metabolic Syndrome: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:773646. [PMID: 34867820 PMCID: PMC8640251 DOI: 10.3389/fendo.2021.773646] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/01/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Sleep duration is thought to play a key role in the development of metabolic syndrome. However, the results have been inconsistent. METHODS We conducted a systematic review and meta-analysis of cohort studies and searched publications in PubMed, Embase, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov. The summary relative risks (RRs) were estimated using a random model. The sensitivity analysis was performed by sequentially excluding each study to test the robustness of the pooled estimates. FINDING We included 13 studies involving 300,202 patients in which short sleep and long sleep significantly increased the risk of metabolic syndrome 15% (RR = 1.15, 95%CI = 1.09-1.22, p < 0.001) and 19% (RR = 1.19, 95%CI = 1.05-1.35, p < 0.001). Moreover, the relationship between sleep duration and metabolic syndrome risk presented a U-shaped curve. Short and long sleep increased the risk of obesity by 14% (RR = 1.14, 95%CI = 1.07-1.22, p<0.001) and 15% (RR = 1.15, 95%CI = 1.00-1.30, p = 0.04), and high blood pressure 16% (RR = 1.16, 95%CI = 1.02-1.31, p = 0.03) and 13% (RR = 1.13, 95%CI = 1.04-1.24, p = 0.01), respectively. Short sleep can potentially increase the risk of high blood sugar by 12% (RR = 1.12, 95%CI = 1.00-1.15, P = 0.05). IMPLICATIONS Based on our findings, sleep is a behavior that can be changed and is economical. Clinically doctors and health professionals should be encouraged to increase their efforts to promote healthy sleep for all people.
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Affiliation(s)
- Tingting Che
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Cheng Yan
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Dingyuan Tian
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
| | - Xuejun Liu
- Department of Neurology, Chu Hsien-I Memorial Hospital, Tianjin Medical University, Tianjin, China
- *Correspondence: Xuejun Liu, ; Zhongming Wu,
| | - Zhongming Wu
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China
- *Correspondence: Xuejun Liu, ; Zhongming Wu,
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15
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Dzierzewski JM, Donovan EK, Kay DB, Sannes TS, Bradbrook KE. Sleep Inconsistency and Markers of Inflammation. Front Neurol 2020; 11:1042. [PMID: 33041983 PMCID: PMC7525126 DOI: 10.3389/fneur.2020.01042] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/10/2020] [Indexed: 12/12/2022] Open
Abstract
Objective: Poor sleep is associated with higher levels of inflammatory biomarkers. Conventionally, higher average time awake, lower average time asleep, and lower sleep efficiency define poor sleep. Recent research suggests that, in addition to average sleep, sleep inconsistency is an important indicator of sleep dysfunction. The current study sought to extend our knowledge of the relationship between sleep and inflammation through an examination of sleep inconsistency and inflammatory biomarkers. Methods: Secondary analyses of the Survey of Midlife in the United States (MIDUS) sleep study were conducted. Five hundred thirty-three individuals completed nightly sleep diaries, actigraphy, and underwent a blood draw for the inflammatory biomarkers C-reactive protein, interleukin-6, and fibrinogen. Sleep inconsistency was derived from 7 consecutive nights of assessment and was operationalized as nightly fluctuations in the following variables: terminal wakefulness, number of awakenings, time in bed, sleep onset latency, and wake after sleep onset. Structural equation modeling was used to examine the influence of a latent average sleep and a latent sleep inconsistency variable on a latent inflammation variable. Models were subsequently adjusted for age, sex, BMI, health, and medication. Stratified models by sex were also analyzed. Results: The average sleep model would not converge. The sleep inconsistency model fit the data well. A significant positive association between the latent factors sleep inconsistency and inflammation was observed (β = 10.18, SE = 4.40, p = 0.021), suggesting inconsistent sleep is associated with higher levels of inflammatory biomarkers. When stratified by sex, the association between the latent sleep inconsistency factor and inflammation was significant for women (β = 1.93, SE = 0.82, p = 0.018), but not men (β = 0.20, SE = 0.35, p = 0.566). The association between sleep inconsistency and inflammation weakened following multivariate adjustment (β = 6.23, SE = 3.71, p = 0.093). Conclusions: Inconsistent sleep may be an associated feature of inflammatory dysfunction, especially in women. Future studies should build upon this preliminary work and examine these associations longitudinally and through treatment trials.
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Affiliation(s)
- Joseph M. Dzierzewski
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Emily K. Donovan
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Daniel B. Kay
- Department of Psychology, Brigham Young University, Provo, UT, United States
| | - Timothy S. Sannes
- Division of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Keighly E. Bradbrook
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States
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16
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Linander CB, Kallemose T, Joergensen LM, Andersen O, Nehlin JO, Jawad BN. The effect of circadian-adjusted LED-based lighting on sleep, daytime sleepiness and biomarkers of inflammation in a randomized controlled cross-over trial by pragmatic design in elderly care home dwellers. Arch Gerontol Geriatr 2020; 91:104223. [PMID: 32805700 DOI: 10.1016/j.archger.2020.104223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/13/2020] [Accepted: 08/03/2020] [Indexed: 01/22/2023]
Abstract
AIM Elderly multimorbid care home dwellers are a heterogenic group of frail individuals that exhibit sleep disturbances and a range of co-morbidities. The project aimed to study the possible effect of indoor circadian-adjusted LED-lighting (CaLED) in the elderly residents' care home on their sleeping patterns and systemic biomarkers associated with inflammation. METHODS A 16-week trial study was performed to follow the intervention and control groups using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) to monitor sleep and daytime sleepiness, and biomarkers IL-6, TNF-α and suPAR, to estimate the levels of inflammation. RESULTS There was no significant impact on sleep improvement after the short intervention time when analyzing the PSQI and ESS results. However, we found several challenges using these tools for this specific group of individuals. Thus, important knowledge was gained for future studies in elderly care home dwellers. The inflammation state throughout the entire study period was stable for most of the elderly and no significant change was detected from before to after the intervention. This study represents a first-to-date attempt to ameliorate the adverse effects of sleep disturbances that characterize a randomly chosen group of elderly multimorbid subjects, by using circadian-adjusted LED-lighting in a natural care home environment. CONCLUSION In this pragmatic randomized study of home dwelling individuals we were not able to demonstrate an improved sleep pattern as judged by PSQI, ESS or a change in inflammatory state.
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Affiliation(s)
| | - Thomas Kallemose
- The Emergency Department, Copenhagen University Hospital, Hvidovre, Denmark.
| | - Lillian Moerch Joergensen
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; The Emergency Department, Copenhagen University Hospital, Hvidovre, Denmark.
| | - Ove Andersen
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; The Emergency Department, Copenhagen University Hospital, Hvidovre, Denmark.
| | - Jan O Nehlin
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.
| | - Baker Nawfal Jawad
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.
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17
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Wall J, Xie H, Wang X. Interaction of Sleep and Cortical Structural Maintenance From an Individual Person Microlongitudinal Perspective and Implications for Precision Medicine Research. Front Neurosci 2020; 14:769. [PMID: 32848551 PMCID: PMC7411006 DOI: 10.3389/fnins.2020.00769] [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: 02/27/2020] [Accepted: 06/30/2020] [Indexed: 12/18/2022] Open
Abstract
Sleep and maintenance of brain structure are essential for the continuity of a person's cognitive/mental health. Interestingly, whether normal structural maintenance of the brain and sleep continuously interact in some way over day-week-month times has never been assessed at an individual-person level. This study used unconventional microlongitudinal sampling, structural magnetic resonance imaging, and n-of-1 analyses to assess normal interactions between fluctuations in the structural maintenance of cerebral cortical thickness and sleep duration for day, week, and multi-week intervals over a 6-month period in a healthy adult man. Correlation and time series analyses provided indications of "if-then," i.e., "if" this preceded "then" this followed, sleep-to-thickness maintenance and thickness maintenance-to-sleep bidirectional inverse interactions. Inverse interaction patterns were characterized by concepts of graded influences across nights, bilaterally positive relationships, continuity across successive weeks, and longer delayed/prolonged effects in the thickness maintenance-to-sleep than sleep-to-thickness maintenance direction. These interactions are proposed to involve normal circadian/allostatic/homeostatic mechanisms that continuously influence, and are influenced by, cortical substrate remodeling/turnover and sleep/wake cycle. Understanding interactions of individual person "-omics" is becoming a central interest in precision medicine research. The present n-of-1 findings contribute to this interest and have implications for precision medicine research use of a person's cortical structural and sleep "-omics" to optimize the continuous maintenance of that individual's cortical structure, sleep, and cognitive/mental health.
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Affiliation(s)
- John Wall
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
| | - Hong Xie
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
| | - Xin Wang
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
- Department of Psychiatry, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
- Department of Radiology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
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18
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Human sleep consolidates allergic responses conditioned to the environmental context of an allergen exposure. Proc Natl Acad Sci U S A 2020; 117:10983-10988. [PMID: 32366650 PMCID: PMC7245114 DOI: 10.1073/pnas.1920564117] [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] [Indexed: 12/15/2022] Open
Abstract
Allergies are highly prevalent, and allergic responses can be triggered even in the absence of allergens due to Pavlovian conditioning to a specific cue. Here we show in humans suffering from allergic rhinitis that merely reencountering the environmental context in which an allergen was administered a week earlier is sufficient to trigger an allergic response-but only if participants had slept after allergen exposure. This context-conditioning effect was entirely absent when participants stayed awake the night after allergen exposure or were tested in a different context. Unlike in context conditioning, cue conditioning (to an odor stimulus) occurred independently of sleep, a differential pattern that is likewise observed for conditioning in the behavioral domain. Our findings provide evidence that allergic responses can be conditioned to contextual information alone, even after only a single-trial conditioning procedure, and that sleep is necessary to consolidate this rapidly acquired maladaptive response. The results unravel a mechanism that could explain part of the strong psychological impact on allergic responses.
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19
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Minich DM, Hanaway PJ. The Functional Medicine Approach to COVID-19: Nutrition and Lifestyle Practices for Strengthening Host Defense. Integr Med (Encinitas) 2020; 19:54-62. [PMID: 33041708 PMCID: PMC7482148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The developing symptoms of COVID-19, as well as the progression of illness and fatality, are a clearly a function of the overall health status of the individual. Complex, chronic diseases such as obesity, hypertension, and diabetes are directly correlated with risk of disease severity and mortality. We explore lifestyle interventions that have specifically been demonstrated to strengthen host defense, reduce the probability and mitigate the severity of viral infection. Lifestyle interventions, from a Functional Medicine perspective, include nutrition, sleep, exercise, stress reduction, and connection. These factors, when in balance, provide a foundation for optimal health and immune function.
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Affiliation(s)
- D M Minich
- Human Nutrition and Functional Medicine Graduate Program, University of Western States, Portland, OR
| | - P J Hanaway
- The Institute for Functional Medicine COVID-19 Task Force, Federal Way, WA
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20
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Cox SR, Ritchie SJ, Allerhand M, Hagenaars SP, Radakovic R, Breen DP, Davies G, Riha RL, Harris SE, Starr JM, Deary IJ. Sleep and cognitive aging in the eighth decade of life. Sleep 2020; 42:5298134. [PMID: 30668819 PMCID: PMC6448287 DOI: 10.1093/sleep/zsz019] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Indexed: 01/23/2023] Open
Abstract
We examined associations between self-reported sleep measures and cognitive level and change (age 70-76 years) in a longitudinal, same-year-of-birth cohort study (baseline N = 1091; longitudinal N = 664). We also leveraged GWAS summary data to ascertain whether polygenic scores (PGS) of chronotype and sleep duration related to self-reported sleep, and to cognitive level and change. Shorter sleep latency was associated with significantly higher levels of visuospatial ability, processing speed, and verbal memory (β ≥ |0.184|, SE ≤ 0.075, p ≤ 0.003). Longer daytime sleep duration was significantly associated slower processing speed (β = -0.085, SE = 0.027, p = 0.001), and with steeper 6-year decline in visuospatial reasoning (β = -0.009, SE = 0.003, p = 0.008), and processing speed (β = -0.009, SE = 0.002, p < 0.001). Only longitudinal associations between longer daytime sleeping and steeper cognitive declines survived correction for important health covariates and false discovery rate (FDR). PGS of chronotype and sleep duration were nominally associated with specific self-reported sleep characteristics for most SNP thresholds (standardized β range = |0.123 to 0.082|, p range = 0.003 to 0.046), but neither PGS predicted cognitive level or change following FDR. Daytime sleep duration is a potentially important correlate of cognitive decline in visuospatial reasoning and processing speed in older age, whereas cross-sectional associations are partially confounded by important health factors. A genetic propensity toward morningness and sleep duration were weakly, but consistently, related to self-reported sleep characteristics, and did not relate to cognitive level or change.
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Affiliation(s)
- Simon R Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Stuart J Ritchie
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Mike Allerhand
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Saskia P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Department of Psychology, University of Edinburgh, Edinburgh, UK.,Division of Psychiatry, University of Edinburgh, Edinburgh, UK.,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ratko Radakovic
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Faculty of Medical and Health Sciences, University of East Anglia, Norwich, UK.,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Gail Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Renata L Riha
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Department of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Sarah E Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,Department of Psychology, University of Edinburgh, Edinburgh, UK
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21
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Health risk behaviours and allostatic load: A systematic review. Neurosci Biobehav Rev 2020; 108:694-711. [DOI: 10.1016/j.neubiorev.2019.12.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/05/2019] [Accepted: 12/11/2019] [Indexed: 12/26/2022]
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22
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Butler ES, McGlinchey E, Juster R. Sexual and gender minority sleep: A narrative review and suggestions for future research. J Sleep Res 2019; 29:e12928. [DOI: 10.1111/jsr.12928] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Eliana S. Butler
- School of Psychology Fairleigh Dickinson University Teaneck NJ USA
| | - Eleanor McGlinchey
- School of Psychology Fairleigh Dickinson University Teaneck NJ USA
- Division of Child and Adolescent Psychiatry Columbia University Medical Center/New York State Psychiatric Institute New York NY USA
| | - Robert‐Paul Juster
- Department of Psychiatry and Addiction University of Montreal Montreal QC Canada
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23
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Besedovsky L, Lange T, Haack M. The Sleep-Immune Crosstalk in Health and Disease. Physiol Rev 2019; 99:1325-1380. [PMID: 30920354 PMCID: PMC6689741 DOI: 10.1152/physrev.00010.2018] [Citation(s) in RCA: 607] [Impact Index Per Article: 121.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 02/08/2023] Open
Abstract
Sleep and immunity are bidirectionally linked. Immune system activation alters sleep, and sleep in turn affects the innate and adaptive arm of our body's defense system. Stimulation of the immune system by microbial challenges triggers an inflammatory response, which, depending on its magnitude and time course, can induce an increase in sleep duration and intensity, but also a disruption of sleep. Enhancement of sleep during an infection is assumed to feedback to the immune system to promote host defense. Indeed, sleep affects various immune parameters, is associated with a reduced infection risk, and can improve infection outcome and vaccination responses. The induction of a hormonal constellation that supports immune functions is one likely mechanism underlying the immune-supporting effects of sleep. In the absence of an infectious challenge, sleep appears to promote inflammatory homeostasis through effects on several inflammatory mediators, such as cytokines. This notion is supported by findings that prolonged sleep deficiency (e.g., short sleep duration, sleep disturbance) can lead to chronic, systemic low-grade inflammation and is associated with various diseases that have an inflammatory component, like diabetes, atherosclerosis, and neurodegeneration. Here, we review available data on this regulatory sleep-immune crosstalk, point out methodological challenges, and suggest questions open for future research.
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Affiliation(s)
- Luciana Besedovsky
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen , Tübingen , Germany ; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts ; and Department of Rheumatology and Clinical Immunology, University of Lübeck , Lübeck , Germany
| | - Tanja Lange
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen , Tübingen , Germany ; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts ; and Department of Rheumatology and Clinical Immunology, University of Lübeck , Lübeck , Germany
| | - Monika Haack
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen , Tübingen , Germany ; Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts ; and Department of Rheumatology and Clinical Immunology, University of Lübeck , Lübeck , Germany
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24
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Ellis EM, Prather AA, Grenen EG, Ferrer RA. Direct and indirect associations of cognitive reappraisal and suppression with disease biomarkers. Psychol Health 2019; 34:336-354. [PMID: 30614281 DOI: 10.1080/08870446.2018.1529313] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Habitual use of emotion regulation strategies may influence physical health. We examined whether the tendencies to employ cognitive reappraisal and suppression were associated with health biomarkers, and whether stress and sleep quality mediated these associations. Design & main outcome measures: Using data from the Biomarkers substudy (n = 1255) of the national Midlife in the U.S. Study, we tested the hypothesis that there would be indirect, but not direct, associations of cognitive reappraisal and suppression to biomarker indicators of multisystem physiological dysregulation, that is, allostatic load (AL). We computed the proportion of biomarkers in the highest risk quartile within seven biological systems, and summed these scores to compute AL. Associations with the biological systems were also examined separately. RESULTS Neither reappraisal nor suppression was directly associated with AL or biomarker function in the seven biological systems. Suppression was indirectly associated with higher AL and greater dysregulation in the inflammatory, metabolic, and hypothalamic-pituitary-adrenal systems via its relations to stress and sleep, p < 0.05. Reappraisal was indirectly associated with lower AL and less metabolic and inflammatory dysregulation, ps<0.05. CONCLUSIONS Suppression and reappraisal may have different downstream health effects via stress, sleep, and biomarker expression, suggesting malleable emotion regulation strategies may be an important intervention target.
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Affiliation(s)
- Erin M Ellis
- a Basic Biobehavioral and Psychological Sciences Branch , Behavioral Research Program, National Cancer Institute , Rockville , MD , USA
| | - Aric A Prather
- b Department of Psychiatry and Weill Institute for Neurosciences , University of California San Francisco , San Francisco , CA , USA
| | - Emily G Grenen
- c London School of Hygiene & Tropical Medicine , London , UK
| | - Rebecca A Ferrer
- a Basic Biobehavioral and Psychological Sciences Branch , Behavioral Research Program, National Cancer Institute , Rockville , MD , USA
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Engert V, Kok BE, Puhlmann LMC, Stalder T, Kirschbaum C, Apostolakou F, Papanastasopoulou C, Papassotiriou I, Pervanidou P, Chrousos GP, Singer T. Exploring the multidimensional complex systems structure of the stress response and its relation to health and sleep outcomes. Brain Behav Immun 2018; 73:390-402. [PMID: 29885438 DOI: 10.1016/j.bbi.2018.05.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/26/2018] [Accepted: 05/27/2018] [Indexed: 11/28/2022] Open
Abstract
To gain a comprehensive understanding of the multidimensional complex systems structure of the stress response and related health outcomes, we utilized network analysis in a sample of 328 healthy participants in two steps. In a first step, we focused on associations between measures of basal hypothalamic-pituitary-adrenal axis functioning and subjective stress perceptions. In a second step, we linked these diverse stress-related measures to biomarkers and self-reports of health and sleep. Overall, measures clustered depending on their method of assessment, with high correlations between different saliva-based indices of diurnal cortisol regulation, between cortisol and cortisone levels in hair, between different biological health indicators (systemic inflammatory activity and body mass index), between state (experience sampling) and trait (questionnaire-based) self-reports of stress and wellbeing, and between different self-reports of sleep. Bridges between clusters suggested that if individuals perceive stress throughout their daily lives this is reflected in their total salivary cortisol output possibly contributing to long-term cortisol accumulation in hair. Likewise, earlier awakening time may contribute to cortisol accumulation in hair via an influence on awakening cortisol processes. Our results show that while meaningful connections between measures exist, stress is a highly complex construct composed of numerous aspects. We argue that network analysis is an integrative statistical approach to address the multidimensionality of the stress response and its effects on the brain and body. This may help uncover pathways to stress-related disease and serve to identify starting points for prevention and therapeutic intervention.
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Affiliation(s)
- Veronika Engert
- Department of Social Neuroscience, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Bethany E Kok
- Department of Social Neuroscience, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Lara M C Puhlmann
- Department of Social Neuroscience, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Tobias Stalder
- Clinical Psychology, University of Siegen, Siegen, Germany
| | - Clemens Kirschbaum
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Filia Apostolakou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | | | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Panagiota Pervanidou
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - George P Chrousos
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Tania Singer
- Department of Social Neuroscience, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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26
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Xu S, Thompson W, Kerr J, Godbole S, Sears DD, Patterson R, Natarajan L. Modeling interrelationships between health behaviors in overweight breast cancer survivors: Applying Bayesian networks. PLoS One 2018; 13:e0202923. [PMID: 30180192 PMCID: PMC6122792 DOI: 10.1371/journal.pone.0202923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/07/2018] [Indexed: 02/04/2023] Open
Abstract
Obesity and its impact on health is a multifaceted phenomenon encompassing many factors, including demographics, environment, lifestyle, and psychosocial functioning. A systems science approach, investigating these many influences, is needed to capture the complexity and multidimensionality of obesity prevention to improve health. Leveraging baseline data from a unique clinical cohort comprising 333 postmenopausal overweight or obese breast cancer survivors participating in a weight-loss trial, we applied Bayesian networks, a machine learning approach, to infer interrelationships between lifestyle factors (e.g., sleep, physical activity), body mass index (BMI), and health outcomes (biomarkers and self-reported quality of life metrics). We used bootstrap resampling to assess network stability and accuracy, and Bayesian information criteria (BIC) to compare networks. Our results identified important behavioral subnetworks. BMI was the primary pathway linking behavioral factors to glucose regulation and inflammatory markers; the BMI-biomarker link was reproduced in 100% of resampled networks. Sleep quality was a hub impacting mental quality of life and physical health with > 95% resampling reproducibility. Omission of the BMI or sleep links significantly degraded the fit of the networks. Our findings suggest potential mechanistic pathways and useful intervention targets for future trials. Using our models, we can make quantitative predictions about health impacts that would result from targeted, weight loss and/or sleep improvement interventions. Importantly, this work highlights the utility of Bayesian networks in health behaviors research.
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Affiliation(s)
- Selene Xu
- Department of Mathematics, University of California, San Diego, San Diego, California, United States of America
| | - Wesley Thompson
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, United States of America
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, United States of America
| | - Suneeta Godbole
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, United States of America
| | - Dorothy D. Sears
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, United States of America
- Department of Medicine, University of California, San Diego, San Diego, California, United States of America
| | - Ruth Patterson
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, United States of America
| | - Loki Natarajan
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, California, United States of America
- * E-mail:
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Garland SN, Irwin MR, Posner D, Perlis ML. Are sleep continuity disturbance and fatigue prodromal symptoms of cancer development? Med Hypotheses 2018; 120:72-75. [PMID: 30220346 DOI: 10.1016/j.mehy.2018.08.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/31/2018] [Accepted: 08/23/2018] [Indexed: 12/21/2022]
Abstract
Sleep continuity disturbance (also known as insomnia) and fatigue are common complaints of individuals diagnosed with cancer. Traditionally, many have believed that sleep continuity disturbance and fatigue are caused, in large measure, by the impact of the cancer diagnosis and treatment. Recent prospective research suggests however, that sleep continuity disturbance and fatigue may actually precede a cancer diagnosis. We suggest that sleep continuity disturbance and fatigue may in fact represent prodromal symptoms of cancer. We review the current perspectives of this sequence of events and present a revised schematic that accounts for the role of biological, behavioural, and cognitive factors that contribute to the development and maintenance of sleep continuity disturbances in cancer patients. Monitoring emergent and unexplained patient-reported fatigue, sleepiness, and insomnia may serve as early warning signs of new onset cancer, providing opportunity for early detection and early intervention.
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Affiliation(s)
- Sheila N Garland
- Departments of Psychology and Oncology, Memorial University, 232 Elizabeth Avenue, St. John's, Newfoundland A1B 3X9, Canada.
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology at the UCLA Semel Institute for Neuroscience, and the Departments of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, 300 UCLA Medical Plaza #3109, Los Angeles, CA 90095, United States
| | - Donn Posner
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5717, United States
| | - Michael L Perlis
- Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 670, Philadelphia, PA 19104, United States
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28
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Pigarev IN, Pigareva ML. Association of sleep impairments and gastrointestinal disorders in the context of the visceral theory of sleep. J Integr Neurosci 2018; 16:143-156. [PMID: 28891506 DOI: 10.3233/jin-170005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
It was noticed long ago that sleep disorders or interruptions to the normal sleep pattern were associated with various gastrointestinal disorders. We review the studies which established the causal link between these disorders and sleep impairment. However, the mechanism of interactions between the quality of sleep and gastrointestinal pathophysiology remained unclear. Recently, the visceral theory of sleep was formulated. This theory proposes that the same brain structures, and particularly the same cortical sensory areas, which in wakefulness are involved in processing of the exteroceptive information, switch during sleep to the processing of information coming from various visceral systems. We review the studies which demonstrated that neurons of the various cortical areas (occipital, parietal, frontal) during sleep began to fire in response to activation coming from the stomach and small intestine. These data demonstrate that, during sleep, the computational power of the central nervous system, including all cortical areas, is engaged in restoration of visceral systems. Thus, the general mechanism of the interaction between quality of sleep and health became clear.
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Affiliation(s)
- Ivan N Pigarev
- Institute for Information Transmission Problems (Kharkevich Institute), Russian Academy of Sciences, Bol'shoy Karetniy st. 19, Moscow, 127994, Russia. E-mail:
| | - Marina L Pigareva
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Butlerova st. 5-a, Moscow, 117485, Russia. E-mail:
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29
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Zhang P, Tan CW, Chen GH, Ge YJ, Xu J, Xia L, Wang F, Li XY, Kong XY. Patients with chronic insomnia disorder have increased serum levels of neurofilaments, neuron-specific enolase and S100B: does organic brain damage exist? Sleep Med 2018; 48:163-171. [PMID: 29957487 DOI: 10.1016/j.sleep.2017.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/30/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The aims of this study were to investigate whether serum levels of neurofilaments heavy chain (NfH) and light chain (NfL), neuron-specific enolase (NSE) and S100 calcium binding protein B (S100B): (1) change, (2) alleviate in post-therapy and (3) are associated with sleep quality and cognitive dysfunction, in patients with chronic insomnia disorder (CID). METHODS Forty CID outpatients constituted free-therapy group (ft-CID), in which twenty-four patients completed follow-up after six-month treatment to form re-visiting group (rv-CID), and twenty healthy good sleepers constituted control group (HC). All subjects completed questionnaires, polysomnography, Chinese-Beijing Version of Montreal Cognitive Assessment (MoCA-C) and Nine Box Maze Test (NBMT) to assess sleep and neuropsychological function. The serum levels of NfH, NfL, NSE and S100B were detected using enzyme-linked immunosorbent assay. RESULTS The ft-CID had higher levels of NfH, NfL, NSE and S100B than the HC. Of note, the levels of NfH, NfL and NSE were significantly reduced in the rv-CID compared to the ft-CID, but not the level of S100B. Principal components analysis revealed that in these serum biomarkers, NfL and S100B had a substantial correlation with subjective and objective sleep parameters. CONCLUSIONS The CID patients had elevated serum levels of NfH, NfL, NSE and S100B, indicating existence of damaged brain microstructure, including neurons, astrocytes and neuronal terminals, which were associated with the insomniac severity or/and cognitive dysfunction and could significantly reduce after effective therapy apart from the S100B.
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Affiliation(s)
- Ping Zhang
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Cheng-Wen Tan
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Gui-Hai Chen
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
| | - Yi-Jun Ge
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Jing Xu
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Lan Xia
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China
| | - Fang Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Xue-Yan Li
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
| | - Xiao-Yi Kong
- Department of Sleep Disorders or Psychiatry or Neurology, The Affiliated Chaohu Hospital of Anhui Medical University, Chaohu, Hefei, 238000, China
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30
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Qiu C, Lawrence W, Gelaye B, Stoner L, Frederick IO, Enquobahrie DA, Sorensen TK, Williams MA. Risk of glucose intolerance and gestational diabetes mellitus in relation to maternal habitual snoring during early pregnancy. PLoS One 2017; 12:e0184966. [PMID: 28926639 PMCID: PMC5605003 DOI: 10.1371/journal.pone.0184966] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 09/04/2017] [Indexed: 12/02/2022] Open
Abstract
Background Obstructive sleep apnea (OSA) or habitual snoring is known to be associated with impaired glucose tolerance and type 2 diabetes among both men and non-pregnant women. We examined the association of habitual snoring during early pregnancy with risk of impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM). Methods A cohort of 1,579 women was interviewed during early pregnancy. We collected information about snoring frequency during early pregnancy. Results from screening and diagnostic tests for IGT and GDM were abstracted from medical records. Multivariate logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (95% CI) of IGT and GDM associated with snoring in early pregnancy. Results Overall, women who snored “most or all of the time” had a 2.1-fold increased odds of IGT (OR 2.10; 95% CI 1.31–3.35) and a 2.5-fold increased odds of GDM (OR 2.50; 95% CI 1.34–4.67) as compared with women who never snored. Compared with lean women (pre-pregnancy body mass index (BMI) <25 kg/m2) who did not snore, lean snorers had a 2-fold increased odds of GDM (OR = 1.99, 95% CI: 1.07–3.68). The odds of GDM risk was particularly elevated among overweight women (BMI ≥ 25 kg/m2) who snored (OR = 5.01; 95% CI 2.71–9.26). However, there was no evidence of an interaction between overweight and snoring with GDM risk (p-value = 0.144). Conclusions These findings, if confirmed, may have important implications for tailoring prenatal care for overweight pregnant women, and /or those with a history of habitual snoring in early pregnancy.
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Affiliation(s)
- Chunfang Qiu
- Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
- * E-mail:
| | - Wayne Lawrence
- Department of Epidemiology, Harvard T. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Lee Stoner
- Department of Sport and Exercise Science, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Ihunnaya O. Frederick
- Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
| | - Daniel A. Enquobahrie
- Department of Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, WA, United States of America
| | - Tanya K. Sorensen
- Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
| | - Michelle A. Williams
- Department of Epidemiology, Harvard T. Chan School of Public Health, Boston, Massachusetts, United States of America
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31
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Bei B, Seeman TE, Carroll JE, Wiley JF. Sleep and Physiological Dysregulation: A Closer Look at Sleep Intraindividual Variability. Sleep 2017; 40:3885856. [PMID: 28651371 PMCID: PMC5806573 DOI: 10.1093/sleep/zsx109] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Study Objectives Variable daily sleep (ie, higher intraindividual variability; IIV) is associated with negative health consequences, but potential physiological mechanisms are poorly understood. This study examined how the IIV of sleep timing, duration, and quality is associated with physiological dysregulation, with diurnal cortisol trajectories as a proximal outcome and allostatic load (AL) as a multisystem distal outcome. Methods Participants are 436 adults (Mage ± standard deviation = 54.1 ± 11.7, 60.3% women) from the Midlife in the United States study. Sleep was objectively assessed using 7-day actigraphy. Diurnal cortisol was measured via saliva samples (four/day for 4 consecutive days). AL was measured using 23 biomarkers from seven systems (inflammatory, hypothalamic-pituitary-adrenal axis, metabolic glucose and lipid, cardiovascular, parasympathetic, sympathetic) using a validated bifactor model. Linear and quadratic effects of sleep IIV were estimated using a validated Bayesian model. Results Controlling for covariates, more variable sleep timing (p = .04 for risetime, p = .097 for bedtime) and total sleep time (TST; p = .02), but not mean sleep variables, were associated with flatter cortisol diurnal slope. More variable sleep onset latency and wake after sleep onset, later average bedtime, and shorter TST were associated with higher AL adjusting for age and sex (p-values < .05); after controlling for all covariates, however, only later mean bedtime remained significantly associated with higher AL (p = .04). Conclusions In a community sample of adults, more variable sleep patterns were associated with blunted diurnal cortisol trajectories but not with higher multisystem physiological dysregulation. The associations between sleep IIV and overall health are likely complex, including multiple biopsychosocial determinants and require further investigation.
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Affiliation(s)
- Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Department of Psychiatry, University of Melbourne, Royal Women’s Hospital, Victoria, Australia
| | - Teresa E Seeman
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Judith E Carroll
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Joshua F Wiley
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Primary Care and Prevention, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne,Victoria, Australia
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Curtis DS, Fuller-Rowell TE, El-Sheikh M, Carnethon MR, Ryff CD. Habitual sleep as a contributor to racial differences in cardiometabolic risk. Proc Natl Acad Sci U S A 2017; 114:8889-8894. [PMID: 28760970 PMCID: PMC5565403 DOI: 10.1073/pnas.1618167114] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Insufficient and disrupted sleep is linked with cardiovascular and metabolic dysregulation and morbidity. The current study examines the degree to which differences in sleep between black/African American (AA) and white/European American (EA) adults explain racial differences in cardiometabolic (CMB) disease risk. Total sleep time and sleep efficiency (percent of time in bed asleep) were assessed via seven nights of wrist actigraphy among 426 participants in the Midlife in the United States Study (31% AA; 69% EA; 61% female; mean age = 56.8 y). CMB risk was indexed as a composite of seven biomarkers [blood pressure, waist circumference, hemoglobin A1c (HbA1c), insulin resistance, triglycerides, HDL cholesterol (HDL-C), and C-reactive protein]. Covariates included sociodemographic characteristics and relevant health behaviors. Results indicated that AAs relative to EAs obtained less sleep (341 vs. 381 min) and had lower sleep efficiency (72.3 vs. 82.2%) (P values < 0.001). Further, 41% and 58% of the racial difference in CMB risk was explained by sleep time and sleep efficiency, respectively. In models stratified by sex, race was indirectly associated with CMB risk via sleep time and efficiency only among females (explaining 33% and 65% of the race difference, respectively). Indirect effects were robust to alternative model specifications that excluded participants with diabetes or heart disease. Consideration of sleep determinants and sleep health is therefore needed in efforts to reduce racial differences in CMB disease.
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Affiliation(s)
- David S Curtis
- Department of Human Development and Family Studies, Auburn University, Auburn, AL 36849;
| | | | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University, Auburn, AL 36849
| | | | - Carol D Ryff
- Department of Psychology, University of Wisconsin-Madison, Madison, WI 53706
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Trudel-Fitzgerald C, Zhou ES, Poole EM, Zhang X, Michels KB, Eliassen AH, Chen WY, Holmes MD, Tworoger SS, Schernhammer ES. Sleep and survival among women with breast cancer: 30 years of follow-up within the Nurses' Health Study. Br J Cancer 2017; 116:1239-1246. [PMID: 28359077 PMCID: PMC5418457 DOI: 10.1038/bjc.2017.85] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 02/09/2017] [Accepted: 03/07/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Breast cancer is a leading cause of cancer death in women. Sleep has been linked with mortality among cancer-free population; however, its association with survival among women with breast cancer is understudied. METHODS Breast cancer patients (N=3682) reported their average sleep duration post diagnosis. Subsamples also provided their pre-diagnosis sleep duration (n=1949) and post-diagnosis sleep difficulties (n=1353). Multivariate Cox models estimated hazard ratios (HR) and confidence intervals (CI) of all-cause, breast cancer, and non-breast cancer mortality. RESULTS At diagnosis, the mean age was 64.9 years and 91.7% were stage I or II. Women sleeping ⩾9 h per night post diagnosis had a strong higher risk of all-cause (multivariate HRs: MV-HR=1.37, CI=1.10-1.71), breast cancer (MV-HR=1.46, CI=1.02-2.07), and non-breast cancer mortality (MV-HR=1.34, CI=1.01-1.79), compared to women sleeping 8 h per night. Increased sleep duration post diagnosis (vs unchanged) and regular sleep difficulties (vs rare/none) were associated with a strong elevated risk of all-cause mortality (MV-HRincreased duration=1.35, CI=1.04-1.74; MV-HRregular difficulties=1.49, CI=1.02-2.19) and a moderate greater risk of breast cancer and non-breast cancer mortality. CONCLUSIONS Various facets of sleep were associated with higher all-cause mortality risk. If replicated, these findings support evaluation of breast cancer patients' sleep duration and difficulties to identify those at risk for poorer outcomes.
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Affiliation(s)
- Claudia Trudel-Fitzgerald
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Eric S Zhou
- Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA
| | - Elizabeth M Poole
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
| | - Xuehong Zhang
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Karin B Michels
- Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E Young Dr S, Los Angeles, CA 90095, USA
| | - A Heather Eliassen
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Wendy Y Chen
- Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
| | - Michelle D Holmes
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Shelley S Tworoger
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Eva S Schernhammer
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Medical University of Vienna, Marianneng. 14/Top 105, Vienna 1090, Austria
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Epigenetic Aging and Immune Senescence in Women With Insomnia Symptoms: Findings From the Women's Health Initiative Study. Biol Psychiatry 2017; 81:136-144. [PMID: 27702440 PMCID: PMC5536960 DOI: 10.1016/j.biopsych.2016.07.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 06/11/2016] [Accepted: 07/10/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Insomnia symptoms are associated with vulnerability to age-related morbidity and mortality. Cross-sectional data suggest that accelerated biological aging may be a mechanism through which sleep influences risk. A novel method for determining age acceleration using epigenetic methylation to DNA has demonstrated predictive utility as an epigenetic clock and prognostic of age-related morbidity and mortality. METHODS We examined the association of epigenetic age and immune cell aging with sleep in the Women's Health Initiative study (N = 2078; mean 64.5 ± 7.1 years of age) with assessment of insomnia symptoms (restlessness, difficulty falling asleep, waking at night, trouble getting back to sleep, and early awakenings), sleep duration (short sleep 5 hours or less; long sleep greater than 8 hours), epigenetic age, naive T cell (CD8+CD45RA+CCR7+), and late differentiated T cells (CD8+CD28-CD45RA-). RESULTS Insomnia symptoms were related to advanced epigenetic age (β ± SE = 1.02 ± 0.37, p = .005) after adjustments for covariates. Insomnia symptoms were also associated with more late differentiated T cells (β ± SE = 0.59 ± 0.21, p = .006), but not with naive T cells. Self-reported short and long sleep duration were unrelated to epigenetic age. Short sleep, but not long sleep, was associated with fewer naive T cells (p < .005) and neither was related to late differentiated T cells. CONCLUSIONS Symptoms of insomnia were associated with increased epigenetic age of blood tissue and were associated with higher counts of late differentiated CD8+ T cells. Short sleep was unrelated to epigenetic age and late differentiated cell counts, but was related to a decline in naive T cells. In this large population-based study of women in the United States, insomnia symptoms are implicated in accelerated aging.
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Irwin MR, Opp MR. Sleep Health: Reciprocal Regulation of Sleep and Innate Immunity. Neuropsychopharmacology 2017; 42:129-155. [PMID: 27510422 PMCID: PMC5143488 DOI: 10.1038/npp.2016.148] [Citation(s) in RCA: 256] [Impact Index Per Article: 36.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/29/2016] [Accepted: 08/02/2016] [Indexed: 12/11/2022]
Abstract
Sleep disturbances including insomnia independently contribute to risk of inflammatory disorders and major depressive disorder. This review and overview provides an integrated understanding of the reciprocal relationships between sleep and the innate immune system and considers the role of sleep in the nocturnal regulation of the inflammatory biology dynamics; the impact of insomnia complaints, extremes of sleep duration, and experimental sleep deprivation on genomic, cellular, and systemic markers of inflammation; and the influence of sleep complaints and insomnia on inflammaging and molecular processes of cellular aging. Clinical implications of this research include discussion of the contribution of sleep disturbance to depression and especially inflammation-related depressive symptoms. Reciprocal action of inflammatory mediators on the homeostatic regulation of sleep continuity and sleep macrostructure, and the potential of interventions that target insomnia to reverse inflammation, are also reviewed. Together, interactions between sleep and inflammatory biology mechanisms underscore the implications of sleep disturbance for inflammatory disease risk, and provide a map to guide the development of treatments that modulate inflammation, improve sleep, and promote sleep health.
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Affiliation(s)
- Michael R Irwin
- Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience Director and Mindful Awareness Research Center, University of California, Los Angeles, CA, USA
| | - Mark R Opp
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
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Barboza Solís C, Fantin R, Kelly-Irving M, Delpierre C. Physiological wear-and-tear and later subjective health in mid-life: Findings from the 1958 British birth cohort. Psychoneuroendocrinology 2016; 74:24-33. [PMID: 27567118 DOI: 10.1016/j.psyneuen.2016.08.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/01/2016] [Accepted: 08/02/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Our body adapts continuously to environmental challenges and stressful conditions. Allostatic load (AL) is a concept that aims to capture the overall physiological wear-and-tear of the body triggered by the repeated activation of compensatory physiological mechanisms as a response to chronic stress. Growing evidence has shown a link between AL and later health decline, morbidity and mortality. However, due to the global physiological effect captured by the AL concept, it is particularly pertinent to examine its association with subsequent health by taking a broad definition of the latter. We examined the association between AL at 44 years and general health as measured by a latent multidimensional measure of subjective health at 50 years integrating sleep patterns, physical and mental health. METHODS AL was constructed using 14 biomarkers representing four physiological systems on 7573 members of the 1958 British birth cohort. Health status was captured using self-reported information about subjective health and summarized using a principal component analysis including: seven dimensions of the SF-36 questionnaire of health-related quality of life, the sleep subscale of the Medical Outcomes Study characterizing quality of sleep patterns, and a malaise inventory score detecting depressive symptoms. RESULTS Higher AL score was gradually associated with worse subjective health, after taking into account classic confounders. CONCLUSIONS Using a physiological index to grasp how the environment can "get under the skin" leading to poor health is of great interest, permitting a better understanding of life course origins of disease and social gradients in health.
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Affiliation(s)
- Cristina Barboza Solís
- LEASP - UMR 1027 Inserm-Université Toulouse III Paul Sabatier, France; Universidad de Costa Rica, 2060 San José, Costa Rica.
| | - Romain Fantin
- LEASP - UMR 1027 Inserm-Université Toulouse III Paul Sabatier, France
| | | | - Cyrille Delpierre
- LEASP - UMR 1027 Inserm-Université Toulouse III Paul Sabatier, France
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Kok VC, Horng JT, Hung GD, Xu JL, Hung TW, Chen YC, Chen CL. Risk of Autoimmune Disease in Adults with Chronic Insomnia Requiring Sleep-Inducing Pills: A Population-Based Longitudinal Study. J Gen Intern Med 2016; 31:1019-26. [PMID: 27130621 PMCID: PMC4978676 DOI: 10.1007/s11606-016-3717-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/11/2016] [Accepted: 04/13/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Recent studies indicate that chronic insomnia is associated with the development of certain somatic diseases. Whether it would be associated with the development of an autoimmune disease (AID) was unknown. OBJECTIVE We aimed to examine the association and quantify the magnitude of risk for AID in individuals suffering from chronic insomnia requiring sleep-inducing pills. DESIGN This was a population-based, nationwide longitudinal study. PARTICIPANTS Using a claims data set containing 1 million randomly sampled, insured subjects derived from the National Health Insurance Research Database, we assembled a chronic insomnia group and a 1:3 propensity score-matched comparison group (CP), which were balanced in terms of sex, age, insurance premium, urbanization, alcohol use disorder, smoking-related diagnoses, and morbid obesity. MAIN MEASURES Person-time data with incidence rate, adjusted hazard ratios (aHR) by the Cox model, AID-free survival functions compared with the log-rank test, and a sensitivity analysis on the time lag effect were presented. Incident AID within the first year of follow-up were excluded. The error rate was controlled using the Benjamini-Hochberg procedure. KEY RESULTS With 39,550 and 129,914 person-years' follow-up for the chronic insomnia and CP groups (n = 5,736 and 17,208), respectively, we found an increased risk for subsequent AID, representing a 70 % increase in the aHR (1.7; 95 % confidence interval [CI], 1.5-1.9, p < 0.0001). A positive association between chronic insomnia and primary Sjögren's syndrome (pSS) was observed (aHR, 1.3; 95 % CI, 1.1-1.6). Sensitivity analysis disclosed that AID risk was even stronger after 5 years of follow-up (aHR, 2.0; 95 % CI, 1.7-2.4). CONCLUSION Chronic insomnia requiring sleep-inducing pills may be associated with a 70 % increased risk for future AID, particularly pSS.
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Affiliation(s)
- Victor C Kok
- Department of Internal Medicine, Kuang Tien General Hospital, 117 Shatien Road, Taichung, 43303, Taiwan.
- Disease Informatics Research Group, Asia University, Taichung, Taiwan.
| | - Jorng-Tzong Horng
- Disease Informatics Research Group, Asia University, Taichung, Taiwan
- Department of Computer Science and Information Engineering, National Central University, Jhongli, Taiwan
| | - Guo-Dung Hung
- Division of Rheumatology & Immunology, Department of Internal Medicine, Kuang Tien General Hospital, Taichung, Taiwan
| | - Jia-Li Xu
- Department of Computer Science and Information Engineering, National Central University, Jhongli, Taiwan
| | - Tzu-Wei Hung
- Department of Computer Science and Information Engineering, National Central University, Jhongli, Taiwan
| | - Yu-Ching Chen
- Disease Informatics Research Group, Asia University, Taichung, Taiwan
| | - Chien-Lung Chen
- Division of Nephrology, Department of Internal Medicine, Taiwan Landseed Hospital, Taoyuan, Taiwan
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Barboza Solís C, Fantin R, Castagné R, Lang T, Delpierre C, Kelly-Irving M. Mediating pathways between parental socio-economic position and allostatic load in mid-life: Findings from the 1958 British birth cohort. Soc Sci Med 2016; 165:19-27. [DOI: 10.1016/j.socscimed.2016.07.031] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/22/2016] [Accepted: 07/24/2016] [Indexed: 01/10/2023]
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Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry 2016; 80:40-52. [PMID: 26140821 PMCID: PMC4666828 DOI: 10.1016/j.biopsych.2015.05.014] [Citation(s) in RCA: 1016] [Impact Index Per Article: 127.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/05/2015] [Accepted: 05/11/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sleep disturbance is associated with inflammatory disease risk and all-cause mortality. Here, we assess global evidence linking sleep disturbance, sleep duration, and inflammation in adult humans. METHODS A systematic search of English language publications was performed, with inclusion of primary research articles that characterized sleep disturbance and/or sleep duration or performed experimental sleep deprivation and assessed inflammation by levels of circulating markers. Effect sizes (ES) and 95% confidence intervals (CI) were extracted and pooled using a random effect model. RESULTS A total of 72 studies (n > 50,000) were analyzed with assessment of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNFα). Sleep disturbance was associated with higher levels of CRP (ES .12; 95% CI = .05-.19) and IL-6 (ES .20; 95% CI = .08-.31). Shorter sleep duration, but not the extreme of short sleep, was associated with higher levels of CRP (ES .09; 95% CI = .01-.17) but not IL-6 (ES .03; 95% CI: -.09 to .14). The extreme of long sleep duration was associated with higher levels of CRP (ES .17; 95% CI = .01-.34) and IL-6 (ES .11; 95% CI = .02-20). Neither sleep disturbances nor sleep duration was associated with TNFα. Neither experimental sleep deprivation nor sleep restriction was associated with CRP, IL-6, or TNFα. Some heterogeneity among studies was found, but there was no evidence of publication bias. CONCLUSIONS Sleep disturbance and long sleep duration, but not short sleep duration, are associated with increases in markers of systemic inflammation.
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Carroll JE, Esquivel S, Goldberg A, Seeman TE, Effros RB, Dock J, Olmstead R, Breen EC, Irwin MR. Insomnia and Telomere Length in Older Adults. Sleep 2016; 39:559-64. [PMID: 26715231 DOI: 10.5665/sleep.5526] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 11/14/2015] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVES Insomnia, particularly in later life, may raise the risk for chronic diseases of aging and mortality through its effect on cellular aging. The current study examines the effects of insomnia on telomere length, a measure of cellular aging, and tests whether insomnia interacts with chronological age to increase cellular aging. METHODS A total of 126 males and females (60-88 y) were assessed for insomnia using the Diagnostic and Statistical Manual IV criterion for primary insomnia and the International Classification of Sleep Disorders, Second Edition for general insomnia (45 insomnia cases; 81 controls). Telomere length in peripheral blood mononuclear cells (PBMC) was determined using real-time quantitative polymerase chain reaction (qPCR) methodology. RESULTS In the analysis of covariance model adjusting for body mass index and sex, age (60-69 y versus 70-88 y) and insomnia diagnosis interacted to predict shorter PBMC telomere length (P = 0.04). In the oldest age group (70-88 y), PBMC telomere length was significantly shorter in those with insomnia, mean (standard deviation) M(SD) = 0.59(0.2) compared to controls with no insomnia M(SD) = 0.78(0.4), P = 0.04. In the adults aged 60-69 y, PBMC telomere length was not different between insomnia cases and controls, P = 0.44. CONCLUSIONS Insomnia is associated with shorter PBMC telomere length in adults aged 70-88 y, but not in those younger than 70 y, suggesting that clinically severe sleep disturbances may increase cellular aging, especially in the later years of life. These findings highlight insomnia as a vulnerability factor in later life, with implications for risk for diseases of aging.
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Affiliation(s)
- Judith E Carroll
- University of California, Los Angeles, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Stephanie Esquivel
- University of California, Los Angeles, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Alyssa Goldberg
- University of California, Los Angeles, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA.,Children's National Medical Center, Department of Pediatrics, Washington, DC
| | - Teresa E Seeman
- University of California, Los Angeles, Department of Medicine, Division of Geriatrics, David Geffen School of Medicine, Los Angeles, CA
| | - Rita B Effros
- University of California, Los Angeles, Department of Pathology and Laboratory Medicine, Los Angeles, CA
| | - Jeffrey Dock
- University of California, Los Angeles, Department of Pathology and Laboratory Medicine, Los Angeles, CA
| | - Richard Olmstead
- University of California, Los Angeles, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Elizabeth C Breen
- University of California, Los Angeles, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
| | - Michael R Irwin
- University of California, Los Angeles, Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
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