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Lou S, Hu S, Chen Y, Zhao K, Zhou Y, Hou J, Liang L, Sun H. Benefits of napping habits in healthy adults: Maintaining alerting performance and cortisol levels change within 90 min of habitual napping time. Sleep Med 2024; 119:214-221. [PMID: 38703605 DOI: 10.1016/j.sleep.2024.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 04/04/2024] [Accepted: 04/14/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Napping is garnering increased attention as a strategy for adults to sustain alertness and alleviate stress in contemporary society. The nuances of napping habits are emerging as an independent factor influencing the extent of individual benefits. This study aimed to demonstrate the long-term benefits of napping and explore the impact of napping habits on individual alertness, as well as whether this effect was correlated with cortisol levels. METHODS The study involved 80 healthy adults categorized into two groups based on self-reported napping habits: habitual nappers (n = 49) and non-habitual nappers (n = 31). Karolinska Sleepiness Scale (KSS), psychomotor vigilance task (PVT), and saliva collection were performed every 30 min within 90 min in the absence of napping during the afternoon dip. The measurements were analyzed using repeated measures ANOVA and Pearson correlation analyses. RESULTS There was an interaction between groups and time in reaction speed and lapse number of PVT and cortisol (all p < 0.05). Post hoc analysis found that habitual nappers maintained higher objective alertness and experienced more significant increases in cortisol over time (all p < 0.05). The cortisol levels at sleepiness time were negatively associated with the slowest 10 % reaction speed of PVT in non-habitual nappers (r = -0.409, p = 0.022). CONCLUSION Under the premise of mitigating the impacts of acute nap deprivation on sleep homeostasis and rhythm, napping habits emerge as a potential factor influencing the ability of individuals to sustain heightened alertness.
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Affiliation(s)
- Sijia Lou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Sifan Hu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yun Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Kangqing Zhao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Yingying Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Jianjun Hou
- Peking University Health Science Center, Beijing, 100191, China
| | - Lining Liang
- Peking University Health Science Center, Beijing, 100191, China
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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2
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Law KC, O'Connell KL, Jacobson SV, Baer MM, Baker PM, Tull MT. Influences of sleep, cortisol reactivity, and risk/reward-based decision-making on suicide. J Behav Ther Exp Psychiatry 2024; 85:101975. [PMID: 38870548 DOI: 10.1016/j.jbtep.2024.101975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/03/2024] [Accepted: 05/25/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND AND OBJECTIVES Poor sleep quality is a known contributor to suicidal thoughts and behaviors. This study examines whether sleep quality modulates the effect of an individual's stress response and risk/reward-based decision making on suicide risk. METHODS Participants were 160 adults at a residential substance use treatment facility with lifetime exposure to trauma who completed a clinician-administered measure of suicide risk, the Iowa Gambling Task (IGT), and a self-report measure of sleep. Cortisol reactivity (i.e., changes in cortisol before and after a personalized trauma script) was used to measure stress response. We used quantile regression to examine the effects of sleep, cortisol, and risk/reward decision-making on suicide risk. RESULTS We found poor sleep quality to be increasingly salient in individuals at greater risk for suicide than those at lower risk for suicide. Furthermore, individuals with moderate to moderate-high levels of suicide risk seem to have greater cortisol reactivity. In the low-moderate quantile, we found suicide risk to be associated with both high stress reactivity and low-risk, high-reward decision-making, as well as low stress reactivity and high-risk/low-reward decision-making. LIMITATIONS These findings should be interpreted considering several methodological constraints, such as the use of a pre-determined sample and instruments not tailored for our hypotheses, the MINI 'Suicide' Module's limited differentiation between suicidal ideation and behavior, and variably timed cortisol sampling. CONCLUSIONS Despite these limitations, the findings from this study support the use of evidence-based interventions focused on improving sleep quality and managing emotional reactivity to decrease suicide risk.
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Affiliation(s)
- Keyne C Law
- Department of Clinical Psychology, Seattle Pacific University, Seattle, WA, USA.
| | | | - Samantha V Jacobson
- Department of Clinical Psychology, Seattle Pacific University, Seattle, WA, USA
| | - Margaret M Baer
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Phillip M Baker
- Department of Psychology, Seattle Pacific University, Seattle, WA, USA
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, OH, USA; Lyra Health Inc., Burlingame, CA, USA
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Kim RH, Paulino YC, Kawabata Y. Validating Constructs of the Depression, Anxiety, and Stress Scale-21 and Exploring Health Indicators to Predict the Psychological Outcomes of Students Enrolled in the Pacific Islands Cohort of College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:509. [PMID: 38673419 PMCID: PMC11050516 DOI: 10.3390/ijerph21040509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental health challenges, such as suicide, and examine the predictive impact of selected health indicators on DASS-21 variables. Three years of data (2017-2019) were pooled from the Pacific Islands Cohort of College Students (PICCS) study conducted annually at the University of Guam. In total, 726 students were included in the secondary data analysis. MPlus statistical software was used to perform a confirmatory factor analysis (CFA) for the validation and structural equation modeling (SEM) for the predictive modeling. The results from the CFA suggested an acceptable model fit (RMSEA: 0.073, CFI: 0.901, TLI: 0.889, RMR: 0.044), while SEM suggested that sleep quality and physical activity were significant predictors of DASS-21 variables. Therefore, the DASS-21 is a valid instrument for measuring depression, anxiety, and stress among emerging adults in Guam.
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Affiliation(s)
- Rebecca H. Kim
- College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96923, USA
| | | | - Yoshito Kawabata
- College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU 96923, USA;
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Ljubičić M, Šare S, Kolčić I. Sleep Quality and Evening Salivary Cortisol Levels in Association with the Psychological Resources of Parents of Children with Developmental Disorders and Type 1 Diabetes. J Autism Dev Disord 2024:10.1007/s10803-024-06269-7. [PMID: 38300504 DOI: 10.1007/s10803-024-06269-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Sleep deprivation can decrease parental well-being and degrade mental and physical health in parents of children with chronic illness. The aim of this study was to explore the associations of sleep quality, psychological stress perception, and evening salivary cortisol concentration with self-esteem, optimism and happiness in parents of children with type 1 diabetes and developmental disorders compared to parents of healthy, typically developing children. METHODS We studied 196 parents of children with chronic conditions, including autistic spectrum disorder (N = 33), cerebral palsy (N = 18), Down syndrome (N = 33), and diabetes mellitus type 1 (N = 40) and parents of healthy children (N = 72). We evaluated parental sleep quality, evening salivary cortisol levels, self-esteem, optimism and happiness. Multiple linear regression models were used to assess associations between variables. RESULTS Compared with those of the control group, the parents of children with autistic spectrum disorders had higher evening cortisol concentrations (β = 0.17; p = 0.038) and lower perceptions of happiness (β=-0.17; p = 0.017), while parents of children with type 1 diabetes had disrupted sleep quality (β = 0.25; p = 0.003). Optimism was negatively associated with the evening cortisol concentration (β=-0.18; p = 0.023) and sleep quality index (β=-0.20; p = 0.012). CONCLUSIONS Public health programs aimed at lifestyle habit improvement, respite care, and relaxation for parents of children with chronic conditions would be useful for improving parental sleep quality, self-esteem, optimism and happiness.
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Affiliation(s)
- Marija Ljubičić
- Department of Health Studies, University of Zadar, Splitska 1, Zadar, 23000, Croatia.
| | - Sonja Šare
- Department of Health Studies, University of Zadar, Splitska 1, Zadar, 23000, Croatia
- Medical School Ante Kuzmanića Zadar, Franje Tuđmana 24G, Zadar, 23000, Croatia
| | - Ivana Kolčić
- Department of Public Health, School of Medicine, University of Split, Šoltanska 2, Split, 21000, Croatia
- Algebra LAB, Algebra University College, Gradišćanska ul. 24, Zagreb, 10000, Croatia
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Rai A, Aldabbas M, Veqar Z. Effect of physical activity on sleep problems in sedentary adults: a scoping systematic review. Sleep Biol Rhythms 2024; 22:13-31. [PMID: 38476845 PMCID: PMC10899995 DOI: 10.1007/s41105-023-00494-w] [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: 11/03/2022] [Accepted: 10/06/2023] [Indexed: 03/14/2024]
Abstract
This systematic review was steered forward with the aim of analyzing how different forms of exercise could influence the objective and subjective sleep outcome among sedentary adults with sleep problems. A pre-detailed study protocol (PROSPERO ID: CRD42021229649) was used to search for RCTs through five databases. The methodological quality of the included RCTs was assessed by PEDro and studies were included if they scored > 5. Effect size of all outcome measures were calculated using Cohen's d. Of the 4154 studies, 19 studies met the inclusion criteria and underwent quality assessment using 11-point PEDRO scale. 9 studies with PEDro score > 5 were finally included in this systematic review out of which, participants of 4 studies had insomnia (nrange = 37-48, agerange = 44-60 years), 3 studies had poor sleep quality (nrange = 80-275, agerange = 52-70 years) and 2 studies had obstructive sleep apnea syndrome (nrange = 26-68, agerange = 51 years). Majority of studies revealed that physical activity seems to have greater improvement with a large effect size on subjective sleep outcomes among sedentary adults with sleep problems like insomnia, poor sleep quality and OSAS, whereas limited studies and non-significant results were observed on objective sleep outcomes. Physical activity improves sleep outcomes especially among sedentary middle-aged and older adults. More research is needed to examine the effect of physical activity programs on objective sleep outcomes especially in younger sedentary adults with different sleep problems. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-023-00494-w.
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Affiliation(s)
- Anushree Rai
- SGT University, Gurugram, Haryana 110025 India
- Al-Azhar University, Faculty of Applied Medical Sciences, Department of Physical Therapy, Gaza, Palestine
| | - Mosab Aldabbas
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (Central University), New Delhi, 110025 India
| | - Zubia Veqar
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (Central University), New Delhi, 110025 India
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Park HJ, Turetsky KM, Dahl JL, Pasek MH, Germano AL, Harper JO, Purdie-Greenaway V, Cohen GL, Cook JE. Investigating Cortisol in a STEM Classroom: The Association Between Cortisol and Academic Performance. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023:1461672231188277. [PMID: 37530549 DOI: 10.1177/01461672231188277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Science, technology, engineering, and mathematics (STEM) education can be stressful, but uncertainty exists about (a) whether stressful academic settings elevate cortisol, particularly among students from underrepresented racial/ethnic groups, and (b) whether cortisol responses are associated with academic performance. In four classes around the first exam in a gateway college STEM course, we investigated participants' (N = 271) cortisol levels as a function of race/ethnicity and tested whether cortisol responses predicted students' performance. Regardless of race/ethnicity, students' cortisol, on average, declined from the beginning to the end of each class and across the four classes. Among underrepresented minority (URM) students, higher cortisol responses predicted better performance and a lower likelihood of dropping the course. Among non-URM students, there were no such associations. For URM students, lower cortisol responses may have indicated disengagement, whereas higher cortisol responses may have indicated striving. The implication of cortisol responses can depend on how members of a group experience an environment.
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Mazgelytė E, Valatkevičiūtė A, Songailienė J, Utkus A, Burokienė N, Karčiauskaitė D. Association of hair glucocorticoid levels with sleep quality indicators: a pilot study in apparently healthy perimenopausal and menopausal women. Front Endocrinol (Lausanne) 2023; 14:1186014. [PMID: 37529598 PMCID: PMC10390219 DOI: 10.3389/fendo.2023.1186014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/25/2023] [Indexed: 08/03/2023] Open
Abstract
Background Poor sleep quality is associated with different physical and mental health diseases. It is proposed that increased hypothalamic-pituitary-adrenal axis activity is a potential contributor affecting sleep pattern and quality. We aimed to analyze the relationship between subjective sleep quality indicators and hair glucocorticoid levels among relatively healthy perimenopausal and postmenopausal women. Methods A total of 145 women aged 50-64 y.o. were enrolled in the cross-sectional pilot study. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index, while stress level was measured using the Perceived Stress Scale. Hair cortisol and cortisone levels were determined by ultra-high-performance liquid chromatography-tandem mass spectrometry. Results Statistically significant positive relationship was found between hair cortisol concentration and Pittsburgh sleep quality index score. Similarly, statistically significant positive associations were observed between hair total glucocorticoid level and Pittsburgh sleep quality index, sleep disturbance, and Perceived Stress Scale scores. Subjects with prolonged sleep latency had significantly higher hair cortisol and total hair glucocorticoid concentrations compared with individuals whose sleep latency is not disturbed. Additionally, Chi-squared test indicated that lower hair cortisol concentration was significantly related to better sleep efficiency. Conclusion Increased hair glucocorticoid (cortisol, cortisone) levels were found to be related with worse sleep quality measured by Pittsburgh sleep quality index score.
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Affiliation(s)
- Eglė Mazgelytė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Agnė Valatkevičiūtė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jurgita Songailienė
- Department of Human and Medical Genetics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Algirdas Utkus
- Department of Human and Medical Genetics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Neringa Burokienė
- Clinics of Internal Diseases and Family Medicine, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Dovilė Karčiauskaitė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Siebra CA, Amorim LS, Quintino JP, Santos ALM, Da Silva FQB. Toward a Holistic Computational Representation for Sleep Quality and its Support for Explainability. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083070 DOI: 10.1109/embc40787.2023.10340630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Sleep quality is recognized as one of the main factors that affect human health. Thus, several studies have been encouraged to analyze features, such as stress level and female menopause, which are directly related to sleep quality. While these works rely mostly on reductionism as the philosophical framework, we approach this problem from a holist perspective, using a model with 10 features that could provide more reliable explanations for inductive conclusions. We demonstrate the principles of this hypothesis by analyzing the data regarding the day before a sleep episode of 1736 volunteers. This analysis shows, for example, the performance of each feature when they are jointly used along prediction tasks. Moreover, we evaluate the readability and accuracy of explanations, given as description logic sentences and based on a knowledge representation that considers the 10 features as elements that compose a sleep quality ontological definition.
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9
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Wright CJ, Milosavljevic S, Pocivavsek A. The stress of losing sleep: Sex-specific neurobiological outcomes. Neurobiol Stress 2023; 24:100543. [PMID: 37252645 PMCID: PMC10209346 DOI: 10.1016/j.ynstr.2023.100543] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/20/2023] [Accepted: 05/06/2023] [Indexed: 05/31/2023] Open
Abstract
Sleep is a vital and evolutionarily conserved process, critical to daily functioning and homeostatic balance. Losing sleep is inherently stressful and leads to numerous detrimental physiological outcomes. Despite sleep disturbances affecting everyone, women and female rodents are often excluded or underrepresented in clinical and pre-clinical studies. Advancing our understanding of the role of biological sex in the responses to sleep loss stands to greatly improve our ability to understand and treat health consequences of insufficient sleep. As such, this review discusses sex differences in response to sleep deprivation, with a focus on the sympathetic nervous system stress response and activation of the hypothalamic-pituitary-adrenal (HPA) axis. We review sex differences in several stress-related consequences of sleep loss, including inflammation, learning and memory deficits, and mood related changes. Focusing on women's health, we discuss the effects of sleep deprivation during the peripartum period. In closing, we present neurobiological mechanisms, including the contribution of sex hormones, orexins, circadian timing systems, and astrocytic neuromodulation, that may underlie potential sex differences in sleep deprivation responses.
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Affiliation(s)
| | | | - Ana Pocivavsek
- Corresponding author. Pharmacology, Physiology, and Neuroscience, USC School of Medicine, Columbia, SC, 29208, USA.
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10
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Separating the influences of means and daily variations of sleep on the stress-induced salivary cortisol response. Psychoneuroendocrinology 2023; 151:106059. [PMID: 36812860 DOI: 10.1016/j.psyneuen.2023.106059] [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: 09/22/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Previous research regarding the effects of sleep quality and quantity on the acute stress response has yielded inconsistent findings. This may be attributed to various factors, including composite sleep components (i.e., means and daily variations) and mixed cortisol stress response (i.e., reactivity and recovery). Thus, this study aimed to separate the effects of means and daily variations of sleep on the reactivity and recovery of cortisol responses to psychological challenges. METHODS In study 1, we recruited 41 healthy participants (24 women; age range, 18-23 years), monitored their sleep during seven consecutive days via wrist actigraphy and sleep diaries, and adopted the Trier Social Stress Test (TSST) paradigm to induce acute stress. Study 2 consisted of a validation experiment using the ScanSTRESS paradigm, which included 77 additional healthy individuals (35 women; age range, 18-26 years). Similarly to the TSST, the ScanSTRESS induces acute stress using uncontrollability and social evaluation. In both studies, saliva samples from the participants were collected before, during, and after the acute stress task. RESULTS Using residual dynamic structural equation modeling, both study 1 and study 2 demonstrated that higher means of objective sleep efficiency, and longer means of objective sleep duration were related to greater cortisol recovery. In addition, fewer daily variations in objective sleep duration were associated with greater cortisol recovery. However, there was no correlation between sleep variables and cortisol reactivity, except for the daily variations in objective sleep duration in study 2. No correlation was observed between subjective sleep and cortisol response to stress. CONCLUSIONS The present study separated two features of multi-day sleep patterns and two components of cortisol stress response, providing a more comprehensive picture of the effect of sleep on the stress-induced salivary cortisol response, and contributing to the future development of targeted interventions for stress-related disorders.
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11
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Brown C, Beardslee J, Frick PJ, Steinberg LD, Cauffman E. Perceived sleep quality predicts aggressive offending in adolescence and young adulthood. J Child Psychol Psychiatry 2023; 64:320-328. [PMID: 35665505 DOI: 10.1111/jcpp.13646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND There are profound consequences when developing youth do not get adequate sleep. Adolescents who experience poor sleep may be more likely to engage in offending behavior. While there is a documented association between the number of hours youth sleep and their likelihood of offending, it is unclear how youths' perceptions of their sleep quality contribute to offending. Further, scholars have yet to rigorously examine the relation between sleep problems and offending in young adulthood, a developmental stage, which is both critical for desistance and in which sleep may play an important role. METHODS Using a sample of 1,216 justice-involved male youth, this study uses within-individual longitudinal methods (fixed-effects Poisson regression models) to examine the relation between changes in perceptions of sleep quality and changes in offending behavior from ages 13 to 24. RESULTS Increases in sleep problems are associated with increases in offending, particularly aggressive/person-related offenses, for both adolescents and young adults. This holds true even after controlling for time-varying anxiety, substance use, and violence exposure. CONCLUSIONS Improving sleep quality may be critical for reducing aggressive behavior in at-risk adolescents and young adults. Interventions that address sleep quality, and not just quantity, may be particularly beneficial.
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Affiliation(s)
- Colleen Brown
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jordan Beardslee
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Paul J Frick
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | | | - Elizabeth Cauffman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
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12
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Sriboonlert J, Munkong W, Rintawut S, Paladkhua S, Suwongsa R, Kirisattayakul W. Cananga odorata Aromatherapy Reduces Anxiety in Unexperienced Patients Hospitalized for Interventional Neuroradiology Procedures: A Randomized Control Trial. J Evid Based Integr Med 2023; 28:2515690X221150527. [PMID: 36659818 PMCID: PMC9871980 DOI: 10.1177/2515690x221150527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The hospitalization and the unfamiliar experiences of patients in interventional radiology procedures cause a moderate to high levels of anxiety. This study was aimed to evaluate the anxiolytic effect of Cananga odorata essential oil (COE) aromatherapy in unexperienced patients hospitalized for interventional neuroradiology (INR) procedures. Forty-four patients admitted for their first INR procedure were randomly divided into COE and placebo control groups. COE or distilled water was dropped onto 2 pieces of mulberry paper and attached to the participant's gown at the shoulder level overnight. The main outcomes were observed from the morning salivary cortisol levels and salivary alpha-amylase activity after intervention. The Thai version of Spielberger State-Trait Anxiety Inventory (STAI) and the vital signs (blood pressure and heart rate) were also assessed before and after COE intervention as the secondary outcome. The demographic and baseline data of both groups did not show any significant difference. After intervention, COE group had a significantly lower salivary alpha-amylase activity than placebo control group. The post-intervention scores of Trait (STAI-T) and State (STAI-S) anxiety were significantly less than those of baseline in both groups. Interestingly, the COE group had a greater percentage reduction on STAI-T after intervention than placebo control group. No significant difference was observed in other outcomes. In addition, the salivary alpha-amylase activity was weak but showed significant correlation with STAI anxiety scores. This study indicates that COE aromatherapy reduces the saliva alpha amylase activity and STAI-T anxiety in unexperienced patients hospitalized for INR procedures.
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Affiliation(s)
- Jetsada Sriboonlert
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Waranon Munkong
- Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Sunantha Rintawut
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Soodjai Paladkhua
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Ratchalita Suwongsa
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Woranan Kirisattayakul
- Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand,Woranan Kirisattayakul, Department of
Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002,
Thailand.
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13
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Avelino DC, da Silva A, Chaves LO, Carraro JCC, de Carvalho Vidigal F, Bressan J. Triglyceride-glucose index is associated with poor sleep quality in apparently healthy subjects: A cross-sectional study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:73-91. [PMID: 36155123 PMCID: PMC9983794 DOI: 10.20945/2359-3997000000517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective We aimed to evaluate the association between the triglyceride glucose index (TyG index) and sleep quality and to establish a cut-off value for the TyG index based on the prevalence of subjects with insulin resistance (IR). Methods This cross-sectional study involved Brazilian health professionals (20-59 years). A total of 138 subjects answered the Pittsburgh Sleep Quality questionnaire to evaluate sleep quality. They were categorized into two groups: good sleep quality (global score ≤ 5 points) and poor sleep quality (global score ≥ 6 points). Also, we classified the subjects as having a high (>8.08 or >4.38) or low TyG index (≤ 8.08 or ≤4.38). Results The majority of the subjects (70%) with high TyG index values (>8.08 or >4.38) reported poor sleep quality (p ≤ 0.001). Those with poor sleep quality had a 1.44-fold higher prevalence of IR (TyG index >8.08 or >4.38) compared to those with good sleep quality, regardless of sex, total cholesterol, LDL/HDL ratio, insulin, complement C3, CRP, and adiponectin (p ≤ 0.001). Conclusion Our data showed a positive and significant association between the TyG index and poor sleep quality. Thus, these findings support the association between poor sleep quality and IR.
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Affiliation(s)
| | - Alessandra da Silva
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, MG, Brasil
| | | | | | | | - Josefina Bressan
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, MG, Brasil
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Vaseghi S, Mostafavijabbari A, Alizadeh MS, Ghaffarzadegan R, Kholghi G, Zarrindast MR. Intricate role of sleep deprivation in modulating depression: focusing on BDNF, VEGF, serotonin, cortisol, and TNF-α. Metab Brain Dis 2023; 38:195-219. [PMID: 36399239 DOI: 10.1007/s11011-022-01124-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/06/2022] [Indexed: 11/19/2022]
Abstract
In this review article, we aimed to discuss intricate roles of SD in modulating depression in preclinical and clinical studies. Decades of research have shown the inconsistent effects of SD on depression, focusing on SD duration. However, inconsistent role of SD seems to be more complicated, and SD duration cannot be the only one factor. Regarding this issue, we chose some important factors involved in the effects of SD on cognitive functions and mood including brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), serotonin, cortisol, and tumor necrosis factor-alpha (TNF-α). It was concluded that SD has a wide-range of inconsistent effects on BDNF, VEGF, serotonin, and cortisol levels. It was noted that BDNF diurnal rhythm is significantly involved in the modulatory role of SD in depression. Furthermore, the important role of VEGF in blood-brain barrier permeability which is involved in modulating depression was discussed. It was also noted that there is a negative correlation between cortisol and BDNF that modulates depression. Eventually, it was concluded that TNF-α regulates sleep/wake cycle and is involved in the vulnerability to cognitive and behavioral impairments following SD. TNF-α also increases the permeability of the blood-brain barrier which is accompanied by depressive behavior. In sum, it was suggested that future studies should focus on these mechanisms/factors to better investigate the reasons behind intricate roles of SD in modulating depression.
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Affiliation(s)
- Salar Vaseghi
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran.
| | | | - Mohammad-Sadegh Alizadeh
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
- Department of Cellular and Molecular Sciences, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Reza Ghaffarzadegan
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran
| | - Gita Kholghi
- Department of Psychology, Faculty of Human Sciences, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Wofford N, Ceballos N, Elkins G, Westerberg CE. A brief nap during an acute stressor improves negative affect. J Sleep Res 2022; 31:e13701. [PMID: 35851731 PMCID: PMC9786543 DOI: 10.1111/jsr.13701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 12/30/2022]
Abstract
Overnight sleep can reduce perceived stress, and improve associated cognitive disruptions and negative affect after an acute stressor. Whether a brief nap can also bestow these benefits in a non-sleep-restricted population is currently unknown. In this study that used a between-subjects design, stress was triggered by administering a modified Trier Social Stress Test to two groups of participants (nap [n = 29], wake [n = 41]). All participants were instructed they would give a speech during the study but the topic would be withheld until later, and then completed a math task. After a 40-min break in which participants watched a neutral video or took a nap monitored with electroencephalography, stress was reinforced by presenting the speech topics and giving participants a 10-min preparation period. Next, instead of giving a speech, the study ended and participants were debriefed. Negative affect, perceived stress and working memory were measured at multiple time points before and after the break. Both groups showed lower perceived stress and improved working memory after the break than before, but a nap did not confer additional benefits for perceived stress or working memory beyond taking a break. However, the nap group exhibited lower negative affect after the break than the wake group, and only the nap group showed a reduction in negative affect compared with initial negative affect levels. These results indicate a nap can improve negative emotions accompanying a stressor to a greater extent than taking a break, and suggest that brief naps may be a useful way to improve mood while experiencing an acute stressor.
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Affiliation(s)
- Nathan Wofford
- Department of PsychologyTexas State UniversitySan MarcosTexasUSA,Department of Psychology and NeuroscienceBaylor UniversityWacoTexasUSA
| | - Natalie Ceballos
- Department of PsychologyTexas State UniversitySan MarcosTexasUSA
| | - Gary Elkins
- Department of Psychology and NeuroscienceBaylor UniversityWacoTexasUSA
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Sweeny K, Medina J. Links between well-being and sleep while awaiting breast biopsy results. Stress Health 2022; 39:299-308. [PMID: 35943042 DOI: 10.1002/smi.3187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/18/2022] [Accepted: 07/27/2022] [Indexed: 11/06/2022]
Abstract
Poor sleep is associated with several negative consequences, including poor health, depression, anxiety, and memory deficits, among others. Although the link from sleep to health and well-being is well-established, fewer studies have examined the reverse relationship. The current study examined the role of one particular challenge to well-being, stressful uncertainty, in the association between well-being and sleep quantity and quality. Female patients (n = 120 for the purpose of analyses) awaiting the results of a breast biopsy participated in an initial interview at their biopsy appointment and then completed daily surveys at home each day until they received their results. Patients who reported poorer well-being on various measures also reported poorer and less sleep on average during the wait for biopsy results, even after controlling for individual differences and well-being at the biopsy appointment. However, when patients experienced positive emotions on a given day, they tended to sleep better that night. Our findings suggest that stressful uncertainty about one's health may have detrimental effects on sleep, but positive emotions may improve sleep during stressful waiting periods.
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Affiliation(s)
- Kate Sweeny
- Department of Psychology, University of California, Riverside, California, USA
| | - Janine Medina
- Department of Psychology, University of California, Riverside, California, USA
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Kater MJ, Werner A, Schlarb AA, Lohaus A. Stress reactivity in salivary cortisol and electrocardiogram in adolescents: Investigating sleep disturbances and insomnia. J Sleep Res 2022; 31:e13591. [PMID: 35843709 DOI: 10.1111/jsr.13591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 01/03/2023]
Abstract
This study examined the role of sleep disturbances and insomnia in the context of stress reactivity in adolescence. One-hundred and thirty-five 11-18 year olds (Mage = 14.2 years, SD = 1.9, 52% female) completed the Trier Social Stress Test for Children. Salivary cortisol and subjective stress ratings were collected at six time points, and heart rate as well as heart rate variability were measured pre-, during and post-stress induction. Additionally, sleep disturbances and insomnia diagnosis were assessed by a self-report questionnaire and a sleep interview. Robust mixed models investigated if adolescents with compared with adolescents without (a) sleep disturbances and (b) insomnia differ regarding cortisol, heart rate, heart rate variability and psychological stress reactivity considering gender effects. The results indicated that boys with high sleep disturbances showed higher cortisol activity compared with boys with low sleep disturbances, B = 0.88, p < 0.05. Moreover, in boys with insomnia, heart rate and alpha 1 significantly differ less than in boys without insomnia. These findings support the notion of sex differences regarding the association between poor sleep and increased activity of the hypothalamic-pituitary-adrenal axis, and a less adaptable autonomic nervous system in boys in response to an experimental social stress task.
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Affiliation(s)
- Maren-Jo Kater
- Faculty of Psychology and Sports Science, Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, Germany
| | - Anika Werner
- Faculty of Psychology and Sports Science, Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, Germany
| | - Angelika A Schlarb
- Faculty of Psychology and Sports Science, Clinical Psychology and Psychotherapy of Children and Adolescents, Bielefeld University, Bielefeld, Germany
| | - Arnold Lohaus
- Faculty of Psychology and Sports Science, Developmental Psychology and Developmental Psychopathology, Bielefeld University, Bielefeld, Germany
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Pundir M, Papagerakis S, De Rosa MC, Chronis N, Kurabayashi K, Abdulmawjood S, Prince MEP, Lobanova L, Chen X, Papagerakis P. Emerging biotechnologies for evaluating disruption of stress, sleep, and circadian rhythm mechanism using aptamer-based detection of salivary biomarkers. Biotechnol Adv 2022; 59:107961. [DOI: 10.1016/j.biotechadv.2022.107961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/30/2022] [Accepted: 04/09/2022] [Indexed: 12/26/2022]
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Blok E, Koopman-Verhoeff ME, Dickstein DP, Saletin J, Luik AI, Rijlaarsdam J, Hillegers M, Kocevska D, White T, Tiemeier H. Sleep and mental health in childhood: a multi-method study in the general pediatric population. Child Adolesc Psychiatry Ment Health 2022; 16:11. [PMID: 35177100 PMCID: PMC8851725 DOI: 10.1186/s13034-022-00447-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/31/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Sleep problems, altered sleep patterns and mental health difficulties often co-occur in the pediatric population. Different assessment methods for sleep exist, however, many studies only use one measure of sleep or focus on one specific mental health problem. In this population-based study, we assessed different aspects of sleep and mother-reported mental health to provide a broad overview of the associations between reported and actigraphic sleep characteristics and mental health. METHODS This cross-sectional study included 788 children 10-11-year-old children (52.5% girls) and 344 13-14-year-old children (55.2% girls). Mothers and children reported on the sleep of the child and wrist actigraphy was used to assess the child's sleep patterns and 24 h activity rhythm. Mental health was assessed via mother-report and covered internalizing, externalizing and a combined phenotype of internalizing and externalizing symptoms, the dysregulation profile. RESULTS Higher reported sleep problems were related to more symptoms of mental health problems in 10-11- and 13-14-year-old adolescents, with standardized ß-estimates ranging between 0.11 and 0.35. There was no association between actigraphy-estimated sleep and most mental health problems, but earlier sleep onset was associated with more internalizing problems (ß = - 0.09, SE = 0.03, p-value = 0.002), and higher intra-daily variability of the 24 h activity rhythm was associated with more dysregulation profile symptoms at age 10-11 (ß = 0.11, SE = 0.04, p-value = 0.002). DISCUSSION Reported sleep problems across informants were related to all domains of mental health problems, providing evidence that sleep can be an important topic to discuss for clinicians seeing children with mental health problems. Actigraphy-estimated sleep characteristics were not associated with most mental health problems. The discrepancy between reported and actigraphic sleep measures strengthens the idea that these two measures tap into distinct constructs of sleep.
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Affiliation(s)
- Elisabet Blok
- grid.416135.40000 0004 0649 0805Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children’s Hospital, University Medical Center, Rotterdam, The Netherlands ,grid.5645.2000000040459992XThe Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - M. Elisabeth Koopman-Verhoeff
- grid.416135.40000 0004 0649 0805Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children’s Hospital, University Medical Center, Rotterdam, The Netherlands ,grid.5645.2000000040459992XThe Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands ,grid.5132.50000 0001 2312 1970Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands ,grid.281318.10000 0004 0443 4869Emma Pendleton Bradley Hospital, East Providence, RI USA
| | - Daniel P. Dickstein
- grid.38142.3c000000041936754XPediMIND Program, McLean Hospital, Harvard Medical School, Boston, MA USA ,grid.38142.3c000000041936754XSimches Center of Excellence in Child and Adolescent Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA USA
| | - Jared Saletin
- grid.281318.10000 0004 0443 4869Emma Pendleton Bradley Hospital, East Providence, RI USA ,grid.40263.330000 0004 1936 9094Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI USA
| | - Annemarie I. Luik
- grid.416135.40000 0004 0649 0805Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children’s Hospital, University Medical Center, Rotterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jolien Rijlaarsdam
- grid.416135.40000 0004 0649 0805Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children’s Hospital, University Medical Center, Rotterdam, The Netherlands
| | - Manon Hillegers
- grid.416135.40000 0004 0649 0805Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children’s Hospital, University Medical Center, Rotterdam, The Netherlands
| | - Desana Kocevska
- grid.416135.40000 0004 0649 0805Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children’s Hospital, University Medical Center, Rotterdam, The Netherlands ,grid.5645.2000000040459992XThe Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands ,grid.419918.c0000 0001 2171 8263Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Society for Arts and Sciences, Amsterdam, The Netherlands
| | - Tonya White
- grid.416135.40000 0004 0649 0805Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children’s Hospital, University Medical Center, Rotterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- grid.416135.40000 0004 0649 0805Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children’s Hospital, University Medical Center, Rotterdam, The Netherlands ,grid.38142.3c000000041936754XDepartment of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA USA
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Inadequate sleep moderates effects of interparental conflict appraisals on adolescent adjustment. Sleep Health 2022; 8:82-88. [PMID: 34972677 PMCID: PMC8821316 DOI: 10.1016/j.sleh.2021.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/15/2021] [Accepted: 10/24/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Previous research and theory suggest that interparental conflict that is perceived by youth as frequent/intense, threatening, and/or the responsibility of the youth is predictive of adjustment problems. In contrast, sleep, an important precursor to emotion regulation, is likely a protective factor for youth experiencing interparental conflict. The goal of the current study was to investigate the extent to which adolescents who maintain better and/or longer sleep are buffered from the adjustment problems associated with greater interparental conflict. METHODS One-hundred and fifty adolescents completed questionnaires assessing interparental conflict (frequency/intensity perceptions as well as threat and self-blame appraisals) as well as internalizing and externalizing behaviors. Participants also wore an actigraph over 1 week to objectively measure sleep quantity and quality; 123 participants had valid actigraphy data. RESULTS Results of structural equation modeling analyses revealed that greater sleep quality weakened the association between interparental conflict and adjustment problems, particularly internalizing behaviors. However, sleep quantity was not a moderator. CONCLUSION These results suggest that higher quality sleep may protect adolescents from the negative effects of interparental conflict.
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Wang Q, Liu Y, Wang B, An Y, Wang H, Zhang Y, Mati K. Problematic internet use and subjective sleep quality among college students in China: Results from a pilot study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:552-560. [PMID: 32407209 DOI: 10.1080/07448481.2020.1756831] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/10/2020] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
Objective poor subjective sleep quality (SSQ) and problematic Internet use (PIU) were common among college students in China, but their prevalence and interconnections were understudied. Participants: 1040 college students (60.0% females), ranging in age from 16 to 26 (mean = 20.32; SD = 1.43). Methods: Participants completed a survey assessing their SSQ, PIU, and other covariates. Multivariate logistic regression analyses were conducted to test association between SSQ and PIU. Results: Around 46.8% of the sample reported poor SSQ, 17.3% was diagnosed with Internet addiction, and 64.3% were Internet overusers. Poor sleepers had 2.03 times greater odds (95%CI: 1.41-2.91) of being Internet overusers, and 3.25 greater odds (95%CI: 2.05-5.17) of being Internet addicts. Conclusions: Poor SSQ was strongly associated with elevated odds of PIU over and above the contributions of poor psychological functioning, substance use, and physical activity. Programs aimed at enhancing SSQ among college students should take reducing PIU into perspective.
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Affiliation(s)
- Qian Wang
- College of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yujie Liu
- College of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Baohong Wang
- College of Clinical Medicine, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yang An
- College of Clinical Medicine, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Haolin Wang
- College of Clinical Medicine, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yaya Zhang
- College of Clinical Medicine, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Komi Mati
- ECONOMETRICA, Inc, Bethesda, MD, USA
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Baek J, Ki J, Ryu J, Smi CK. Relationship between occupational stress, sleep disturbance, and presenteeism of shiftwork nurses. J Nurs Scholarsh 2022; 54:631-638. [PMID: 35084088 DOI: 10.1111/jnu.12766] [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: 03/16/2021] [Revised: 12/15/2021] [Accepted: 01/05/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to determine the relationships between occupational stress, sleep disturbance, and presenteeism in shiftwork nurses in South Korea. DESIGN This cross-sectional study used survey data from 442 shiftwork nurses at two hospitals in South Korea. Data were collected between March 2018 and April 2020. METHODS A self-reported questionnaire was used to assess shiftwork nurses' demographic and job-related information, presenteeism, occupational stress, and sleep disturbance. Data were analyzed using descriptive statistics, multiple regression, and the PROCESS macro. FINDINGS The mean presenteeism score was 39.52. Multiple regression analysis revealed that job insecurity, interpersonal conflict, occupational climate, lack of reward, and job demand are significantly associated with presenteeism. Sleep disturbance was related to presenteeism and had a moderating effect on the relationship between occupational stress and presenteeism. CONCLUSIONS This study indicates that proper occupational climate, positive interpersonal relationships, and adequate sleep can reduce shiftwork presenteeism. Therefore, individual and organizational efforts to alleviate occupational stress and sleep disturbances are essential. CLINICAL RELEVANCE Organizational support is needed to maintain a positive occupational climate and interpersonal relationships and ameliorate sleep disturbance among shiftwork nurses.
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Affiliation(s)
- Jihyun Baek
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Republic of Korea
| | - Jison Ki
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Jaegeum Ryu
- Department Nursing Science, Chodang University, Muan, Republic of Korea
| | - Choi-Kwon Smi
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
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Abstract
Abstract
Quality of sleep directly impacts quality of life, whilst lifestyle significantly impacts night rest. Cigarette smoking is a serious threat to overall health, including sleep. Nicotine in cigarettes affects the nervous system, whilst the respiratory system is impacted by carcinogenic substances, such as dusts and tarred substances, inhaled with smoke. Cigarettes are assumed to be a risk factor in sleep disorders, including breathing sleep disorders.
This study’s aim was to analyze the impact of cigarette smoking on adult men’s polysomnographic parameters.
Polysomnographic records for 94 adult men were obtained from the polysomnography laboratory in Opolskie Province, Poland. Additionally co-morbidities, height, weight and frequency of smoking were also noted. Three groups of men were categorised according to the frequency with which they smoked: non-smokers, smoking less than a pack a day, smoking more than a pack a day.
Compared to non-smokers and mild smokers, men who were heavy smokers also exhibited the longest sleepless time (H=8.11; p=0.017), the maximum waking time following the onset of sleep (H=7.99; p= 0.018), the lowest sleep efficiency across the three groups (H=7.96; p=0.019), the greatest number of apnea events per hour of sleep (H=6.23; p= 0.045), the lowest Oxygen Level Nadir (H=11.44; p= 0.003) and the highest rate of limb movements per hour of sleep (H=9.81; p=0.007).
The dose effect was identified, which correlated more cigarettes men smoked per day with lower sleep quality.
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Acute Stress in Health Workers during Two Consecutive Epidemic Waves of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010206. [PMID: 35010465 PMCID: PMC8751091 DOI: 10.3390/ijerph19010206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic has provoked generalized uncertainty around the world, with health workers experiencing anxiety, depression, burnout, insomnia, and stress. Although the effects of the pandemic on mental health may change as it evolves, the majority of reports have been web-based, cross-sectional studies. We performed a study assessing acute stress in frontline health workers during two consecutive epidemic waves. After screening for trait anxiety/depression and dissociative experiences, we evaluated changes in acute stress, considering resilience, state anxiety, burnout, depersonalization/derealization symptoms, and quality of sleep as cofactors. During the first epidemic wave (April 2020), health workers reported acute stress related to COVID-19, which was related to state anxiety. After the first epidemic wave, acute stress decreased, with no increase during the second epidemic wave (December 2020), and further decreased when vaccination started. During the follow-up (April 2020 to February 2021), the acute stress score was related to bad quality of sleep. However, acute stress, state anxiety, and burnout were all related to trait anxiety/depression, while the resilience score was invariant through time. Overall, the results emphasize the relevance of mental health screening before, during, and after an epidemic wave of infections, in order to enable coping during successive sanitary crises.
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25
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Smith CE, Lee S. Identifying diverse forms of (un)healthy sleep: Sleep profiles differentiate adults' psychological and physical well-being. Soc Sci Med 2021; 292:114603. [PMID: 34875579 DOI: 10.1016/j.socscimed.2021.114603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/20/2021] [Accepted: 11/22/2021] [Indexed: 01/07/2023]
Abstract
RATIONALE Sleep health is best described by the co-occurrence of various dimensions (e.g., regularity, daytime alertness, satisfaction, efficiency, duration) but is rarely measured this way. Information is needed regarding common within-person patterns of sleep characteristics among adults and their relative healthiness. OBJECTIVE To deepen understanding of healthy and unhealthy sleep, the present study aimed to uncover multidimensional sleep profiles in adults and their associations with a variety of psychological and physical well-being outcomes. METHODS Survey data from 4622 adults who participated in the Midlife in the United States (MIDUS) project was used to identify latent sleep profiles across five core sleep dimensions. Adjusting for individual sleep dimensions and sociodemographic covariates, General Linear Models were used to test the associations of sleep profile membership with hedonic and eudemonic well-being and chronic physical conditions. RESULTS Four latent sleep profiles were revealed, good sleepers, sufficient but irregular sleepers, nappers, and short, dissatisfied, and inefficient sleepers. The profiles differentially related to well-being outcomes above and beyond individual sleep dimensions and sociodemographic covariates. Good sleepers generally reported the best outcomes, and short, dissatisfied, and inefficient sleepers generally reported the worst outcomes. CONCLUSION Four common sleep profiles describe adults' holistic sleep experiences and predict a variety of well-being outcomes beyond other known predictors. In adulthood, healthy sleep may involve sufficient sleep across all dimensions whereas unhealthy sleep may involve insufficient sleep across three key dimensions: duration, satisfaction, and efficiency.
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Affiliation(s)
- Claire E Smith
- School of Aging Studies, University of South Florida, 4202 East Fowler Avenue, Tampa, FL, 33620, USA; Department of Psychology, Bowling Green State University, 822 East Merry Avenue, Bowling Green, OH, 43403, USA.
| | - Soomi Lee
- School of Aging Studies, University of South Florida, 4202 East Fowler Avenue, Tampa, FL, 33620, USA
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Gusman MS, Grimm KJ, Cohen AB, Doane LD. Stress and Sleep Across the Onset of the COVID-19 Pandemic: Impact of Distance Learning on U.S. College Students' Health Trajectories. Sleep 2021; 44:6332862. [PMID: 34331445 PMCID: PMC8385849 DOI: 10.1093/sleep/zsab193] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/07/2021] [Indexed: 11/12/2022] Open
Abstract
Study Objectives This study examined associations between average and intraindividual trajectories of stress, sleep duration, and sleep quality in college students before, during, and after transitioning to online learning due to the COVID-19 pandemic. Methods One hundred and sixty-four first-year college students answered twice-weekly questionnaires assessing stress exposure and perception, sleep duration, and sleep quality from January until May, 2020 (N=4,269 unique observations). Results Multilevel growth modeling revealed that prior to distance learning, student stress was increasing and sleep duration and quality were decreasing. After transitioning online, students’ stress exposure and perception trajectories immediately and continuously decreased; sleep quality initially increased but decreased over time; and sleep duration increased but then plateaued for the remainder of the semester. Days with higher stress exposure than typical for that student were associated with lower sleep quality, and both higher stress exposure and perception at the transition were linked with simultaneous lower sleep quality. Specific groups (e.g., females) were identified as at-risk for stress and sleep problems. Conclusion Although transitioning to remote learning initially alleviated college students’ stress and improved sleep, these effects plateaued, and greater exposure to academic, financial, and interpersonal stressors predicted worse sleep quality on both daily and average levels. Environmental stressors may particularly dictate sleep quality during times of transition, but adaptations in learning modalities may help mitigate short-term detrimental health outcomes during global emergencies, even during a developmental period with considerable stress vulnerability. Future studies should examine longer-term implications of these trajectories on mental and physical health.
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Affiliation(s)
| | - Kevin J Grimm
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Adam B Cohen
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, AZ, USA
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Tohidinik HR, Rodríguez A, Regueira-Méndez C, Takkouche B. Sleep quality and risk of recurrent aphthous ulcers: A Spanish cohort study. Oral Dis 2021; 28:1882-1890. [PMID: 34242451 DOI: 10.1111/odi.13955] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Recurrent aphthous stomatitis (RAS) is a condition that affects 20% of the world population and is characterized by painful ulcers in the oral mucosa. So far, the epidemiology and risk factors of RAS have been infrequently studied. Our objective was to determine whether sleep-related factors are related to the occurrence of RAS in the first prospective study carried out on this topic. METHODS A cohort of 11210 Spanish students, 13-17 years old, was followed up for one year. Sleep disorders were assessed at baseline using a standard validated questionnaire. RESULTS We detected 2655 new cases of RAS with a total of 287,262 person-week of follow-up. Subjects with high (4th quartile) Insomnia Index showed an incidence rate ratio (IRR) of RAS of 1.29 (95% confidence interval (CI) 1.15-1.45), while subjects with high Hypersomnia Index presented an IRR of 1.42 (95% CI 1.26-1.61). A high score of sleep-related phenomena was also associated with an increased IRR: 1.53 (95% CI 1.37-1.69). Adolescents with high level of sleep satisfaction were at lower risk of RAS: 0.88 (95% CI 0.77-1.01). CONCLUSION These findings suggest that sleep disorders are moderately associated with RAS in adolescents.
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Affiliation(s)
- Hamid Reza Tohidinik
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Almudena Rodríguez
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Regueira-Méndez
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP, Madrid, Spain
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP, Madrid, Spain
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Effects of Electroacupuncture on Sleep via the Dopamine System of the HPA Axis in Rats after Cage Change. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5527060. [PMID: 34306138 PMCID: PMC8270700 DOI: 10.1155/2021/5527060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/13/2021] [Indexed: 11/17/2022]
Abstract
Background Insomnia is often related to stressful events. The hypothalamus-pituitary-adrenal (HPA) axis is related to stress, and dopamine (DA) and DA receptors are involved in the regulation of HPA axis. Electroacupuncture (EA) can improve sleep in individuals with insomnia, but the mechanism is unclear. We demonstrated that EA can improve sleep in rats after cage change through DA and the DA receptors in the HPA axis. Methods A rat model of insomnia was established by cage change to a dirty cage. The rats in treatment groups were intervened by EA and D1R (or D2R) antagonists. Electroencephalography (EEG) and electromyogram (EMG) were recorded to compare the changes in sleep. The DA, corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and cortisol (CORT) levels in the plasma and hypothalamus were measured by ELISAs, and the D1R and D2R levels were measured by RT-PCR and immunohistochemistry. Results The dirty group showed a significant increase in the amount of wakefulness and decrease in the amount of NREM sleep, with decreased numbers of long NREM sleep bouts and REM sleep bouts and increased mean duration of wakefulness during the light period. EA and D1R (or D2R) antagonists intervention could improve sleep disturbance by decreasing wakefulness in the light period after cage change, EA and D1R (or D2R) antagonists could increase the hypothalamus DA, CRH, ACTH, CORT level, and the D1R and D2R mRNA levels in the HPA axis, and the effect of EA plus D1R (or D2R) antagonist was not superior to that of EA or D1R (or D2R) antagonists alone. Conclusions EA can improve the sleep of rats after cage change, and the mechanism may be related to the regulation of DA and D1R or D2R in the HPA axis.
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Bowers SJ, Lambert S, He S, Lowry CA, Fleshner M, Wright KP, Turek FW, Vitaterna MH. Immunization with a heat-killed bacterium, Mycobacterium vaccae NCTC 11659, prevents the development of cortical hyperarousal and a PTSD-like sleep phenotype after sleep disruption and acute stress in mice. Sleep 2021; 44:6025170. [PMID: 33283862 DOI: 10.1093/sleep/zsaa271] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/20/2020] [Indexed: 12/27/2022] Open
Abstract
STUDY OBJECTIVES Sleep deprivation induces systemic inflammation that may contribute to stress vulnerability and other pathologies. We tested the hypothesis that immunization with heat-killed Mycobacterium vaccae NCTC 11659 (MV), an environmental bacterium with immunoregulatory and anti-inflammatory properties, prevents the negative impacts of 5 days of sleep disruption on stress-induced changes in sleep, behavior, and physiology in mice. METHODS In a 2 × 2 × 2 experimental design, male C57BL/6N mice were given injections of either MV or vehicle on days -17, -10, and -3. On days 1-5, mice were exposed to intermittent sleep disruption, whereby sleep was disrupted for 20 h per day. Immediately following sleep disruption, mice were exposed to 1-h social defeat stress or novel cage (control) conditions. Object location memory (OLM) testing was conducted 24 h after social defeat, and tissues were collected 6 days later to measure inflammatory markers. Sleep was recorded using electroencephalography (EEG) and electromyography (EMG) throughout the experiment. RESULTS In vehicle-treated mice, only the combination of sleep disruption followed by social defeat (double hit): (1) increased brief arousals and NREM beta (15-30 Hz) EEG power in sleep immediately post-social defeat compared to baseline; (2) induced an increase in the proportion of rapid-eye-movement (REM) sleep and number of state shifts for at least 5 days post-social defeat; and (3) induced hyperlocomotion and lack of habituation in the OLM task. Immunization with MV prevented most of these sleep and behavioral changes. CONCLUSIONS Immunization with MV ameliorates a stress-induced sleep and behavioral phenotype that shares features with human posttraumatic stress disorder.
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Affiliation(s)
- Samuel J Bowers
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL.,Department of Neurobiology, Northwestern University, Evanston, IL
| | - Sophie Lambert
- Department of Neurobiology, Northwestern University, Evanston, IL
| | - Shannon He
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL.,Department of Neurobiology, Northwestern University, Evanston, IL
| | - Christopher A Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO.,Center for Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Monika Fleshner
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO.,Center for Neuroscience, University of Colorado Boulder, Boulder, CO
| | - Kenneth P Wright
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO.,Center for Neuroscience, University of Colorado Boulder, Boulder, CO.,Sleep and Chronobiology Laboratory, University of Colorado Boulder, Boulder, CO
| | - Fred W Turek
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL.,Department of Neurobiology, Northwestern University, Evanston, IL.,The Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Martha H Vitaterna
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, IL.,Department of Neurobiology, Northwestern University, Evanston, IL
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Kuebler U, Fischer S, Mernone L, Breymann C, Abbruzzese E, Ehlert U. Is stress related to the presence and persistence of oncogenic human papillomavirus infection in young women? BMC Cancer 2021; 21:419. [PMID: 33863301 PMCID: PMC8052668 DOI: 10.1186/s12885-021-08010-4] [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: 01/13/2020] [Accepted: 03/04/2021] [Indexed: 11/28/2022] Open
Abstract
Background Persistent infection with high-risk human papillomavirus (HR-HPV) is the most important risk factor for the development of cervical cancer, but factors contributing to HR-HPV persistence are incompletely understood. The objective of this study was to test for associations of chronic stress and two aspects of diurnal cortisol secretion (i.e., the cortisol awakening response [CAR] and total cortisol output over the day [AUCgday]) with HR-HPV status at baseline and 12 months later (follow-up). Methods We evaluated 188 women (25 ± 3 years) at baseline. Follow-up investigation was restricted to HR-HPV infected women at baseline. Of the initial 48 HR-HPV positive participants, 42 completed the follow-up (16 HR-HPV positive and 26 HR-HPV negative). At baseline and follow-up, we determined HR-HPV status in cervical smears, assessed chronic stress, and repeatedly measured salivary cortisol over the day. At baseline, we analyzed salivary cortisol only in a subgroup of 90 participants (45 HR-HPV negative and 45 HR-HPV positive). Results At baseline, higher chronic stress (excessive demands at work: p = .022, chronic worrying: p = .032), and a higher CAR (p = .014) were related to baseline HR-HPV positivity. At follow-up, there was a statistical trend for a positive association between the CAR and HR-HPV positivity (p = .062). Neither the CAR nor the AUCgday mediated the associations between chronic stress and HR-HPV status. Conclusions Our findings suggest that both chronic stress and diurnal cortisol are related to the presence of HR-HPV infection and may thus play a role in HPV-associated cervical carcinogenesis.
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Affiliation(s)
- Ulrike Kuebler
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14/26, 8050, Zurich, Switzerland
| | - Susanne Fischer
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14/26, 8050, Zurich, Switzerland
| | - Laura Mernone
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14/26, 8050, Zurich, Switzerland
| | | | - Elvira Abbruzzese
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14/26, 8050, Zurich, Switzerland
| | - Ulrike Ehlert
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14/26, 8050, Zurich, Switzerland.
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Yuksel D, de Zambotti M, Sugarbaker D, Schulte T, Colrain IM, Baker FC. Physiological responses to acute psychosocial stress in women with menopausal insomnia. Int J Psychophysiol 2021; 164:87-94. [PMID: 33647384 DOI: 10.1016/j.ijpsycho.2021.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/06/2021] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Insomnia disorder is a common sleep disorder and frequently emerges in the context of menopause, being associated with menopause-specific factors such as hot flashes and other psychosocial variables. Increased vulnerability to stress may also contribute to the development of insomnia in midlife women. Here, we aimed to investigate whether there are differences in physiological reactivity to acute psychosocial stress in women with menopausal insomnia compared with controls. METHODS We investigated cortisol and heart rate [HR] responses to an acute experimental psychosocial stress (Trier Social Stress Test, TSST) approximately 1 h after waking in the morning in midlife women with (n = 22) and without (n = 16) DSM-IV insomnia disorder (Age: 50.05 ± 3.10 years), developed in the context of menopause. RESULTS Despite similar perceived stress levels, women with insomnia showed blunted HR increases (~29% HR acceleration) to the TSST compared to controls (~44% HR acceleration) (p = 0.026). No group differences in HR were detected at baseline or during post-task recovery. Cortisol stress responses were inconclusive, with most of the women (60%) failing to exhibit significant cortisol increases in response to the TSST. A greater magnitude of the cortisol awakening response (CAR) predicted the likelihood of being a non-responder (p = 0.036), showing the confounding effect of CAR on cortisol stress responses. DISCUSSION Women with menopausal insomnia show blunted cardiac responses to stress, suggesting alterations in the autonomic reactivity to acute stress. Whether these alterations are pre-existing or are a consequence of insomnia, needs to be determined.
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Affiliation(s)
- Dilara Yuksel
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | | | - David Sugarbaker
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Tilman Schulte
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA; Department of Psychology, Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA 94304, USA
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA; Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg 2000, South Africa.
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Choshen-Hillel S, Ishqer A, Mahameed F, Reiter J, Gozal D, Gileles-Hillel A, Berger I. Acute and chronic sleep deprivation in residents: Cognition and stress biomarkers. MEDICAL EDUCATION 2021; 55:174-184. [PMID: 32697336 PMCID: PMC7854866 DOI: 10.1111/medu.14296] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/29/2020] [Accepted: 07/16/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Insufficient sleep affects circadian hormonal profiles and inflammatory markers and may modulate attention, executive functioning and decision-making. Medical professionals and specifically resident physicians, who are involved in long-term nightshift schedules during their post-graduate training, are prone to acute and chronic sleep deprivation and disruption, putting them at risk for making medical errors. The aim of the study was to evaluate the impact of chronic and acute-on-chronic sleep deprivation and disruption among residents on selected physiological and cognitive measures. METHODS Thirty-three medical and surgical residents were evaluated twice - at baseline and after a 26-hour shift. Eighteen young attending physicians who did not engage in nightshift schedules served as controls and were evaluated once. Measures included morning cortisol and high-sensitivity C-reactive protein (hs-CRP), computerised tests of attention and behaviour, the Behaviour Rating Inventory of Executive Function, a risk-taking questionnaire and the Pittsburgh Sleep Quality Index. RESULTS Residents, but not attendings, reported chronic sleep disruption and deprivation. Residents at baseline exhibited reduced morning cortisol levels and elevated hs-CRP levels, compared to attendings. Residents at baseline had impaired global executive function compared to attendings. A nightshift with acute sleep deprivation further reduced residents' executive function. Residents at baseline and after a nightshift demonstrated increased impulsivity and slower processing time than attendings. Residents and attendings did not differ in risk-taking tendencies which were assessed in a separate cohort. CONCLUSIONS In a real-life setting, resident physicians exhibit increased low-grade systemic inflammation (hs-CRP) and impaired HPA-axis function. Their chronic sleep curtailment is associated with greater impulsivity, slower cognitive processing, and impaired executive function. Future research is warranted to understand how improving working schedule by increasing sleep duration may minimise the short-term and potential long-term risks to physicians in training.
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Affiliation(s)
- Shoham Choshen-Hillel
- School of Business Administration and the Federmann Center for the Study of Rationality, Hebrew University of Jerusalem
| | - Ahmad Ishqer
- Pediatric Pulmonary & Sleep Unit, Hadassah-Hebrew University Medical Center
| | - Fadi Mahameed
- Pediatric Pulmonary & Sleep Unit, Hadassah-Hebrew University Medical Center
| | - Joel Reiter
- Pediatric Pulmonary & Sleep Unit, Hadassah-Hebrew University Medical Center
| | - David Gozal
- Department of Child Health, MU Women’s and Children’s Hospital, University of Missouri School of Medicine
| | - Alex Gileles-Hillel
- Pediatric Pulmonary & Sleep Unit, Hadassah-Hebrew University Medical Center
- The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center
| | - Itai Berger
- Pediatric Neurology; Department of Pediatrics, Assuta-Ashdod University Medical Center
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva
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Gaffey AE, Jeon S, Conley S, Jacoby D, Ash GI, Yaggi HK, O’Connell M, Linsky SJ, Redeker NS. Perceived Stress, Subjective, and Objective Symptoms of Disturbed Sleep in Men and Women with Stable Heart Failure. Behav Sleep Med 2021; 19:363-377. [PMID: 32394733 PMCID: PMC7658015 DOI: 10.1080/15402002.2020.1762601] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective/Background: Sleep disturbance is prevalent among patients with heart failure (HF) and is associated with increased morbidity and mortality. Stress also affects health and quality of life among patients with cardiovascular disease and likely plays a prominent role in HF. However, little is known about the associations between stress and sleep among HF patients.Participants: One hundred fifty-three stable New York Heart Association (NYHA) Classification I-IV HF patients with at least low symptoms of insomnia (Mage:63.0 ± 12.8, 42% Women).Methods: We examined baseline stress, sleep disturbance, and sleep-related characteristics from a randomized controlled trial of cognitive behavioral therapy for insomnia, including the Perceived Stress Scale, Insomnia Severity Index, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Sleep Disturbance Questionnaire, Dysfunctional Beliefs about Sleep Scale, PROMIS Cognitive Ability, SF-36 Mental Health, and wrist actigraphy. We used Pearson correlations and general linear models to assess stress-sleep associations, including the potential moderating effects of sex and symptom severity (NYHA).Results: There were moderate-to-large correlations between stress and self-reported sleep disturbance, dysfunctional beliefs about sleep, cognitive ability, and mental health (p's < 0.01). High stress was associated with more objectively-measured (i.e., actigraph-assessed) awakenings and sleep fragmentation among women than men (β = - 0.04, p < 0.01; β = - 0.71, p = 0.04). Relationships between stress and objectively-measured sleep did not vary by symptom severity.Conclusions: Perceived stress is related to sleep disturbance among HF patients, and effects may be sex-dependent. Subsequent research should determine the temporal links between sleep and stress, and optimal opportunities for intervention among HF patients.
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Affiliation(s)
- Allison E. Gaffey
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510,VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516,Corresponding Author: Yale School of Medicine, Department of Internal Medicine, 333 Cedar Street, New Haven, CT 06510, Phone: (203) 932-5711 ext. 3332,
| | - Sangchoon Jeon
- Yale School of Nursing, 400 West Campus Drive, Orange, CT 06477
| | - Samantha Conley
- Yale School of Nursing, 400 West Campus Drive, Orange, CT 06477
| | - Daniel Jacoby
- Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510
| | - Garrett I. Ash
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516,Department of Internal Medicine (General), Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510
| | - Henry K. Yaggi
- VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516,Department of Internal Medicine (Pulmonary, Critical Care, and Sleep Medicine), Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510
| | | | - Sarah J. Linsky
- Yale School of Nursing, 400 West Campus Drive, Orange, CT 06477
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Fernández-Pires P, Valera-Gran D, Hurtado-Pomares M, Espinosa-Sempere C, Sánchez-Pérez A, Juárez-Leal I, Ruiz-Carbonell MP, Peral-Gómez P, Campos-Sánchez I, Pérez-Vázquez MT, Navarrete-Muñoz EM. Sleep Duration and Quality and Sensory Reactivity in School-Aged Children: The Spanish Cross-Sectional InProS Study. Front Pediatr 2021; 9:646011. [PMID: 34291016 PMCID: PMC8286990 DOI: 10.3389/fped.2021.646011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 06/04/2021] [Indexed: 01/30/2023] Open
Abstract
Background: The relationship between children's sleep and health has been widely examined; however, research focused on the link between sleep and sensory reactivity in children without medical conditions is relatively new and based on studies with small samples. Hence, we aimed at exploring the association between sleep duration and quality and prevalence of sensory reactivity in a population-based sample of children aged 3-7. Methods: We examined data on 579 school-age children from the InProS project, a cross-sectional population-based study. Children's sleep duration was classified as <10 vs. ≥10 h/day, and sleep quality was measured using the Pediatric Sleep Questionnaire, defining poor quality sleep as a score of ≥0.33. The Short Sensory Profile (SSP) was used to classify children with or without sensory reactivity using the cut-off points proposed by W. Dunn for SSP total score and each SSP subscale. Prevalence ratios (PR) using Poisson multiple regression models with robust variance were estimated to examine main associations. Results: Around a third (32.6%; n = 189) slept <10 h/day and 10.4% presented poor sleep quality. The prevalence of sensory reactivity was 29.5% for total SSP (<155), 11.4% for tactile sensitivity (<30), 15% for taste/smell sensitivity (<15), 22.5% for movement sensitivity (<13), 49.1% for under-responsive/seeks sensation (<27), 44.4% for auditory filtering (<23), 12.4% for low energy/weak (<26), and 25.4% for visual/auditory sensitivity (<19). Main findings indicated that poor sleep quality was significantly associated with a greater prevalence of sensory reactivity for SSP total score (PR = 1.27; IC 95%: 1.18; 1.38), tactile sensitivity (PR = 1.09, IC95%: 1.00-1.19), taste/smell sensitivity (PR = 1.18, IC95%: 1.08-1.30), under-responsive/seeks sensation (PR = 1.28, IC95%: 1.20-1.37), auditory filtering (PR = 1.31, IC95%: 1.23-1.39), low energy/weak (PR = 1.14, IC95%: 1.04-1.25) and audiovisual sensitivity (PR = 1.15, IC95%: 1.05-1.26) scores after adjusting for potential confounders. Conclusions: In this study, we observed that poor sleep quality was statistically significantly associated with a higher prevalence of sensory reactivity as measured by the total SSP and almost all SSP subscales. To our knowledge, this is the first time that this association has been explored and reported. Further research from prospective studies is required to confirm these findings.
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Affiliation(s)
| | - Desirée Valera-Gran
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain.,Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
| | - Miriam Hurtado-Pomares
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain.,Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain.,Miguel Hernández University-Vice Rectorade of Institutional Relations, Elche, Spain
| | - Cristina Espinosa-Sempere
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain.,Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
| | - Alicia Sánchez-Pérez
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain.,Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
| | - Iris Juárez-Leal
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain.,Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
| | - María-Pilar Ruiz-Carbonell
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain.,Centro de Desarrollo Infantil Sentits, Alicante, Spain
| | - Paula Peral-Gómez
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain.,Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
| | - Irene Campos-Sánchez
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain
| | - María-Teresa Pérez-Vázquez
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain.,Miguel Hernández University-Vice Rectorade of Institutional Relations, Elche, Spain
| | - Eva-María Navarrete-Muñoz
- Department of Surgery and Pathology, Miguel Hernández University, Alicante, Spain.,Occupational Therapy Research Group (InTeO, Investigación en Terapia Ocupacional), Miguel Hernández University, Alicante, Spain
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Wickham SR, Amarasekara NA, Bartonicek A, Conner TS. The Big Three Health Behaviors and Mental Health and Well-Being Among Young Adults: A Cross-Sectional Investigation of Sleep, Exercise, and Diet. Front Psychol 2020; 11:579205. [PMID: 33362643 PMCID: PMC7758199 DOI: 10.3389/fpsyg.2020.579205] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/05/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sleep, physical activity, and diet have been associated with mental health and well-being individually in young adults. However, which of these "big three" health behaviors most strongly predicts mental health and well-being, and their higher-order relationships in predictive models, is less known. This study investigated the differential and higher-order associations between sleep, physical activity, and dietary factors as predictors of mental health and well-being in young adults. METHOD In a cross-sectional survey design, 1,111 young adults (28.4% men) ages 18-25 from New Zealand and the United States answered an online survey measuring typical sleep quantity and quality; physical activity; and consumption of raw and processed fruit and vegetables, fast food, sweets, and soda, along with extensive covariates (including demographics, socioeconomic status, body mass index, alcohol use, smoking, and health conditions) and the outcome measures of depressive symptoms [measured by the Center for Epidemiological Depression Scale (CES-D)] and well-being (measured by the Flourishing Scale). RESULTS Controlling for covariates, sleep quality was the strongest predictor of depressive symptoms and well-being, followed by sleep quantity and physical activity. Only one dietary factor-raw fruit and vegetable consumption-predicted greater well-being but not depressive symptoms when controlling for covariates. There were some higher-order interactions among health behaviors in predicting the outcomes, but these did not survive cross-validation. CONCLUSION Sleep quality is an important predictor of mental health and well-being in young adults, whereas physical activity and diet are secondary but still significant factors. Although strictly correlational, these patterns suggest that future interventions could prioritize sleep quality to maximize mental health and well-being in young adults.
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Affiliation(s)
| | | | | | - Tamlin S. Conner
- Department of Psychology, University of Otago, Dunedin, New Zealand
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36
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Leger KA, Charles ST. Affective recovery from stress and its associations with sleep. Stress Health 2020; 36:693-699. [PMID: 32472738 DOI: 10.1002/smi.2966] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/14/2020] [Accepted: 05/23/2020] [Indexed: 11/07/2022]
Abstract
Good sleep habits are important for emotional well-being. Studies have linked sleep with people's ability to regulate their emotions in response to stressful events, yet little is known specifically about how sleep is related to a person's ability to recover affectively from a stressful experience. The current study examined self-reported sleep habits and their associations with both positive and negative affective recovery from a laboratory-induced stressor. Participants (N = 120) reported their sleep habits over the previous month and then engaged in a laboratory psychosocial stress task. Affect was measured before, during, and 6 minutes after the task. Different aspects of sleep were related to poorer positive and negative affective recovery. Worse sleep quality was associated with higher post-recovery negative affect, whereas worse sleep efficiency was associated with lower post-recovery positive affect. Findings suggest that poor sleep is associated with prolonged affective recovery from a stressful event. Implications for health and well-being are discussed.
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Affiliation(s)
- Kate A Leger
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Susan T Charles
- Department of Psychological Science, University of California, Irvine, California, USA
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Zhao X, Li J, Ren X, Yang J. The effect of sleep on the salivary cortisol response to acute stressors: a review and suggestions. Sleep Med 2020; 77:35-44. [PMID: 33310112 DOI: 10.1016/j.sleep.2020.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/29/2020] [Accepted: 11/21/2020] [Indexed: 11/28/2022]
Abstract
There have been steadily increasing studies on the relationship between sleep and stress. However, the findings regarding the effects of sleep on the acute stress response have been inconsistent. Elevated, blunted, or unchanged salivary cortisol stress response have been reported. Therefore, this study conducted a systematic review of previous studies to provide a comprehensive summary of the factors that influence the effects of sleep on the salivary cortisol stress response. We conducted a comprehensive electronic literature search in PubMed, PsycINFO, PsycARTICLES, Web of Science, MEDLINE, and EMBASE for human studies published in English (up to June 2019). Finally, 17 articles with participants aged 6.4-72 years were included in this review. We assessed the following factors: designing factors (sleep measurement, stress induction, cortisol sampling period, and time intervals between sleep measurement and the acute stress task), analyzing factors (cortisol analysis), and participants' characteristics (age, sex, and background stress levels); subsequently, we explained conflicting findings across the current literature. Further, we provide study design, analysis, and report suggestions for optimal assessment of the effects of sleep on the acute stress response. This summary of influencing factors and suggestions for future studies could help elucidate the impact of sleep on stress and advance the field.
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Affiliation(s)
- Xiaolin Zhao
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Jiwen Li
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Xi Ren
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Juan Yang
- Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China.
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Koopman‐Verhoeff ME, Mulder RH, Saletin JM, Reiss I, van der Horst GT, Felix JF, Carskadon MA, Tiemeier H, Cecil CA. Genome-wide DNA methylation patterns associated with sleep and mental health in children: a population-based study. J Child Psychol Psychiatry 2020; 61:1061-1069. [PMID: 32361995 PMCID: PMC7586967 DOI: 10.1111/jcpp.13252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND DNA methylation (DNAm) has been implicated in the biology of sleep. Yet, how DNAm patterns across the genome relate to different sleep outcomes, and whether these associations overlap with mental health is currently unknown. Here, we investigated associations of DNAm with sleep and mental health in a pediatric population. METHODS This cross-sectional study included 465 10-year-old children (51.3% female) from the Generation R Study. Genome-wide DNAm levels were measured using the Illumina 450K array (peripheral blood). Sleep problems were assessed from self-report and mental health outcomes from maternal questionnaires. Wrist actigraphy was used in 188 11-year-old children to calculate sleep duration and midpoint sleep. Weighted gene co-expression network analysis was used to identify highly comethylated DNAm 'modules', which were tested for associations with sleep and mental health outcomes. RESULTS We identified 64 DNAm modules, one of which associated with sleep duration after covariate and multiple testing adjustment. This module included CpG sites spanning 9 genes on chromosome 17, including MAPT - a key regulator of Tau proteins in the brain involved in neuronal function - as well as genes previously implicated in sleep duration. Follow-up analyses suggested that DNAm variation in this region is under considerable genetic control and shows strong blood-brain concordance. DNAm modules associated with sleep did not overlap with those associated with mental health. CONCLUSIONS We identified one DNAm region associated with sleep duration, including genes previously reported by recent GWAS studies. Further research is warranted to examine the functional role of this region and its longitudinal association with sleep.
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Affiliation(s)
- Maria Elisabeth Koopman‐Verhoeff
- Department of Child and Adolescent PsychiatryErasmus University Medical CenterSophia Children’s HospitalRotterdamThe Netherlands,The Generation R Study GroupErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,EP Bradley Hospital Sleep LaboratoryAlpert Medical School of Brown UniversityProvidenceRIUSA
| | - Rosa H. Mulder
- Department of Child and Adolescent PsychiatryErasmus University Medical CenterSophia Children’s HospitalRotterdamThe Netherlands,The Generation R Study GroupErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,Institute of Education and Child StudiesLeiden UniversityLeidenThe Netherlands
| | - Jared M. Saletin
- EP Bradley Hospital Sleep LaboratoryAlpert Medical School of Brown UniversityProvidenceRIUSA
| | - Irwin Reiss
- Department of PediatricsErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | | | - Janine F. Felix
- The Generation R Study GroupErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,Department of PediatricsErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Mary A. Carskadon
- EP Bradley Hospital Sleep LaboratoryAlpert Medical School of Brown UniversityProvidenceRIUSA
| | - Henning Tiemeier
- Department of Child and Adolescent PsychiatryErasmus University Medical CenterSophia Children’s HospitalRotterdamThe Netherlands,Department of Social and Behavioral ScienceHarvard TH Chan School of Public HealthBostonMAUSA
| | - Charlotte A.M. Cecil
- Department of Child and Adolescent PsychiatryErasmus University Medical CenterSophia Children’s HospitalRotterdamThe Netherlands,The Generation R Study GroupErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands,Department of EpidemiologyErasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
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The relationship between sleep problems and cortisol in people with type 2 diabetes. Psychoneuroendocrinology 2020; 117:104688. [PMID: 32353817 PMCID: PMC7302424 DOI: 10.1016/j.psyneuen.2020.104688] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/04/2020] [Accepted: 04/12/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Sleep problems are linked with negative health outcomes, including coronary heart disease. Neuroendocrine dysfunction has been associated with sleep problems and may be a pathway linking sleep and ill health. Dysregulated cortisol output has observed in people with type 2 diabetes (T2D), though little is known about the links between sleep and cortisol in this population at high risk of coronary disease. METHOD This study investigated the association between sleep problems and cortisol over the course of an ordinary day and in response to acute laboratory stress in a sample of 129 individuals with T2D. Sleep problems were assessed using the Jenkins sleep problems questionnaire. Mental stress was induced using two five-minute laboratory stress tasks: a mirror-tracing task and the Stroop color-word interference task. RESULTS Sleep problems were positively associated with daily cortisol area under the curve (B = 17.051, C.I. = 6.547 to 27.554, p = 0.002) adjusting for age, sex, marital status, education, household income, body mass index and smoking; suggesting that those with greater sleep problems had greater cortisol concentrations over the course of an ordinary day. Participants reporting greater sleep problems also had raised evening cortisol levels (B = 0.96, C.I. = 0.176 to 1.746, p = 0.017) in adjusted models. In the laboratory sleep problems were negatively associated with cortisol immediately post-task (B = -0.030, C.I. = -0.059 to 0.000, p = 0.048) and 45 minutes post-task (B = -0.037, C.I. = -0.072 to -0.002, p = 0.039) in fully adjusted models; indicating that those who experienced greater sleep problems had lower cortisol concentrations after stress. CONCLUSIONS Sleep problems were associated with disturbances in cortisol responses to stress, as well as changes diurnal cortisol output in people with T2D. Further research is needed to assess if neuroendocrine disturbance increases the risk of cardiovascular disease in this population.
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Glavin EE, Ceneus M, Chanowitz M, Kantilierakis J, Mendelow E, Mosquera J, Spaeth AM. Relationships between sleep, exercise timing, and chronotype in young adults. J Health Psychol 2020; 26:2636-2647. [PMID: 32498631 DOI: 10.1177/1359105320926530] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
To examine the relationships between exercise timing, chronotype, sleep, and mood, college students (N = 909, 19.6 ± 1.4 years, 38% female) completed questionnaires immediately after exercising. Evening exercisers had later bedtimes, poorer sleep quality, and lower sleep efficiency compared to morning exercisers. Evening chronotypes reported poorer sleep quality, greater daytime dysfunction, and less positive affect compared to morning/neither chronotypes. Chronotype moderated the relationship between exercise timing and bedtime; with each minute delay in exercise timing, bedtime was delayed by 6.1 minutes in morning-types and only 3.6 minutes in evening-types. University health initiatives should target evening exercisers to mitigate the consequences of prolonged insufficient sleep.
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Xiong W, Fan F, Qi H. Effects of Environmental Change on Travelers' Sleep Health: Identifying Risk and Protective Factors. Front Psychol 2020; 11:724. [PMID: 32477203 PMCID: PMC7237733 DOI: 10.3389/fpsyg.2020.00724] [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: 08/24/2019] [Accepted: 03/25/2020] [Indexed: 11/17/2022] Open
Abstract
Objective The aim of this study is to predict the risk and protective factors for the differential effects of the environment on travelers’ sleep health. Methods A sample of 505 travelers who stayed overnight in one of 28 hotels completed a sleep quality scale (SQS), a reduced scale of the Morningness/Eveningness questionnaire (rMEQ), and a hotel customer satisfaction questionnaire (H-SCI). Results Individuals who are of morning type (p = 0.002), have reduced sleep duration (p = 0.010), and have high sensitivity to the sleep environment (p = 0.000) are most affected by environmental change. Interestingly, business travelers are more affected by sleep disturbances than leisure travelers, travelers who are more satisfied with hotels are less likely to experience insomnia in a new sleep environment (p = 0.000), and insomniacs are more likely to recover from insomnia during a trip (p = 0.000). Conclusion Environmental change has an inconsistent impact on the sleep health of different individuals. In a new sleep environment, the possible risk factors for sleep health include (1) being of morning type, (2) reduced sleep duration during trip, (3) sensitivity to the sleep environment, and (4) business stress, while a possible protective factor is satisfaction with the hotel. Possible factors aiding in recovery from home insomnia include (1) being of evening type and (2) higher satisfaction with the hotel.
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Affiliation(s)
- Wei Xiong
- School of Psychology, South China Normal University, Guangzhou, China.,School of Tourism Management, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, Guangzhou, China
| | - Fang Fan
- School of Psychology, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, Guangzhou, China.,Center for Studies of Psychological Application, South China Normal University, Guangzhou, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Haiying Qi
- School of Psychology, South China Normal University, Guangzhou, China.,Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, Guangzhou, China.,Center for Studies of Psychological Application, South China Normal University, Guangzhou, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
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Associations between objective measures of physical activity, sleep and stress levels among preschool children. BMC Pediatr 2020; 20:258. [PMID: 32460881 PMCID: PMC7254697 DOI: 10.1186/s12887-020-02108-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 04/29/2020] [Indexed: 11/25/2022] Open
Abstract
Background Cortisol is often used as a biological marker for stress. When measured in urine or serum, representing a short-term measurement of the hormone, it has been associated with unfavorable sleep characteristics and both low and high physical activity levels. However, cortisol in hair represents a long-term stress measure and has been suggested as a promising new marker for chronic stress. Therefore, we aimed to examine the association between objectively measured sleep, physical activity and hair cortisol levels in preschool children. Methods In order to obtain objective measures of physical activity and sleep habits, 54 children aged 2–6 years wore an ActiGraph for 5 consecutive days and nights. For chronic stress measurements of each child, hair was cut from the back of the head close to the scalp for analysis of cortisol levels. Associations between measured sleep quality and quantity and level of physical activity and hair cortisol levels were estimated using linear regression analysis, presented as β. Results were adjusted for sex, age and BMI z-score. Results We found no significant association between log-transformed cortisol (pg/mg) and sleep duration (hours) (β = − 0.0016, p = 0.99), sleep efficiency (β = − 3.1, p = 0.18), sleep latency (β = 0.015, p = 0.16) or physical activity level (100 counts per min) (β = 0.014, p = 0.22). However, sleep latency (min) was directly associated with physical activity (counts per min) levels (β = 35.2, p = 0.02), while sleep duration (hours) (β = − 142.1, p = 0.55) and sleep efficiency (%) (β = − 4087, p = 0.26) showed no significant associations. Conclusions In our study, a high physical activity level was associated with poorer sleep habits. Neither sleep quality nor physical activity were related to long term cortisol exposure. These results are among the first to study associations between objectively measured sleep, physical activity and chronic cortisol levels among preschool children. More and larger studies are therefore needed.
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St-Onge MP, Campbell A, Aggarwal B, Taylor JL, Spruill TM, RoyChoudhury A. Mild sleep restriction increases 24-hour ambulatory blood pressure in premenopausal women with no indication of mediation by psychological effects. Am Heart J 2020; 223:12-22. [PMID: 32135337 DOI: 10.1016/j.ahj.2020.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 02/06/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Studies assessing the impact of sleep restriction (SR) on blood pressure (BP) are limited by short study length, extreme SR (<4 hours a night), and lack of attention to psychological distress as a possible mediator. METHODS A community-based cohort was assembled with 237 women (age 34.1 ± 13.5 years; body mass index 25.4 ± 5.4 kg/m2), and a randomized, crossover, intervention study was conducted in 41 women (24 completed: age 30.2 ± 6.5 years; body mass index 24.3 ± 2.8 kg/m2) to determine the causal effect of SR on BP. Sleep was maintained as usual (HS) or reduced by 1.5 hours a night (SR) for 6 weeks. In the cohort, associations between sleep and psychosocial factors were evaluated using multivariable models adjusted for demographic and clinical confounders. In the intervention study, in-office BP was measured weekly; ambulatory BP was measured at end point. Psychological factors were assessed at baseline and end point. Mixed-model analyses with total sleep time (TST, main predictor), week and fraction of time spent in physical activity (covariates), and subject (random effect) were performed. RESULTS Among the community cohort, higher perceived stress, stressful events and distress, and lower resilience were associated with shorter sleep, worse sleep quality, and greater insomnia symptoms (P < .05). In the intervention, systolic BP increased as TST decreased (TST × week interaction, [coefficient ± standard error] -0.0097 ± 0.0046, P = .036). Wake ambulatory diastolic blood pressure (-0.059 ± 0.022, P = .021) and mean arterial pressure (-0.067 ± 0.023, P = .018) were higher after SR versus HS. Psychological distress variables were not affected by TST and did not mediate the effects of SR on BP. CONCLUSIONS These results suggest that SR influences CVD risk in women via mechanisms independent of psychological stressors.
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Affiliation(s)
- Marie-Pierre St-Onge
- Sleep center of excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY; Institute of Human Nutrition, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY.
| | - Ayanna Campbell
- Sleep center of excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Brooke Aggarwal
- Sleep center of excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Jasmine L Taylor
- Institute of Human Nutrition, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY; Tulane Medical Center, New Orleans, LA
| | - Tanya M Spruill
- Department of Population Health, NYU School of Medicine, New York, NY
| | - Arindam RoyChoudhury
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY
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Eiman MN, Pomeroy JML, Weinstein AA. Relationship of actigraphy-assessed sleep efficiency and sleep duration to reactivity to stress. SLEEP SCIENCE (SAO PAULO, BRAZIL) 2020; 12:257-264. [PMID: 32318246 PMCID: PMC7159077 DOI: 10.5935/1984-0063.20190090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Objective: Sleep duration is an important predictor of cardiovascular health outcomes, but the role of sleep efficiency is less clear. This study investigated actigraphy-assessed sleep efficiency and sleep duration and their relationship with responses to mental and physical challenge tasks. Methods: To record sleep, actigraph devices were worn on the wrist continuously by 25 participants (age: 33.9±6.9, 60% female) for the duration of a seven-day period. Movement data were used to estimate sleep duration and efficiency. Mental (Stroop test) and physical (cold pressor) challenges were used to assess reactivity to and recovery from stress. During these tasks, heart rate, blood pressure, and emotional states were measured. Results: Significant findings from the mental challenge included a negative correlation between sleep efficiency and reaction time. There were no significant relationships between sleep efficiency and cardiovascular measures during the mental challenge, but sleep duration was related to cardiovascular reactivity. For the physical challenge, sleep efficiency was positively and significantly correlated with blood pressure recovery and sleep duration was not related to any outcome measures. Discussion: Previous literature has focused on sleep duration when assessing sleep and cardiovascular outcomes. However, sleep efficiency may be equally or more important when investigating reactivity to and recovery from stress.
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Affiliation(s)
- Matthew N Eiman
- George Mason University, Center for the Study of Chronic Illness and Disability - Fairfax - Virginia - United States
| | - Julia Mary Louise Pomeroy
- George Mason University, Center for the Study of Chronic Illness and Disability - Fairfax - Virginia - United States
| | - Ali A Weinstein
- George Mason University, Center for the Study of Chronic Illness and Disability - Fairfax - Virginia - United States
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Nollet M, Wisden W, Franks NP. Sleep deprivation and stress: a reciprocal relationship. Interface Focus 2020; 10:20190092. [PMID: 32382403 PMCID: PMC7202382 DOI: 10.1098/rsfs.2019.0092] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2020] [Indexed: 12/19/2022] Open
Abstract
Sleep is highly conserved across evolution, suggesting vital biological functions that are yet to be fully understood. Animals and humans experiencing partial sleep restriction usually exhibit detrimental physiological responses, while total and prolonged sleep loss could lead to death. The perturbation of sleep homeostasis is usually accompanied by an increase in hypothalamic–pituitary–adrenal (HPA) axis activity, leading to a rise in circulating levels of stress hormones (e.g. cortisol in humans, corticosterone in rodents). Such hormones follow a circadian release pattern under undisturbed conditions and participate in the regulation of sleep. The investigation of the consequences of sleep deprivation, from molecular changes to behavioural alterations, has been used to study the fundamental functions of sleep. However, the reciprocal relationship between sleep and the activity of the HPA axis is problematic when investigating sleep using traditional sleep-deprivation protocols that can induce stress per se. This is especially true in studies using rodents in which sleep deprivation is achieved by exogenous, and potentially stressful, sensory–motor stimulations that can undoubtedly confuse their conclusions. While more research is needed to explore the mechanisms underlying sleep loss and health, avoiding stress as a confounding factor in sleep-deprivation studies is therefore crucial. This review examines the evidence of the intricate links between sleep and stress in the context of experimental sleep deprivation, and proposes a more sophisticated research framework for sleep-deprivation procedures that could benefit from recent progress in biotechnological tools for precise neuromodulation, such as chemogenetics and optogenetics, as well as improved automated real-time sleep-scoring algorithms.
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Affiliation(s)
- Mathieu Nollet
- Department of Life Sciences, Imperial College London, London, UK.,UK Dementia Research Institute at Imperial College London, London, UK
| | - William Wisden
- Department of Life Sciences, Imperial College London, London, UK.,UK Dementia Research Institute at Imperial College London, London, UK.,Centre for Neurotechnology, Imperial College London, London, UK
| | - Nicholas P Franks
- Department of Life Sciences, Imperial College London, London, UK.,UK Dementia Research Institute at Imperial College London, London, UK.,Centre for Neurotechnology, Imperial College London, London, UK
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Tonon AC, Carissimi A, Schimitt RL, de Lima LS, Pereira FDS, Hidalgo MP. How do stress, sleep quality, and chronotype associate with clinically significant depressive symptoms? A study of young male military recruits in compulsory service. ACTA ACUST UNITED AC 2020; 42:54-62. [PMID: 31166545 PMCID: PMC6986495 DOI: 10.1590/1516-4446-2018-0286] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 02/04/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Although studies have shown an association between poor sleep and chronotype with psychiatric problems in young adults, few have focused on identifying multiple concomitant risk factors. METHODS We assessed depressive symptoms (Beck Depression Inventory [BDI]), circadian typology (Morningness-Eveningness Questionnaire [MEQ]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), perceived stress (Perceived Stress Scale [PSS]), social rhythm (Social Rhythm Metrics [SRM]), and salivary cortisol (morning, evening and night, n=37) in 236 men (all 18 years old). Separate analyses were conducted to understand how each PSQI domain was associated with depressive symptoms. RESULTS Depressive symptoms were more prevalent in individuals with higher perceived stress (prevalence ratio [PR] = 6.429, p < 0.001), evening types (PR = 2.58, p < 0.001) and poor sleepers (PR = 1.808, p = 0.046). Multivariate modeling showed that these three variables were independently associated with depressive symptoms (all p < 0.05). The PSQI items subjective sleep quality and sleep disturbances were significantly more prevalent in individuals with depressive symptoms (PR = 2.210, p = 0.009 and PR = 2.198, p = 0.008). Lower levels of morning cortisol were significantly associated with higher depressive scores (r = -0.335; p = 0.043). CONCLUSION It is important to evaluate multiple factors related to sleep and chronotype in youth depression studies, since this can provide important tools for comprehending and managing mental health problems.
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Affiliation(s)
- André C Tonon
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | - Alicia Carissimi
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | | | | | - Fernanda Dos S Pereira
- Unidade de Análises Moleculares e de Proteínas, Centro de Pesquisa Experimental, HCPA, UFRGS, Porto Alegre, RS, Brazil
| | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
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Abstract
BACKGROUND There are high levels of stress among graduate students, and stress is associated with multiple negative outcomes among student populations, including academic burnout. Sleep could play an important role in explaining the association between stress and burnout, but these relationships have not been explored among the graduate student population. The current study assessed whether or not sleep duration and quality moderated the relationship between stress and burnout (i.e., exhaustion, cynicism, and inefficacy) among graduate students. METHODS A sample of 2683 master's, doctoral, and professional graduate students from two large, public universities completed an online survey. Linear regression models with interaction terms were developed to evaluate the relationships between stress and burnout while examining moderation by sleep duration and quality. RESULTS Participants slept an average of 6.4 h per night, with 62% indicating good sleep quality. Stress had significant, positive relationships with exhaustion, cynicism, and inefficacy. The relationship between stress and exhaustion lessened as sleep duration increased, and the relationship between stress and exhaustion was weaker among students with good sleep quality when compared with those with poor sleep quality. Neither sleep duration nor sleep quality moderated the relationships between stress and cynicism or stress and inefficacy. CONCLUSIONS Improving sleep habits has the potential to lessen the negative association between stress and graduate student functioning. Future research utilizing longitudinal designs is needed to understand the temporality of these associations and the influence of possible co-factors like individual propensity for mental health problems and social support.
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Bowers SJ, Vargas F, González A, He S, Jiang P, Dorrestein PC, Knight R, Wright KP, Lowry CA, Fleshner M, Vitaterna MH, Turek FW. Repeated sleep disruption in mice leads to persistent shifts in the fecal microbiome and metabolome. PLoS One 2020; 15:e0229001. [PMID: 32078624 PMCID: PMC7032712 DOI: 10.1371/journal.pone.0229001] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 01/27/2020] [Indexed: 02/07/2023] Open
Abstract
It has been established in recent years that the gut microbiome plays a role in health and disease, potentially via alterations in metabolites that influence host physiology. Although sleep disruption and gut dysbiosis have been associated with many of the same diseases, studies investigating the gut microbiome in the context of sleep disruption have yielded inconsistent results, and have not assessed the fecal metabolome. We exposed mice to five days of sleep disruption followed by four days of ad libitum recovery sleep, and assessed the fecal microbiome and fecal metabolome at multiple timepoints using 16S rRNA gene amplicons and untargeted LC-MS/MS mass spectrometry. We found global shifts in both the microbiome and metabolome in the sleep-disrupted group on the second day of recovery sleep, when most sleep parameters had recovered to baseline levels. We observed an increase in the Firmicutes:Bacteroidetes ratio, along with decreases in the genus Lactobacillus, phylum Actinobacteria, and genus Bifidobacterium in sleep-disrupted mice compared to control mice. The latter two taxa remained low at the fourth day post-sleep disruption. We also identified multiple classes of fecal metabolites that were differentially abundant in sleep-disrupted mice, some of which are physiologically relevant and commonly influenced by the microbiome. This included bile acids, and inference of microbial functional gene content suggested reduced levels of the microbial bile salt hydrolase gene in sleep-disrupted mice. Overall, this study adds to the evidence base linking disrupted sleep to the gut microbiome and expands it to the fecal metabolome, identifying sleep disruption-sensitive bacterial taxa and classes of metabolites that may serve as therapeutic targets to improve health after poor sleep.
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Affiliation(s)
- Samuel J. Bowers
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, Illinois, United States of America
- Department of Neurobiology, Northwestern University, Evanston, Illinois, United States of America
- * E-mail:
| | - Fernando Vargas
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California San Diego, La Jolla, California, United States of America
| | - Antonio González
- Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, California, United States of America
| | - Shannon He
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, Illinois, United States of America
- Department of Neurobiology, Northwestern University, Evanston, Illinois, United States of America
| | - Peng Jiang
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, Illinois, United States of America
- Department of Neurobiology, Northwestern University, Evanston, Illinois, United States of America
| | - Pieter C. Dorrestein
- Collaborative Mass Spectrometry Innovation Center, Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California San Diego, La Jolla, California, United States of America
- Center for Microbiome Innovation, University of California San Diego, La Jolla, California, United States of America
| | - Rob Knight
- Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, California, United States of America
- Center for Microbiome Innovation, University of California San Diego, La Jolla, California, United States of America
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, California, United States of America
| | - Kenneth P. Wright
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States of America
- Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado, United States of America
- Sleep and Chronobiology Laboratory, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Christopher A. Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States of America
- Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Monika Fleshner
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States of America
- Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Martha H. Vitaterna
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, Illinois, United States of America
- Department of Neurobiology, Northwestern University, Evanston, Illinois, United States of America
| | - Fred W. Turek
- Center for Sleep and Circadian Biology, Northwestern University, Evanston, Illinois, United States of America
- Department of Neurobiology, Northwestern University, Evanston, Illinois, United States of America
- The Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
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49
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Bani-Issa W, Radwan H, Al Marzooq F, Al Awar S, Al-Shujairi AM, Samsudin AR, Khasawneh W, Albluwi N. Salivary Cortisol, Subjective Stress and Quality of Sleep Among Female Healthcare Professionals. J Multidiscip Healthc 2020; 13:125-140. [PMID: 32103972 PMCID: PMC7008192 DOI: 10.2147/jmdh.s229396] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 01/08/2020] [Indexed: 12/29/2022] Open
Abstract
Background Stress is globally recognised as a risk factor impacting workers’ health and workplace safety. Women healthcare professionals are at risk for considerable stress given the demanding nature of their jobs and current working conditions. This study assessed levels of stress among women healthcare professionals using measures of their cortisol levels, subjective stress and quality of sleep. Participants and Methods This study used a cross-sectional design. Data were collected from 335 apparently healthy adult women healthcare professionals working in the United Arab Emirates. Participants provided morning and bedtime saliva samples for analysis of their cortisol levels. The Perceived Stress Scale, Stress Symptoms Scale, Brief Coping Scale and Pittsburgh Sleep Quality Index were used to assess perceived stress level, symptoms of stress, stress-coping strategies and sleep quality, respectively. Results In total, 121 (36.15%) women had impaired morning cortisol levels (below the normal range of 0.094–1.551 µg/dL) and 48 (14.3%) had impaired bedtime cortisol levels (above 0.359 µg/dL). Around 57% of women reported moderate levels of perceived stress, with the most frequently reported stress symptoms being heart rate and back/neck pain. Poor sleep quality was reported by around 60% of participating women. No significant association was found between cortisol and psychosocial measurements of stress or sleep quality. However, night shift and longer shift duration (more than 8 hrs) were significantly associated with impaired morning and bedtime cortisol levels (P ≥ 0.05). Impaired cortisol levels were strongly dependent on using adaptive coping strategies such as active coping, acceptance and seeking emotional support (P ≥ 0.05). Conclusion Evaluating cortisol levels and subjective stress could help to identify groups with impaired response to stress and elevated cortisol levels. Our findings support the need to examine shift work patterns and stress coping strategies in women healthcare professionals to promote their health and productivity and maintain workplace safety.
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Affiliation(s)
- Wegdan Bani-Issa
- Sharjah Institute for Medical Research, College of Health Sciences, Department of Nursing, University of Sharjah, Sharjah, United Arab Emirates
| | - Hadia Radwan
- College of Health Sciences, Clinical Nutrition and Dietetics, University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Al Marzooq
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Shamsa Al Awar
- Department of Obstetrics and Gynaecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Arwa M Al-Shujairi
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ab Rani Samsudin
- College of Dental Medicine, Oral and Craniofacial Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Najla Albluwi
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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50
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Crowley SK, Rebellon J, Huber C, Leonard AJ, Henderson D, Magal M. Cardiorespiratory fitness, sleep, and physiological responses to stress in women. Eur J Sport Sci 2020; 20:1368-1377. [PMID: 31939334 DOI: 10.1080/17461391.2020.1716855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Epidemiological studies suggest that cardiorespiratory fitness (CRfitness) is associated with reduced risk of depression and anxiety in women, however, the mechanisms by which CRfitness may be protective against the development of these disorders are less clear. Because sleep problems are associated with both a higher risk for mental illness and altered physiological responses to stress, this study investigated whether sleep quality might influence the relationship between CRfitness and physiological stress responses in women. Thirty healthy women (18-45 y) who were medication-free, with regular menstrual cycles completed: (1) enrolment visit [including the assessment of CRfitness via maximal oxygen consumption during exercise]; (2) one-week sleep monitoring period including subjective (daily sleep diaries) and objective (wrist actigraphy) sleep measures; and (3) psychosocial stressor protocol (the Trier Social Stress Test; TSST) for the collection of heart rate (HR), blood pressure (BP), and salivary cortisol stress responses. Higher CRfitness was associated with reduced wake after sleep onset (WASO) duration (r = -.38, p = 0.04), higher self-reported sleep quality (higher scores reflect poorer sleep quality; r = -.37, p = 0.05), and lower HR (r = -.43, p = 0.02) during the stressor. Higher sleep quality was associated with a lower HR during the stressor (r = .44, p = 0.01). Increased WASO duration and WASO number were associated with blunted cortisol output during the stressor (r = -.44, p = 0.02, and r = -.46, p = 0.02, respectively). Results suggest that, in women, CRfitness may be protective against the deleterious effects of stress via improved sleep quality.
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Affiliation(s)
- Shannon K Crowley
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA.,Department of Health Promotion, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Julia Rebellon
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Christina Huber
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Abigail J Leonard
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Daniel Henderson
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Meir Magal
- Department of Exercise Science, North Carolina Wesleyan College, Rocky Mount, NC, USA
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