1
|
Stafford A, Oduola S, Reeve S. Sleep and socio-occupational functioning in adults with serious mental illness: A systematic review. Psychiatry Res 2024; 339:116111. [PMID: 39083962 DOI: 10.1016/j.psychres.2024.116111] [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: 10/31/2023] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024]
Abstract
Sleep is a crucial factor influencing mental health and quality of life. Individuals with serious mental illness (SMI) often experience significant sleep problems. This can further exacerbate their symptoms and impact their socio-occupational functioning (SOF) (the extent to which a person is able to engage in 'self-care and activities of daily living, communication, interpersonal relations, instrumental living skills, and work'). Despite the well-established bidirectional relationship between sleep and mental health, the specific association between sleep and SOF in the context of SMI remains underexplored. A systematic review was conducted. Comprehensive searches in PubMed and PsycNet yielded 832 results. After applying inclusion criteria, 24 studies were included in the narrative synthesis. Study characteristics and key findings were extracted for analysis. Collectively, studies investigated sleep quality, satisfaction, duration, disturbance, specific disorders, and objectively-recorded sleep parameters across various study designs. Studies included a total population of 10,938, utilising a range of sleep and SOF outcome measures. Nearly all studies indicated that worsened sleep was associated with reduced SOF in SMI populations. The review supports the potential role of improved sleep as a route to improved SOF in SMI populations. This has clear implications for research and clinical care for patients with SMI.
Collapse
Affiliation(s)
- Aviva Stafford
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom.
| | - Sheri Oduola
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Sarah Reeve
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, United Kingdom
| |
Collapse
|
2
|
Allgood JE, Roe A, Sparks BB, Castillo M, Cruz A, Brooks AE, Brooks BD. The Correlation of Sleep Disturbance and Location of Glioma Tumors: A Narrative Review. J Clin Med 2023; 12:4058. [PMID: 37373751 DOI: 10.3390/jcm12124058] [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: 05/01/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Sleep disturbance can occur when sleep centers of the brain, regions that are responsible for coordinating and generating healthy amounts of sleep, are disrupted by glioma growth or surgical resection. Several disorders cause disruptions to the average duration, quality, or patterns of sleep, resulting in sleep disturbance. It is unknown whether specific sleep disorders can be reliably correlated with glioma growth, but there are sufficient numbers of case reports to suggest that a connection is possible. In this manuscript, these case reports and retrospective chart reviews are considered in the context of the current primary literature on sleep disturbance and glioma diagnosis to identify a new and useful connection which warrants further systematic and scientific examination in preclinical animal models. Confirmation of the relationship between disruption of the sleep centers in the brain and glioma location could have significant implications for diagnostics, treatment, monitoring of metastasis/recurrence, and end-of-life considerations.
Collapse
Affiliation(s)
- JuliAnne E Allgood
- Department of Neuroscience, University of Wyoming, Laramie, WY 82071, USA
| | - Avery Roe
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
| | - Bridger B Sparks
- Department of Neuroscience, University of Wyoming, Laramie, WY 82071, USA
| | - Mercedes Castillo
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
| | - Angel Cruz
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
| | - Amanda E Brooks
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
| | - Benjamin D Brooks
- College of Osteopathic Medicine, Rocky Vista University, Greenwood Village, CO 80112, USA
| |
Collapse
|
3
|
Cognitive-Behavioural Therapy for Type 1 Narcolepsy Comorbid With Sleep and Psychiatric Disturbances: A Case Report. BEHAVIOUR CHANGE 2022. [DOI: 10.1017/bec.2022.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
There is currently a lack of clinical research that would strongly support the application of CBT in the treatment of narcolepsy type 1. Despite that, there are several guidelines that suggest some techniques should be routinely applied. Currently, there is still a lack of results on what to do with patients who have comorbid sleep and psychiatric disorders or other psychosocial comorbidities and problems. This case study concerns a 27-year-old female who had narcolepsy type 1 and history of sleep, psychosocial, and psychiatric problems. Her main problems included cataplexy, daily tiredness and sleepiness, a problem with daily physical activity, and problems in her psychosocial functioning. The patient received 7 session of CBT treatment based on recommended techniques for patients with hypersomnia. Self-reported measure of sleep, anxiety, and depression were collected at the start and 1-month post-treatment. Objective psychological measures recorded positive changes in post-treatment assessment of CBT effect on her sleep pattern, significant reduction of cataplexy, depressive and anxiety symptoms, daily activity, and tiredness during the day.
Collapse
|
4
|
Abstract
Sleep homeostasis is a complex neurobiologic phenomenon involving a number of molecular pathways, neurotransmitter release, synaptic activity, and factors modulating neural networks. Sleep plasticity allows for homeostatic optimization of neural networks and the replay-based consolidation of specific circuits, especially important for cognition, behavior, and information processing. Furthermore, research is currently moving from an essentially brain-focused to a more comprehensive view involving other systems, such as the immune system, hormonal status, and metabolic pathways. When dysfunctional, these systems contribute to sleep loss and fragmentation as well as to sleep need. In this chapter, the implications of neural plasticity and sleep homeostasis for the diagnosis and treatment of some major sleep disorders, such as insomnia and sleep deprivation, obstructive sleep apnea syndrome, restless legs syndrome, REM sleep behavior disorder, and narcolepsy are discussed in detail with their therapeutical implications. This chapter highlights that sleep is necessary for the maintenance of an optimal brain function and is sensitive to both genetic background and environmental enrichment. Even in pathologic conditions, sleep acts as a resilient plastic state that consolidates prior information and prioritizes network activity for efficient brain functioning.
Collapse
|
5
|
Lin CH, Chen CH, Hong SY, Chou IC, Liang SJ, Hang LW. Polysomnography Is an Important Method for Diagnosing Pediatric Sleep Problems: Experience of One Children’s Hospital. CHILDREN 2021; 8:children8110991. [PMID: 34828704 PMCID: PMC8622789 DOI: 10.3390/children8110991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
In this study, we collected and analyzed polysomnography (PSG) data to investigate the value of PSG in diagnosing sleep problems in children. The results of PSG studies of children (<18 years old) with sleep problems conducted from April 2015 to May 2017 at a children’s hospital in Taiwan were collected and analyzed retrospectively. Data for 310 patients (209 males and 101 females) who underwent PSG were collected. The final diagnoses were as follows: obstructive sleep apnea in 159 (51.3%), snoring in 81 (26.4%), limb movement sleep disorder in 25 (8.1%), hypersomnias in 12 (3.9%), central apnea in 8 (2.9%), enuresis in 7 (2.3%), bruxism in 5 (1.6%), sleep terrors in 5 (1.6%), narcolepsy in 3 (1.0%), sleep seizures in 3 (1.0%), sleep walking in 1 (0.3%), and insomnia in 1 (0.3%). PSG may help detect significant sleep-related problems in children and is useful for making therapeutic decisions regarding children. Obstructive sleep apnea syndrome (OSAS) was the primary sleep problem for most of the children (51.3%); however, only 7.4% of them underwent surgery for OSAS. We therefore suggest that children with sleep problems should undergo PSG.
Collapse
Affiliation(s)
- Chien-Heng Lin
- Division of Pediatric Pulmonology, China Medical University Children’s Hospital, Taichung 404327, Taiwan; (C.-H.L.); (C.-H.C.)
- College of Medicine, China Medical University, Taichung 404328, Taiwan;
| | - Chieh-Ho Chen
- Division of Pediatric Pulmonology, China Medical University Children’s Hospital, Taichung 404327, Taiwan; (C.-H.L.); (C.-H.C.)
| | - Syuan-Yu Hong
- College of Medicine, China Medical University, Taichung 404328, Taiwan;
- Division of Pediatric Neurology, China Medical University Children’s Hospital, Taichung 404327, Taiwan;
| | - I-Ching Chou
- Division of Pediatric Neurology, China Medical University Children’s Hospital, Taichung 404327, Taiwan;
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404328, Taiwan
| | - Shinn-Jye Liang
- Sleep Medicine Center, Department of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung 404327, Taiwan;
| | - Liang-Wen Hang
- Sleep Medicine Center, Department of Pulmonary and Critical Care Medicine, China Medical University Hospital, Taichung 404327, Taiwan;
- School of Nursing & Graduate Institute of Nursing, China Medical University, Taichung 404328, Taiwan
- Correspondence:
| |
Collapse
|
6
|
Ghorbani M, Azar M, Bavand K, Shojaei H, Mollahoseini R. Successful microvascular decompression surgery for dolichoectatic vertebral artery compression of medulla oblongata in a patient with hypersomnia disorder. Br J Neurosurg 2019:1-3. [PMID: 31014113 DOI: 10.1080/02688697.2019.1594694] [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: 10/26/2022]
Abstract
INTRODUCTION Hypersomnia is a condition in which a person has trouble staying awake during the day. There are several potential causes of it, including sleep apnea and sleep disorders. CASE PRESENTATION A 43 year old male was referred to our practice with complaints of hypersomnia, snoring, slurred speech and sleep apnea for more diagnostic and therapeutic interventions. His brain MRI was significant for a vascular loop compression on medulla oblongata. The patient underwent microvascular decompression surgery subsequently and showed improvement in all of his symptoms. CONCLUSION One of the rare causes of sleep apnea is medulla oblongata compression by a vascular loop. Vertebrobasilar dolichoectasia may cause this phenomenon probably and should be reviewed in imaging examinations more precisely. Microvascular decompression by using a synthetic Teflon patch may be helpful in management of these patients.
Collapse
Affiliation(s)
- Mohammad Ghorbani
- a Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital , Iran University of Medical Sciences , Tehran , Iran
| | - Maziar Azar
- b Department of Neurosurgery, School of Medicine, Rasoul-e-Akram Hospital , Iran University of Medical Sciences , Tehran , Iran
| | - Karan Bavand
- a Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital , Iran University of Medical Sciences , Tehran , Iran
| | - Hamidreza Shojaei
- a Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital , Iran University of Medical Sciences , Tehran , Iran
| | - Reza Mollahoseini
- a Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital , Iran University of Medical Sciences , Tehran , Iran
| |
Collapse
|
7
|
Ruge M, Skaaby T, Andersson AM, Linneberg A. Cross-sectional analysis of sleep hours and quality with sex hormones in men. Endocr Connect 2019; 8:141-149. [PMID: 30668526 PMCID: PMC6376994 DOI: 10.1530/ec-18-0548] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/22/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Reduced total hours of sleep and low quality of sleep have been suggested to be associated with low levels of male hormones. Few studies have examined the association between excessive sleep and male reproductive hormones. OBJECTIVE To investigate the association of total hours of sleep and quality of sleep with serum levels of total, bioavailable and free testosterone (tT, bT and fT), sex hormone-binding globulin (SHBG) and dehydroepiandrosteron-sulfate (DHEAS). METHODS Serum levels of tT, SHBG and DHEAS were measured with immunoassays in a cross-sectional population-based study of 2095 males. bT and fT were calculated in accordance with Vermeulens method. Information on total hours of sleep and sleep quality was obtained by questionnaire. Linear regression was used to calculate hormones according to total hours of sleep and the results were expressed as β-estimates and 95% confidence intervals (CI). The adjustment in the multivariable models was constructed taking age, BMI, smoking, alcohol intake and physical activity into account. RESULTS Excessive sleep (>9 h) compared to 7-9 h of sleep was significantly associated with lower tT, bT and fT, but not with SHBG or DHEAS, after multivariable adjustment. These significant associations were also found in our analyses with hormones as continuous variables but no associations were found in our general additive model analyses. CONCLUSIONS In this cross-sectional study in men, excessive sleep associated with lower levels of male reproductive hormones. Longitudinal studies are needed to determine the causal direction of the observed association between excessive sleep and lower male reproductive hormones levels.
Collapse
Affiliation(s)
- Morten Ruge
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Tea Skaaby
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Correspondence should be addressed to A-M Andersson:
| | - Allan Linneberg
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
- Department of Clinical Experimental Research, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
8
|
Urbanek JK, Spira AP, Di J, Leroux A, Crainiceanu C, Zipunnikov V. Epidemiology of objectively measured bedtime and chronotype in US adolescents and adults: NHANES 2003-2006. Chronobiol Int 2017; 35:416-434. [PMID: 29283283 DOI: 10.1080/07420528.2017.1411359] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND We propose a method for estimating the timing of in-bed intervals using objective data in a large representative US sample, and quantify the association between these intervals and age, sex, and day of the week. METHODS The study included 11,951 participants 6 years and older from the National Health and Nutrition Examination Survey (NHANES) 2003-2006, who wore accelerometers to measure physical activity for seven consecutive days. Participants were instructed to remove the device just before the nighttime sleep period and put it back on immediately after. This nighttime period of non-wear was defined in this paper as the objective bedtime (OBT), an objectively estimated record of the in-bed interval. For each night of the week, we estimated two measures: the duration of the OBT (OBT-D) and, as a measure of the chronotype, the midpoint of the OBT (OBT-M). We estimated day-of-the-week-specific OBT-D and OBT-M using gender-specific population percentile curves. Differences in OBT-M (chronotype) and OBT-D (the amount of time spent in bed) by age and sex were estimated using regression models. RESULTS The estimates of OBT-M and their differences among age groups were consistent with the estimates of chronotype obtained via self-report in European populations. The average OBT-M varied significantly by age, while OBT-D was less variable with age. In the reference group (females, aged 17-22 years), the average OBT-M across 7 days was 4:19 AM (SD = 30 min) and the average OBT-D was 9 h 19 min (SD = 12 min). In the same age group the average OBT-D was 18 minutes shorter for males than for females, while the average OBT-M was not significantly different between males and females. The most pronounced differences were observed between OBT-M of weekday and weekend nights. In the reference group, compared to the average OBT-M of 3:50 am on Monday through Thursday nights, there was a 57-minute delay in OBT-M on Friday nights (entering the weekend), a 69-minute delay on Saturday nights (staying in the weekend), and a 23-minute delay on Sunday night (leaving the weekend). For both OBT-M and OBT-D, in most age groups and for most days of the week, there were no statistically significant differences between males and females, except for OBT-D on Wednesdays and Thursdays, with males having 31 (p-value < 0.05) and 45 (p-value < 0.05) minutes shorter OBT-D, respectively. CONCLUSIONS The proposed measures, OBT-D and OBT-M, provide useful information of time in bed and chronotype in NHANES 2003-2006. They identify within-week patterns of bedtime and can be used to study associations between the bedtime and the large number of health outcomes collected in NHANES 2003-2006.
Collapse
Affiliation(s)
- Jacek K Urbanek
- a Department of Medicine , Johns Hopkins University School of Medicine , Baltimore , Maryland , US
| | - Adam P Spira
- b Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , US.,c Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, 21287 Johns Hopkins Center on Aging and Health , Baltimore , Maryland , US
| | | | - Andrew Leroux
- d Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , US
| | - Ciprian Crainiceanu
- d Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , US
| | - Vadim Zipunnikov
- d Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , US
| |
Collapse
|
9
|
Klein-Levin syndrome versus bipolar disorder not otherwise specified- diagnostic challenges. Asian J Psychiatr 2017; 28:186-187. [PMID: 28784386 DOI: 10.1016/j.ajp.2017.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/01/2017] [Indexed: 11/22/2022]
Abstract
Hypersomnia presents as excessive daytime sleepiness with a prevalence of 7.1% in general population. Hypersomnia has serious negative effects on persons functioning. The aetiology of hypersomnia can be due to neurological conditions, primary sleep disorders, Substance induced, Psychiatric disorders and idiopathic. Klein-Levin syndrome (KLS) is condition characterised by hypersomnia, hyperphagia and hypersexuality. Among the psychiatric disorders, hypersomnia is seen in bipolar depression. In bipolar disorder, hypersomnia can be present during the depressive episode and also inter-episodically. Here is a case report on hypersomnia and diagnostic challenges.
Collapse
|
10
|
Suzuki Y, Khoury S, El-Khatib H, Chauny JM, Paquet J, Giguère JF, Denis R, Gosselin N, Lavigne GJ, Arbour C. Individuals with pain need more sleep in the early stage of mild traumatic brain injury. Sleep Med 2017; 33:36-42. [DOI: 10.1016/j.sleep.2016.06.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 06/03/2016] [Accepted: 06/06/2016] [Indexed: 10/20/2022]
|
11
|
Trogstad L, Bakken IJ, Gunnes N, Ghaderi S, Stoltenberg C, Magnus P, Håberg SE. Narcolepsy and hypersomnia in Norwegian children and young adults following the influenza A(H1N1) 2009 pandemic. Vaccine 2017; 35:1879-1885. [PMID: 28302408 DOI: 10.1016/j.vaccine.2017.02.053] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 02/20/2017] [Accepted: 02/23/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Associations between influenza infection and sleep disorders are poorly studied. We investigated if pandemic influenza infection or vaccination with Pandemrix in 2009/2010 was associated with narcolepsy or hypersomnia in children and young adults. METHODS We followed the Norwegian population under age 30 from January 2008 through December 2012 by linking national health registry data. Narcolepsy diagnoses were validated using hospital records. Risks of narcolepsy or hypersomnia were estimated as adjusted hazard ratios (HRs) in Cox regression models with influenza infection and vaccination as time-dependent exposures. RESULTS Among the 1,638,526 persons under age 30 in Norway in 2009, 3.6% received a physician diagnosis of influenza during the pandemic, while 41.9% were vaccinated against pandemic influenza. Between October 1st 2009 and December 31st 2012, 72 persons had onset of narcolepsy and 305 were diagnosed with hypersomnia. The risk of a sleep disorder was associated with infection during the first six months, adjusted HR 3.31 with 95% confidence interval [CI], 1.01-10.79 for narcolepsy and adjusted HR 3.13 (95% CI, 1.12-8.76) for hypersomnia. The risk of narcolepsy was strongly associated with vaccination during the first six months adjusted HR 17.21 (95% CI, 6.28-47.14), while the adjusted HR for hypersomnia was 1.54 (95% CI, 0.81-2.93). CONCLUSIONS The study confirms an increased HR of narcolepsy following pandemic vaccination. Slightly increased HRs of narcolepsy and hypersomnia are also seen after influenza infection. However, the role of infection should be viewed with caution due to underreporting of influenza.
Collapse
Affiliation(s)
| | | | - Nina Gunnes
- Norwegian Institute of Public Health, Norway.
| | | | - Camilla Stoltenberg
- Norwegian Institute of Public Health, Norway; University of Bergen, Bergen, Norway.
| | - Per Magnus
- Norwegian Institute of Public Health, Norway; University of Oslo, Oslo, Norway.
| | | |
Collapse
|
12
|
Armstrong TS, Shade MY, Breton G, Gilbert MR, Mahajan A, Scheurer ME, Vera E, Berger AM. Sleep-wake disturbance in patients with brain tumors. Neuro Oncol 2017; 19:323-335. [PMID: 27286798 PMCID: PMC5464298 DOI: 10.1093/neuonc/now119] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/04/2016] [Indexed: 02/07/2023] Open
Abstract
Sleep-wake disturbances are defined as perceived or actual alterations in sleep that result in impaired daytime functioning. Unlike other cancers, there is limited information about sleep-wake disturbances in adults with primary brain tumors throughout the illness trajectory. Sleep-wake disturbance is among the most severe and common symptoms reported by primary brain-tumor patients, particularly those undergoing radiation therapy. As with other cancers and neurologic illness, sleep-wake disturbance may also be clustered or related to other symptoms such as fatigue, depression, and cognitive impairment. There is increasing evidence for a genetic basis of normal sleep and sleep regulation in healthy adults. Specific mutations and single nucleotide variants have been reported to be associated with both fatigue and sleep-wake disorders, and both inflammation and alterations in circadian rhythms have been postulated to have a potential role. Guidelines for assessment and interventions have been developed, with cognitive behavioral therapy, exercise, and sleep hygiene demonstrating benefit in patients with other solid tumors. Further research is needed to identify risk and appropriate treatment in the brain-tumor patient population.
Collapse
Affiliation(s)
| | - Marcia Y Shade
- University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Ghislain Breton
- Department of Integrative Biology, UTHealth McGovern Medical School, Houston, Texas, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Anita Mahajan
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Elizabeth Vera
- University of Texas Health Science Center, Houston, Texas, USA
| | - Ann M Berger
- University of Nebraska Medical Center, Omaha, Nebraska, USA
| |
Collapse
|
13
|
Larson-Prior LJ, Ju YE, Galvin JE. Cortical-subcortical interactions in hypersomnia disorders: mechanisms underlying cognitive and behavioral aspects of the sleep-wake cycle. Front Neurol 2014; 5:165. [PMID: 25309500 PMCID: PMC4160996 DOI: 10.3389/fneur.2014.00165] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/18/2014] [Indexed: 01/01/2023] Open
Abstract
Subcortical circuits mediating sleep–wake functions have been well characterized in animal models, and corroborated by more recent human studies. Disruptions in these circuits have been identified in hypersomnia disorders (HDs) such as narcolepsy and Kleine–Levin Syndrome, as well as in neurodegenerative disorders expressing excessive daytime sleepiness. However, the behavioral expression of sleep–wake functions is not a simple on-or-off state determined by subcortical circuits, but encompasses a complex range of behaviors determined by the interaction between cortical networks and subcortical circuits. While conceived as disorders of sleep, HDs are equally disorders of wake, representing a fundamental instability in neural state characterized by lapses of alertness during wake. These episodic lapses in alertness and wakefulness are also frequently seen in neurodegenerative disorders where electroencephalogram demonstrates abnormal function in cortical regions associated with cognitive fluctuations (CFs). Moreover, functional connectivity MRI shows instability of cortical networks in individuals with CFs. We propose that the inability to stabilize neural state due to disruptions in the sleep–wake control networks is common to the sleep and cognitive dysfunctions seen in hypersomnia and neurodegenerative disorders.
Collapse
Affiliation(s)
- Linda J Larson-Prior
- Department of Radiology, Washington University School of Medicine , St. Louis, MO , USA ; Department of Neurology, Washington University School of Medicine , St. Louis, MO , USA
| | - Yo-El Ju
- Department of Neurology, Washington University School of Medicine , St. Louis, MO , USA
| | - James E Galvin
- Departments of Neurology, New York University Langone School of Medicine , New York, NY , USA ; Department of Psychiatry, New York University Langone School of Medicine , New York, NY , USA ; Department of Population Health, New York University Langone School of Medicine , New York, NY , USA
| |
Collapse
|
14
|
Patterson KC, Huang F, Oldham JM, Bhardwaj N, Hogarth DK, Mokhlesi B. Excessive daytime sleepiness and obstructive sleep apnea in patients with sarcoidosis. Chest 2013; 143:1562-1568. [PMID: 23258454 DOI: 10.1378/chest.12-1524] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Systemic symptoms are common in sarcoidosis and are associated with a decreased quality of life. Excessive daytime sleepiness (EDS) often is associated with obstructive sleep apnea (OSA) but may be a systemic symptom independently associated with sarcoidosis. The aim of this study was to assess the relationship between sarcoidosis and EDS. METHODS In a retrospective analysis, we used Epworth Sleepiness Scale scores to compare sleepiness in 62 patients with sarcoidosis with 1,005 adults without sarcoidosis referred for polysomnography for suspicion of OSA. Linear regression models controlled for covariates. In a subgroup analysis of patients with sarcoidosis, sleepiness scores and polysomnograms were compared between those with normal and those with abnormal pulmonary function based on total lung capacity. RESULTS EDS was more common in patients with sarcoidosis than in those without, and sarcoidosis remained an independent predictor of increased sleepiness after controlling for covariates. Compared with control patients referred for polysomnography, fewer patients with sarcoidosis had clinically significant OSA. However, among patients with sarcoidosis, OSA was more severe in those with abnormal lung function. CONCLUSIONS Sarcoidosis is independently associated with EDS. Sleepiness may contribute to the morbidity of sarcoidosis and should be followed even after treating for potentially coexisting OSA or depression. Abnormal lung function in sarcoidosis may contribute to OSA, although the mechanisms for this are not known.
Collapse
Affiliation(s)
- Karen C Patterson
- Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL.
| | - Frank Huang
- Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL
| | - Justin M Oldham
- Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL
| | - Nakul Bhardwaj
- Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL
| | - D Kyle Hogarth
- Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL
| | - Babak Mokhlesi
- Section of Pulmonary and Critical Care, The University of Chicago, Chicago, IL; University of Chicago Sleep Disorders Center, The University of Chicago, Chicago, IL
| |
Collapse
|
15
|
Walz JC, Magalhães PV, Reckziegel R, Costanzi M, Giglio L, Kapczinski F. Daytime sleepiness, sleep disturbance and functioning impairment in bipolar disorder. Acta Neuropsychiatr 2013; 25:101-4. [PMID: 25287311 DOI: 10.1111/j.1601-5215.2012.00673.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To verify the prevalence and clinical impact of excessive daytime sleepiness (EDS) in outpatients with bipolar disorder. METHODS Eighty-one outpatients with bipolar disorder and 79 healthy control subjects were recruited. Patients were required not to be acutely manic or depressed. We used the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index and the Functioning Assessment Short Test to assess sleepiness, sleep problems and functioning, respectively. RESULTS Patients had a higher prevalence of sleepiness (40%) than the control group (18%). Sleepiness and sleep disturbance had independent impacts on disability in the multivariable model. CONCLUSIONS This study suggests that EDS is a relevant clinical dimension in patients with bipolar disorder. It is a frequent symptom that often overlaps with other sleep disturbances. This study also reveals that once present it has the potential to increase functional impairment.
Collapse
Affiliation(s)
- Julio C Walz
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pedro V Magalhães
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ramiro Reckziegel
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Monise Costanzi
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Larriany Giglio
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávio Kapczinski
- 1 Bipolar Disorders Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
16
|
Gruber J, Harvey AG, Wang PW, Brooks JO, Thase ME, Sachs GS, Ketter TA. Sleep functioning in relation to mood, function, and quality of life at entry to the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). J Affect Disord 2009; 114:41-9. [PMID: 18707765 PMCID: PMC2677624 DOI: 10.1016/j.jad.2008.06.028] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2008] [Revised: 06/20/2008] [Accepted: 06/20/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sleep disturbance in bipolar disorder can be both a risk factor and symptom of mood episodes. However, the associations among sleep and clinical characteristics, function, and quality of life in bipolar disorder have not been fully investigated. METHODS The prevalence of sleep disturbance, duration, and variability, as well as their associations with mood, function, and quality of life, was determined from 2024 bipolar patients enrolled in the National Institute of Mental Health Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). RESULTS Analyses indicated that 32% of patients were classified as short sleepers, 38% normal sleepers, and 23% long sleepers. Overall, short sleepers demonstrated greater mood elevation, earlier age at onset, and longer illness duration compared to both normal and long sleepers. Both short and long sleepers had greater depressive symptoms, poorer life functioning, and quality of life compared to normal sleepers. DISCUSSION Short sleep duration in bipolar disorder was associated with a more severe symptom presentation, whereas both short and long sleep duration are associated with poorer function and quality of life compared to normal sleep duration. Sleep disturbance could be a trait marker of bipolar disorder, though longitudinal assessments are warranted to assess potential causal relations and the longer-term implications of sleep disturbance in bipolar disorder.
Collapse
Affiliation(s)
- June Gruber
- Department of Psychology, University of California, Berkeley
| | | | - Po W. Wang
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | - John O. Brooks
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
- Palo Alto Veterans Affairs Health Care System
| | - Michael E. Thase
- Bipolar Clinic and Research Program, Massachusetts General Hospital
| | - Gary S. Sachs
- Bipolar Clinic and Research Program, Massachusetts General Hospital
| | - Terence A. Ketter
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| |
Collapse
|
17
|
Decker MJ, Lin JMS, Tabassum H, Reeves WC. Hypersomnolence and sleep-related complaints in metropolitan, urban, and rural Georgia. Am J Epidemiol 2009; 169:435-43. [PMID: 19066308 PMCID: PMC2640164 DOI: 10.1093/aje/kwn365] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Persistent daytime hypersomnolence is associated with significant morbidity and mortality, but its prevalence in the population has been poorly documented. This study sought to characterize the prevalence of persistent daytime hypersomnolence, difficulties initiating and maintaining sleep, unrefreshing sleep, snoring, and the presence of physician-diagnosed sleep disorders in metropolitan, urban, and rural US Georgia populations. Between September 2004 and July 2005, a total of 6,530 randomly selected well and unwell adults, identified by screening interviews of 10,837 households (contacted by random digit dialing), completed a detailed phone interview. Sixteen percent reported persistent problems staying awake during the day; 26% reported persistent problems falling asleep at night; 31% experienced problems sleeping through the night; 34% were bothered by unrefreshing sleep; and 33% reported that they snored. In spite of the high occurrence of reported persistent sleep problems, only 10% of the survey participants reported having been diagnosed with a sleep disorder. These study findings highlight the need for increased public and clinician awareness with respect to proactively indentifying signs and symptoms of sleep disorders, a better understanding of their adverse impact upon morbidity and mortality, and their negative impact upon socioeconomic and academic potential.
Collapse
Affiliation(s)
- Michael J Decker
- Chronic Viral Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
| | | | | | | |
Collapse
|
18
|
Ursavaş A, Karadag M, Burgazlioglu B, Coşkun F, Ceylan E, Onart S, Gozu RO. Relief from sleep apnea after radiation and chemotherapy. Clin Lung Cancer 2007; 8:502-3. [PMID: 17922976 DOI: 10.3816/clc.2007.n.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Superior vena cava syndrome (SVCS) can result from extrinsic compression by a primary tumor, mediastinal lymph nodes metastases, benign lesions, or intraluminal thrombosis. The association between obstructive sleep apnea and SVCS has not been extensively evaluated. To our knowledge, only 5 cases of obstructive sleep apnea in SVCS have been reported in the literature. We presented a 53-year-old man who was admitted with dyspnea, edema of the face, and excessive daytime sleepiness. Chest radiography and computed tomography revealed lung cancer. A biopsy of the tumor revealed squamous cell carcinoma. Obstructive sleep apnea was diagnosed by polysomnography (apnea hypopnea index: 13 per hour). After radiation and chemotherapy, edema of the face, snoring, and daytime sleepiness were alleviated, and the patient's apnea hypopnea index decreased to 0.6 per hour. In conclusion, there is a relationship between obstructive sleep apnea and SVCS.
Collapse
Affiliation(s)
- Ahmet Ursavaş
- Department of Pulmonary Medicine, School of Medicine, University of Uludag, Bursa, Turkey.
| | | | | | | | | | | | | |
Collapse
|