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Fjell AM, Walhovd KB. Individual sleep need is flexible and dynamically related to cognitive function. Nat Hum Behav 2024; 8:422-430. [PMID: 38379065 DOI: 10.1038/s41562-024-01827-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/15/2024] [Indexed: 02/22/2024]
Abstract
Given that sleep deprivation studies consistently show that short sleep causes neurocognitive deficits, the effects of insufficient sleep on brain health and cognition are of great interest and concern. Here we argue that experimentally restricted sleep is not a good model for understanding the normal functions of sleep in naturalistic settings. Cross-disciplinary research suggests that human sleep is remarkably dependent on environmental conditions and social norms, thus escaping universally applicable rules. Sleep need varies over time and differs between individuals, showing a complex relationship with neurocognitive function. This aspect of sleep is rarely addressed in experimental work and is not reflected in expert recommendations about sleep duration. We recommend focusing on the role of individual and environmental factors to improve our understanding of the relationship between human sleep and cognition.
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Affiliation(s)
- Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway.
- Center for Computational Radiology and Artificial Intelligence, Oslo University Hospital, Oslo, Norway.
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Center for Computational Radiology and Artificial Intelligence, Oslo University Hospital, Oslo, Norway
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Chambe J, Reynaud E, Maruani J, Fraih E, Geoffroy PA, Bourgin P. Light therapy in insomnia disorder: A systematic review and meta-analysis. J Sleep Res 2023; 32:e13895. [PMID: 37002704 DOI: 10.1111/jsr.13895] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
In the management of insomnia, physicians and patients are seeking alternative therapeutics to sleeping pills, in addition to sleep hygiene and cognitive behavioural therapy. Bright light therapy (LT) has proven its efficacy in circadian and mood disorders. We conducted a systematic literature review and meta-analysis according to Cochrane and PRISMA guidelines and using the databases Medline, Cochrane, and Web of Science, with a special focus on light therapy and insomnia. Twenty-two studies with a total of 685 participants were included, five of which with a high level of proof. Meta-analysis was performed with 13 of them: light therapy for insomnia compared with control conditions significantly improved wake after sleep onset (WASO: SMD = -0.61 [-1.11, -0.11]; p = 0.017; weighted difference of 11.2 min ±11.5 based on actigraphy, and SMD = -1.09 [-1.43, -0.74] (p < 0.001) weighted difference of -36.4 min ±15.05) based on sleep diary, but no other sleep measures such as sleep latency, total sleep time (TST), or sleep efficiency. Qualitative analysis of the review showed some improvement mainly in subjective measures. Morning light exposure advanced sleep-wake rhythms and evening exposure led to a delay. No worsening was observed in objective nor subjective measures, except for TST in one study with evening exposure. A light dose-response may exist but the studies' heterogeneity and publication bias limit the interpretation. To conclude, light therapy shows some effectiveness for sleep maintenance in insomnia disorders, but further research is needed to refine the light parameters to be chosen according to the type of insomnia, in the hope of developing personalised therapeutics.
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Affiliation(s)
- Juliette Chambe
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
- Institute for Cellular and Integrative Neurosciences (INCI), CNRS UPR 3212, Strasbourg, France
| | - Eve Reynaud
- Institute for Cellular and Integrative Neurosciences (INCI), CNRS UPR 3212, Strasbourg, France
| | - Julia Maruani
- Psychiatry and Addictology Department, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat, Paris, France
- GHU Paris - Psychiatry & Neurosciences, Paris, France
- Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
| | - Elise Fraih
- General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Pierre A Geoffroy
- Institute for Cellular and Integrative Neurosciences (INCI), CNRS UPR 3212, Strasbourg, France
- Psychiatry and Addictology Department, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat, Paris, France
- GHU Paris - Psychiatry & Neurosciences, Paris, France
- Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
| | - Patrice Bourgin
- Institute for Cellular and Integrative Neurosciences (INCI), CNRS UPR 3212, Strasbourg, France
- Sleep Disorders Center - CIRCSom (International Research Center for ChronoSomnology), University Hospital of Strasbourg 1, Strasbourg, France
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Season is related to the slow wave and sigma activity of infants and toddlers. Sleep Med 2022; 100:364-377. [PMID: 36201888 DOI: 10.1016/j.sleep.2022.09.006] [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: 05/29/2022] [Revised: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE/BACKGROUND Slow wave activity (SWA) and sigma frequency activity (SFA) are hallmarks of NREM sleep EEG and important indicators of neural plasticity, development of the central nervous system, and cognition. However, little is known about the factors that modulate these sleep EEG activities, especially in small children. PATIENTS/METHODS We analyzed the power spectral densities of SWA (1-4 Hz) and SFA range (10-15 Hz) from six EEG derivations of 56 infants (8 months) and 60 toddlers (24 months) during their all-night sleep and during the first and the last half of night sleep. The spectral values were compared between the four seasons. RESULTS In the spring group of infants, compared with the darker seasons, SFA was lower in the centro-occipital EEG derivations during both halves of the night. The SWA findings of the infants were restricted to the last half of the night (SWA2) and frontally, where SWA2 was higher during winter than spring. The toddlers presented less frontal SWA2 during winter compared with autumn. Both age groups showed a reduction in both SWA and SFA towards the last half of the night. CONCLUSIONS The sleep EEG spectral power densities are more often associated with seasons in infants' SFA range. The results might stem from seasonally changing light exposure, but the exact mechanism warrants further study. Moreover, contrary to the adult-like increment of SFA, the SFA at both ages was lower at the last part of the night sleep. This suggests different regulation of spindle activity in infants and toddlers.
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