Psychological Profile and Distinct Salivary Cortisol Awake Response (CAR) in Two Different Study Populations with Obstructive Sleep Apnea (OSA) and Central Serous Chorioretinopathy (CSC)

The association between sedentary behavior and obstructive sleep apnea: a cross-sectional study from the NHANES (2007-2008 to 2015-2020)

BACKGROUND

Sedentary behavior (SB) may contribute to obesity and lower extremity fluid retention, which may favor the development of obstructive sleep apnea (OSA). However, linking sedentary behavior to OSA is unclear. The purpose of this study was to determine if there is an association between SB and OSA.

METHODS

Three typical questions in the NHANES questionnaire(①The frequency of feeling excessively sleepy per month. ②The frequency of gasping, snorting or stopping breathing per week. ③The frequency of snoring per week.) have been used for the assessment of OSA. A physical activity questionnaire(On a typical day, the amount of time you spend sitting or reclining.) was used to assess SB. This secondary analysis included National Health and Nutrition Examination Survey (NHANES) participants (unweighted = 20,115). Weighted sample and multiple logistic regression complex sample analysis techniques were used in this study.

RESULTS

After adjustment for confounders, participants with SB(> 8 h/d) had a higher risk of OSA compared to SB(< 4 h/d). Stratified analysis by gender showed that there was no significant association of SB and OSA in men. However, in women, with SB(< 4 h/d) as the reference, participants with(≥ 4 h/d) had an increased risk of OSA. By age-stratified analysis, the association of SB with OSA was stronger among older participants.

CONCLUSION

Analysis in this study showed a positive association between SB and OSA, more pronounced in women and participants older than 60 years old.

The mediating effect of personality on mental workload and perceived professional benefits of nurses in East China

BACKGROUND

Nursing work is a work with high-stress load, and nurses with different personality may have different subjective feelings about their workload. Therefore, it is particularly necessary to comprehend the perceived professional benefits of nurses engaged in nursing work under high-pressure background, especially during the epidemic period. This study explored the relationship between mental workload, personality, and perceived professional benefits of nurses, and offer advices for the intervention of nurses with different personality to improve their perceived professional benefits.

MATERIALS AND METHODS

In this study, we used a cross-sectional study with a convenient sampling. 473 in-service nurses in Class A tertiary hospitals of Zhejiang Province were recruited by using the NASA Mission Load Index scale of nurses, the brief version of China's Big Five Personality Questionnaire, and the Nurses' perceived professional benefits questionnaire from July 2020 to March 2021. Sample size is 54.91%, and the response rate is 100%. Cronbach's alpha method was used to evaluate the reliability of the instruments. Descriptive statistical analysis was used to describe the socio-demographic data of the subject, and scores for research variables. The Mann-Whitney U-test, and Kruskal-Wallis H rank-sum test were used to compare the scores of perceived professional benefits with different demographic characteristics. Correlation analysis results were presented as the Spearman correlation coefficient. The plug-in v2.16.3 provided by SPSS software was used for linear regression analysis, and the deviation-corrected percentile Bootstrap method was used to examine the mediating role of personality (neuroticism, conscientiousness, agreeableness, openness and extroversion).

RESULTS

Age, length of service in nursing, and record of formal schooling can affect nurses' perceived professional benefits. Mental workload, and perceived professional benefits were all above the median value. The mental workload was negatively correlated with perceived professional benefits (r= -0.129, P < 0.01), positively correlated with neuroticism (r = 0.242, P < 0.01), negatively correlated with agreeableness, openness, extroversion (r=-0.229~-0.221, P < 0.01), and negatively correlated with conscientiousness, but the differences were not significant. Nurses' perceived professional benefits were negatively correlated neuroticism (r=-0.109, P < 0.05), but positively associated with conscientiousness, agreeableness, openness, and extroversion (r = 0.098 ~ 0.326, P < 0.05). The mental workload can directly affect the perceived professional benefits in the direct effects, and can also affect the it through the mediating effect of agreeableness, extroversion, neuroticism, and openness.

CONCLUSIONS

Age, length of service in nursing, and record of formal schooling could affect nurses' perceived professional benefits, and personality played a partial mediating role in the influence of mental workload on the perceived professional benefits. The results of this study can provide strategies for nurses' human resource management. According to different demographic factors, and personality, various measures should be taken to guide nurses to evaluate the mental workload correctly, reduce their emotional pressure, increase job resources, and improve their perceived professional benefits.

Mild to Moderate Sleep Restriction Does Not Affect the Cortisol Awakening Response in Healthy Adult Males

The cortisol awakening response (CAR) is a distinct rise in cortisol that occurs upon awakening that is thought to contribute to arousal, energy boosting, and anticipation. There is some evidence to suggest that inadequate sleep may alter the CAR, but the relationship between sleep duration and CAR has not been systematically examined. Healthy males (n = 111; age: 23.0 ± 3.6 yrs) spent 10 consecutive days/nights in a sleep laboratory. After a baseline night (9 h time in bed), participants spent either 5 h (n = 19), 6 h (n = 23), 7 h (n = 16), 8 h (n = 27), or 9 h (n = 26) in bed for seven nights, followed by a 9 h recovery sleep. The saliva samples for cortisol assay were collected at 08:00 h, 08:30 h and 08:45 h at baseline, on experimental days 2 and 5 and on the recovery day. The primary dependent variables were the cortisol concentration at awakening (08:00 h) and the cortisol area under the curve (AUC). There was no effect of time in bed on either the cortisol concentration at awakening or cortisol AUC. In all the time in bed conditions, the cortisol AUC tended to be higher at baseline and lower on experimental day 5. Five consecutive nights of mild to moderate sleep restriction does not appear to affect the CAR in healthy male adults.

Exploring the relationship of sleep, cognition, and cortisol in sickle cell disease

Background

Neurocognitive impairment is common in people with Sickle Cell Disease (SCD) and evidence is accumulating that sleep disturbances play a role. The interaction between cortisol and sleep in the general population is associated with cognition as well as general wellbeing but there are few data in SCD. We aimed to understand the relationship between cortisol and sleep in individuals with SCD and explored associations with cognition.

Methods

Forty-five participants of black heritage (SCD: N = 27, 9–29 years, 16 females; Controls: N = 18, 11–25 years, 13 females) were recruited from the community between 2018 - 2020. Participants completed standardized questionnaires about their sleep behaviour and wore actigraphy MotionWatch8 for 7 nights to assess nocturnal sleep patterns. Salivary cortisol samples were taken on wakening and 3 times after 14:00. Cognition was assessed using the Wechsler Intelligence Scales for children and adults.

Results

People with SCD took longer to fall asleep and experienced greater wake bouts, mobile minutes and fragmented sleep compared to controls. Although non-significant, people with SCD experienced lower morning cortisol, with a flattened diurnal cortisol ratio compared to controls. Interestingly, SCD participants, but not controls, with low diurnal variation scored lowest on processing speed (PSI) and perceptual reasoning index (PRI). A moderator analysis revealed that the effect of morning cortisol and diurnal cortisol ratio on PRI by group health (i.e., SCD and healthy controls) depended on sleep quality.

Discussion

Sleep and cortisol may play a crucial role in the expression of cognitive difficulties seen in SCD. This should be considered for the development of interventions to optimise cognitive functioning and sleep. This, in turn, could positively impact on secretion of cortisol and general health in SCD.

•

We examined sleep patterns, cortisol and cognition in 27 participants with Sickle Cell Disease (SCD) and 18 healthy controls.

•

People with SCD had lower cognitive scores compared to healthy controls.

•

People with SCD took longer to fall asleep, had greater wake bouts, mobile minutes, and fragmented sleep.

•

People with SCD experienced a flattened diurnal cortisol profile.

•

Sleep disturbances might interfere with diurnal cortisol rhythm and contribute to lower cognitive scores .

Sharing the Same Perspective. Mental Disorders and Central Serous Chorioretinopathy: A Systematic Review of Evidence from 2010 to 2020

Background: The relevance of the association between mental disorders and other conditions might have been underestimated due to its complexity. Central Serous Chorioretinopathy (CSC) is an ophthalmological disorder associated with many psychiatric factors. The aim of this systematic review is to evaluate the association between mental disorders and CSC. Methods: Articles about studies performed on humans on CSC published in peer-reviewed journals from 1 January 2010 to 31 December 2020 were included in the review. Results: We selected 21 research papers. Nine studies measured stress and anxious depressive symptoms, which are associated with CSC onset and recurrences, emerging as a state marker of the disease. Four out of the five studies focused on sleep disorders suggested a reliable association with CSC. Four studies evaluated other various psychiatric factors. The role of psychopharmacological medication has still not been elucidated (three studies). Conclusion: Multiple pieces of evidence highlights that CSC might arise in the context of systemic disease. This notion, together with the increasing evidence supporting a link between psychiatric disorders and choroidal thickness, suggests that CSC and mental disorders may share some etiopathogenetic pathways. Further research is needed to better investigate possible common etiopathogenetic pathways, especially vascular, immunological and endocrinological systems.

Exploring the Biopsychosocial Pathways Shared by Obstructive Sleep Apnea (OSA) and Central Serous Chorioretinopathy (CSC): A Literature Overview

This study addressed the following question: “Is it possible to highlight the link between obstructive sleep apnea (OSA) and central serous chorioretinopathy (CSC) through common biopsychosocial pathogenetic pathways?”. The study was conducted through electronic searches of the PubMed, Web of Science, and Scopus databases. All relevant selected human research studies published from January 2003 to December 2020 were included. The scientific literature search was performed through repeated use of the words “OSA” and/or “acute/chronic CSC” paired with “biomedical/biopsychosocial illness model”, “psychopathology”, “stress”, “personality characteristics”, “functional diseases”, “comorbidity”, and “quality of life” in different combinations. Our literature search identified 213 reports, of which 54 articles were ultimately reviewed in this paper. Taken together, the results indicate that there is a cross-link between OSA and CSC that can be classified among biopsychological disorders in which various major biological variables integrate with psychological-functional and sociological variables; many of these variables appear in both diseases. This concept can have important implications for improving patients’ quality of life, thus providing the necessary strategies to cope with challenging life events even through nonpharmacological approaches.