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Pignatiello GA, Griggs S, Hoffer SA, Hickman RL. Multidimensional Sleep Health in Surrogate Decision-Makers of Critically Ill Patients. Am J Crit Care 2024; 33:468-472. [PMID: 39482083 DOI: 10.4037/ajcc2024174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2024]
Abstract
BACKGROUND Supporting the sleep health of surrogate decision-makers of patients in the intensive care unit is a research priority. However, few studies have approached sleep health as a multidimensional construct, instead focusing on 1 or 2 dimensions in isolation. OBJECTIVE To holistically examine the sleep health (satisfaction, timing, efficiency, duration) of surrogate decision-makers of critically ill patients. METHODS This secondary analysis involved surrogate decision-makers of incapacitated intensive care unit patients at a tertiary medical center in northeastern Ohio (n = 19). Sleep-health data were captured by means of a subjective scale (satisfaction) and objectively (timing, efficiency, duration) by means of a wrist-worn accelerometer (Actiwatch Spectrum Plus; Philips Respironics). Upon enrollment, participants completed the satisfaction scale and wore the Actiwatch Spectrum Plus for 3 consecutive days. Descriptive statistics of the study variables were evaluated. RESULTS A minority (15%) of the sample reported poor sleep satisfaction. Sleep timing variables were comparable to those found in other adult studies. Participants averaged approximately 6 hours of sleep per day with an average sleep efficiency of 83.7%. CONCLUSIONS Despite adequate satisfaction scores, intensive care unit surrogate decision-makers' sleep duration is inadequate and sleep efficiency is suboptimal. Sleep-health interventions may be needed in this at-risk population. Future research should consider the impact of surrogate decision-maker sleep health on their capacity to serve in the surrogate decision-maker role.
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Affiliation(s)
- Grant A Pignatiello
- Grant A. Pignatiello is an assistant professor at the Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
| | - Stephanie Griggs
- Stephanie Griggs is an associate professor at the Frances Payne Bolton School of Nursing, Case Western Reserve University
| | - Seth Alan Hoffer
- Seth Alan Hoffer is a professor of neurological surgery and neurology at the School of Medicine, Case Western Reserve University, and University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Ronald L Hickman
- Ronald L. Hickman, Jr, is the Ruth M. Anderson Endowed Professor and Associate Dean for Research at the Frances Payne Bolton School of Nursing, Case Western Reserve University
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Li L, Wang C, Wang D, Li H, Zhang S, He Y, Wang P. Optimal exercise dose and type for improving sleep quality: a systematic review and network meta-analysis of RCTs. Front Psychol 2024; 15:1466277. [PMID: 39421847 PMCID: PMC11484100 DOI: 10.3389/fpsyg.2024.1466277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 09/23/2024] [Indexed: 10/19/2024] Open
Abstract
Background A substantial amount of research has explored the intricate relationship between exercise and sleep quality, consistently confirming that exercise can effectively enhance sleep quality. Nevertheless, previous studies have yet to conclusively determine which specific exercise program is most efficacious in improving sleep quality. To address this gap, the present study systematically evaluated the differential effects of various types of exercise, as well as exercise dosages (including duration, intervention period, frequency, and intensity), on sleep outcomes using a network meta-analysis approach. This endeavor aims to provide evidence-based support for the development of scientifically effective exercise programs tailored to improve sleep quality. Methods Through the Web of Science, PubMed, Cochrane Library, Embase, and Scopus databases, we conducted a search for randomized controlled trials investigating the effects of exercise interventions on sleep, with a search cutoff date of April 30, 2024. We rigorously selected the literature according to the PICOS principle, and two independent researchers extracted the data. We would like to change this passage to: Bias risk assessment was conducted using the RevMan 5.4 software, and traditional meta-analysis and network meta-analysis were performed using Stata 17.0 software to generate forest plots, network evidence plots, and funnel plots. Furthermore, we adopted the surface under the cumulative ranking curve (SUCRA) to evaluate and rank the intervention effects of different exercise types and dosages on sleep quality. To verify the robustness of our study results, we performed a sensitivity analysis using the leave-one-out method. Results The study strictly adhered to the PRISMA guidelines and included 58 RCT papers with a total of 5,008 participants. The network meta-analysis revealed significant variations in the impact of exercise frequency on sleep outcomes when compared to the control group. Interventions of 1-2 times per week [SMD = -0.85, 95% CI (-1.43, -0.26)], 3 times per week [SMD = -0.45, 95% CI (-0.80, -0.11)], and 4 times per week [SMD = -1.09, 95% CI (-1.92, -0.26)] demonstrated the most notable effects. Interventions lasting ≤30 min and 60-65 min were significantly more effective than the control group, with ≤30 min proving significantly more effective than 40-55 min [SMD = 0.75, 95% CI (0.01, 1.49)]. Interventions lasting 9-10 weeks [SMD = -1.40, 95% CI (-2.37, -0.44)], 12-16 weeks [SMD = -0.55, 95% CI (-0.90, -0.20)], and ≥ 24 weeks [SMD = -0.71, 95% CI (-1.31, -0.10)] were all significantly more effective than the control group. Additionally, the 9-10 weeks intervention period was found to be significantly more effective than the 6-8 weeks period [SMD = -1.21, 95% CI (-2.37, -0.04)]. Furthermore, interventions of moderate intensity [SMD = -1.06, 95% CI (-1.52, -0.61)] and high intensity [SMD = -1.48, 95% CI (-2.55, -0.40)] exercise interventions yielded significantly greater benefits compared to the control group. Specifically, high intensity interventions [SMD = -1.97, 95% CI (-3.37, -0.56)] and moderate intensity [SMD = -1.55, 95% CI (-2.57, -0.54)] exercise interventions were found to be significantly more effective than moderate-high intensity interventions. In terms of exercise types, aerobic exercise [SMD = -0.56, 95% CI (-0.86, -0.27)], traditional Chinese exercises [SMD = -0.57, 95% CI (-0.97, -0.18)], and combined exercise [SMD = -0.99, 95% CI (-1.66, -0.32)] interventions all produced significant improvements compared to the control group. The study determined that the most effective combination of exercise prescription elements for enhancing sleep quality includes a frequency of 4 times per week (SUCRA = 84.7), a duration of ≤30 min (SUCRA = 92.2), a period of 9-10 weeks (SUCRA = 89.9), and high-intensity (SUCRA = 92.9) combined exercise (SUCRA = 82.7). Conclusion The current evidence indicates that combined exercise with a frequency of 4 times per week, a duration of ≤30 min, a period of 9-10 weeks, and high intensity is most effective for improving sleep quality. Nevertheless, due to the limited number of studies included, further research is needed to enhance the reliability of the findings. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42024555428.
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Affiliation(s)
- Li Li
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Chunxiao Wang
- School of Sport Science and Health, University of Harbin Sport, Harbin, China
| | - Dandan Wang
- School of Sport Science and Health, University of Harbin Sport, Harbin, China
| | - Hua Li
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Shuai Zhang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Yuanchun He
- Physical Education Department of Xiamen University, Xiamen, China
| | - Ping Wang
- Postgraduate School, University of Harbin Sport, Harbin, China
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Fucà E, Guerrera S, Falvo S, Sestito S, De Rose P, Vicari S. Characterization of sleep difficulties in maltreated children and adolescents. Eur J Pediatr 2024; 183:4445-4455. [PMID: 39133304 DOI: 10.1007/s00431-024-05718-w] [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: 02/01/2024] [Revised: 05/03/2024] [Accepted: 08/05/2024] [Indexed: 08/13/2024]
Abstract
Numerous studies have identified connections between child maltreatment and sleep-related issues. However, poor is known on potential links between sleep patterns and day-to-day functioning, along with psychopathology in maltreated youths. Additionally, existing research on the relationship between sleep difficulties and maltreatment often lacks investigation into specific sleep difficulty profiles across different age ranges. The current study aimed to determine the prevalence of diverse sleep disturbance profiles in a sample of maltreated children and adolescents, exploring distinct sleep disorder profiles based on sex, age, and the type of maltreatment experienced. Potential variations in adaptive and psychopathological profiles between maltreated children with and without sleep disturbances were also explored. This retrospective study included 91 children and adolescents (56% males, 44% females), aged 6 to 17, with a history of maltreatment (physical maltreatment, sexual abuse, psychological abuse, or neglect), referring for a neuropsychiatric and psychological evaluation at a pediatric hospital. Data were obtained through a retrospective file review. Sleep difficulties were measured through the Sleep Disturbance Scale for Children; cognitive abilities, adaptive skills, and emotional and behavioral features were also investigated. Among maltreated youth, difficulties in initiating and maintaining sleep were the most frequently observed by caregivers. Poor sex differences emerged, whereas adolescents exhibited more daytime somnolence than school-age children. Children with sleep difficulties exhibited more anxiety symptoms and worse global functioning in comparison with children without sleep difficulties.Conclusion: Considering the vital impact of sleep quality on healthy development, practitioners should offer tailored services to child maltreatment victims. Enhancing the sleep quality of these children could help foster their resilience.
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Affiliation(s)
- Elisa Fucà
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Silvia Guerrera
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefania Falvo
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Simona Sestito
- Life Sciences and Public Health Department, Catholic University, Rome, Italy
| | - Paola De Rose
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Life Sciences and Public Health Department, Catholic University, Rome, Italy
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Yeo Y, Wong JCM, Pereira TLB, Shorey S. A qualitative systematic review of adolescent's perceptions of sleep: Awareness of, barriers to and strategies for promoting healthy sleep patterns. J Clin Nurs 2024; 33:4124-4137. [PMID: 39119732 DOI: 10.1111/jocn.17401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 07/21/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024]
Abstract
AIMS To consolidate adolescents' perspectives regarding various aspects of sleep and offer insights to promote healthier sleep habits during their critical developmental years. METHODS/DATA SOURCES Six electronic databases (PubMed, CINAHL, Embase, Scopus, PsycINFO and Web of Science) were searched from their inception dates to June 2023. Data were extracted and meta-summarised using Sandelowski and Barroso's approach and synthesised using Thomas and Harden's thematic analysis framework. RESULTS Meta-synthesis from 11 peer-reviewed published studies identified four main themes: (1) Awareness and understanding of sleep's significance, (2) The shadows and radiance of slumber, (3) Traversing the sleepscape: trouble bubbles and (4) Illuminating the path: Guiding lights to enhanced sleep. CONCLUSION/IMPLICATIONS Our review findings suggest a lack of awareness and guidance regarding the significance of sleep and the cultivation of good sleep habits among adolescents. Identified barriers to adequate sleep encompass various factors, including overthinking, poor habits, family/environmental influences, extensive technology use, peer pressure, the fear of missing out, academic demands and involvement in extracurricular activities. Strategies to improve adolescents' sleep health involve multiple sleep strategies, including sleep education, workshops/seminars, parental involvement, incorporating digital well-being practices, the promotion of relaxation techniques and the provision of essential resources. Prioritising sleep health and implementing targeted interventions are key steps to empower adolescents, create supportive environments and shape a healthier future generation. Future research endeavours should focus on evaluating the effectiveness of interventions and exploring the influence of cultural factors. IMPACT There exists a notable lack of awareness and guidance regarding the significance of sleep and the cultivation of good sleep habits among adolescents. Barriers to achieving adequate sleep among adolescents include overthinking, poor habits, family/environmental influences, extensive technology use, peer pressure, the fear of missing out, academic demands and involvement in extracurricular activities. The collaboration between healthcare institutions, professionals and educational institutions is crucial to facilitate (1) the implementation of sleep education workshops/seminars targeting adolescents, (2) increased parental involvement and role-modelling to instil good sleep practices among adolescents and (3) enhanced integration of digital well-being practices, the promotion of relaxation techniques and accessibility to essential sleep hygiene resources. REPORTING METHOD Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. TRIAL AND PROTOCOL REGISTRATION This review was registered on the Prospective Register of Systematic Reviews (CRD42023403775).
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Affiliation(s)
- Yumi Yeo
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - John Chee Meng Wong
- Department of Psychological Medicine, National University of Singapore, Singapore & National University Hospital, Singapore, Singapore
| | - Travis Lanz-Brian Pereira
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Fell J. Mind wandering, poor sleep, and negative affect: a threefold vicious cycle? Front Hum Neurosci 2024; 18:1441565. [PMID: 39310791 PMCID: PMC11413873 DOI: 10.3389/fnhum.2024.1441565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 08/26/2024] [Indexed: 09/25/2024] Open
Abstract
Mind wandering (MW) is intricately linked to sleep and affect, bearing clinical relevance for various psychiatric conditions, notably attention deficit/hyperactivity disorder, depression, and anxiety disorders. Most reviews concur that the relationship between disturbed sleep and negative affect is bidirectional. The directional relationships between MW propensity and disturbed sleep, as well as MW propensity and negative affect, are less clear. Therefore, this brief review aims to examine the limited studies that have directly explored temporally sequential relationships. These studies provide clear evidence for an impact of affect on MW and of MW on sleep, along with less unequivocal evidence for an influence of MW on affect and sleep on MW. Collectively, these individual reinforcement loops may constitute a threefold vicious cycle, which may contribute to the development and perpetuation of psychiatric disorders. Available data convincingly suggest an impact cycle in the direction "MW propensity → disturbed sleep → negative affect → MW propensity," while evidence for the inverse impact cycle is less pronounced.
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Affiliation(s)
- Juergen Fell
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
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Webber HE, Badawi JC, Schmitz JM, Yoon JH, Calvillo DJ, Becker CI, Lane SD. Objective and subjective measurement of sleep in people who use substances: Emerging evidence and recommendations from a systematic review. J Sleep Res 2024:e14330. [PMID: 39238202 DOI: 10.1111/jsr.14330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 07/30/2024] [Accepted: 08/21/2024] [Indexed: 09/07/2024]
Abstract
People who use substances commonly experience sleep disruptions, affecting the regulation of physical and mental health, and presenting a significant barrier to treatment success. Sleep impairments are noted in all phases of substance use; however, differences between subjective versus objective methods used to measure sleep quality have been reported. While polysomnography is the gold-standard for sleep measurement, recent advances in actigraphy may help address the discordance between subjective and objective sleep reports. This systematic review examined emerging evidence (2016-present) for sleep impairment in people who use substances, with the twofold goal of: (1) identifying whether sleep outcomes vary across substance type (alcohol, nicotine, cannabis, cocaine, methamphetamine and opioids); and (2) contrasting results from subjective and objective measures. While some differences between subjective and objective sleep were noted, there was overwhelming evidence of clinically relevant sleep impairment in people who use alcohol, nicotine, cocaine, methamphetamine and opioids, with less consistent results for cannabis. Gaps in the literature are identified and future recommendations are presented, including utilization of common methodological frameworks, identification of mechanisms, and closer examination of sleep across stages of substance use and the interconnection between sleep and return to use.
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Affiliation(s)
- Heather E Webber
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jessica C Badawi
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Joy M Schmitz
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jin H Yoon
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Douglas J Calvillo
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
| | - Cabrina I Becker
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Scott D Lane
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Zhang Z, Lưu BCP, Gilbert-Diamond D. Acceptability, engagement, and preliminary efficacy of a college human physiology course with integrated mindfulness practice to support student wellbeing. Front Psychol 2024; 15:1365778. [PMID: 39205975 PMCID: PMC11350291 DOI: 10.3389/fpsyg.2024.1365778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 07/24/2024] [Indexed: 09/04/2024] Open
Abstract
Objective To evaluate the acceptability of and engagement with an undergraduate human physiology course embedded with mindfulness practice. To assess its preliminary efficacy on student mindfulness and wellbeing. Methods Students (N = 36, 17% freshman, 33% sophomore, 22% junior, and 28% senior) answered online surveys at course completion. Primary outcomes were course ratings, assignment and assessment completion rates, minutes, types of mindfulness practice, changes in trait mindfulness (Mindful Attention Awareness Scale, MAAS), and self-reported wellbeing outcomes. We ran Chi-square goodness of fit tests and paired Wilcoxon signed-rank tests to decide if the outcomes differed significantly post-class. We tested the dose-response relation between mindfulness practice time and trait mindfulness and whether the out-of-class practice time was consistent across the weeks with generalized linear mixed-effect models. Results All participants reported finding the course enjoyable and that they would recommend it to their friends. They practiced for an average of 66 (SD = 27) min per week in the class and 112 (SD = 59) min on their own. The most common out-of-class practices were mindful movements, sitting meditation, and breathing. Per self-reports, the course increased student understanding of specific mindfulness practices and appreciation for their body. It improved wellbeing and trait mindfulness (MAAS mean within-person change = 1.2, SD = 0.8, p < 0.00001). We found no does-response relation between practice time and trait mindfulness. Conclusions This pilot study supports that incorporating mindfulness practice into college-level courses may promote student wellbeing and such approaches warrant further investigation.
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Affiliation(s)
- Zhuoya Zhang
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | | | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
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Graham-Engeland JE. Moving toward affective immunology: Legacy and future directions. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 19:100241. [PMID: 38910934 PMCID: PMC11190499 DOI: 10.1016/j.cpnec.2024.100241] [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] [Received: 05/13/2024] [Accepted: 05/27/2024] [Indexed: 06/25/2024] Open
Abstract
The term "affective immunology" has recently been used to denote a field focused on the interplay between affective processes (including mood states, specific emotions, and regulatory processes) and various aspects of immune function. The overarching goals of this commentary are a) to provide historical underpinnings of this field with a focus on the profound impact of the work of Janice Kiecolt-Glaser, who is further honored in this special issue, b) to review important off-shoots of her legacy work in this domain, and c) to highlight important future directions for the field. Kiecolt-Glaser's work laid much of the foundation for affective immunology, with groundbreaking research related to depression, hostility and dyadic interactions, loneliness, and other affective patterns, often in the context of holistic models, novel experimental designs, and interventions. Her former mentees (and many of their mentees) have carried on her legacy in these domains, in ways that continue to advance appreciation of how affective processes relate to immune function. There are numerous remaining questions for the field to pursue, including better understanding of the role of emotion regulation, emotional reactivity and recovery, restorative processes, affective variability, and developmental and dynamic social processes. Such work will require greater use of longitudinal and within-person approaches and/or examination of processes in daily life, as well as models that account for interactive and reciprocal processes and which integrate behavior, social context, sociocultural factors, individual differences, and other aspects of health. As more work in these domains continues, building on Kiecolt-Glaser's rich legacy, we move toward the emergence of affective immunology as an important subfield in the domain of psychoneuroimmunology, one which will offer more nuanced understanding of the role of affective processes in immune health.
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Guo W, Nazari N, Sadeghi M. Cognitive-behavioral treatment for insomnia and mindfulness-based stress reduction in nurses with insomnia: a non-inferiority internet delivered randomized controlled trial. PeerJ 2024; 12:e17491. [PMID: 39071123 PMCID: PMC11283175 DOI: 10.7717/peerj.17491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/09/2024] [Indexed: 07/30/2024] Open
Abstract
Background Insomnia is a highly prevalent sleep disorder frequently comorbid with mental health conditions in nurses. Despite the effectiveness of evidence-based cognitive behavioral therapy for insomnia (CBT-I), there is a critical need for alternative approaches. This study investigated whether internet-delivered mindfulness-based stress reduction (IMBSR) for insomnia could be an alternative to internet-delivered CBT-I (ICBT-I). Objective The hypothesis was that the IMBSR would be noninferior to the ICBT-I in reducing the severity of insomnia among nurses with insomnia. Additionally, it was expected that ICBT-I would produce a greater reduction in the severity of insomnia and depression than IMBSR. Method Among 240 screened nurses, 134 with insomnia were randomly allocated (IMBSR, n = 67; ICBT-I, n = 67). The assessment protocol comprised clinical interviews and self-reported outcome measures, including the Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), the 15-item Five Facet Mindfulness Questionnaire (FFMQ), and the Client Satisfaction Questionnaire (CSQ-I). Results The retention rate was 55% with 77.6% (n = 104) of participants completing the study. At post-intervention, the noninferiority analysis of the ISI score showed that the upper limit of the 95% confidence interval was 4.88 (P = 0.46), surpassing the pre-specified noninferiority margin of 4 points. Analysis of covariance revealed that the ICBT-I group had significantly lower ISI (Cohen's d = 1.37) and PHQ-9 (Cohen's d = 0.71) scores than did the IMBSR group. In contrast, the IMBSR group showed a statistically significant increase in the FFMQ-15 score (Cohen's d = 0.67). Within-group differences showed that both the IMBSR and ICBT-I were effective at reducing insomnia severity and depression severity and improving mindfulness. Conclusion Overall, nurses demonstrated high levels of satisfaction and adherence to both interventions. The IMBSR significantly reduced insomnia severity and depression, but the findings of this study do not provide strong evidence that the IMBSR is at least as effective as the ICBT-I in reducing insomnia symptoms among nurses with insomnia. The ICBT-I was found to be significantly superior to the IMBSR in reducing insomnia severity, making it a recommended treatment option for nurses with insomnia.
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Affiliation(s)
- Wanran Guo
- School of Public Policy and Administration, Nanchang University, Nanchang, Nanchang, China
| | - Nabi Nazari
- Department of Psychology, Faculty of Human Sciences, University of Lorestan, Khorramabad, Lorestan, Iran
| | - Masoud Sadeghi
- Department of Psychology, Faculty of Human Sciences, University of Lorestan, Khorramabad, Lorestan, Iran
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10
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Straus LD, ten Brink M, Sikka P, Srivastava R, Gross JJ, Colvonen PJ. The role of objective sleep in implicit and explicit affect regulation: A comprehensive review. Neurobiol Stress 2024; 31:100655. [PMID: 39036771 PMCID: PMC11260030 DOI: 10.1016/j.ynstr.2024.100655] [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] [Received: 12/21/2022] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/23/2024] Open
Abstract
Impairments in sleep and affect regulation are evident across a wide range of mental disorders. Understanding the sleep factors that relate to affect regulatory difficulties will inform mechanistic understanding and aid in treatment. Despite rising interest, some research challenges in this area include integrating across different clinical and non-clinical literatures investigating the role of sleep architecture (measured with polysomnography) and experimentally manipulated sleep, as well as integrating more explicit versus implicit affect regulation processes. In this comprehensive review, we use a unifying framework to examine sleep's relationship with implicit-automatic regulation and explicit-controlled regulation, both of which are relevant to mental health (e.g., PTSD and depression). Many studies of implicit-automatic regulation (e.g., fear extinction and safety learning) demonstrate the importance of sleep, and REM sleep specifically. Studies of explicit-controlled regulation (e.g., cognitive reappraisal and expressive suppression) are less consistent in their findings, with results differing depending on the type of affect regulation and/or way that sleep was measured or manipulated. There is a clear relationship between objective sleep and affect regulation processes. However, there is a need for 1) more studies focusing on sleep and explicit-controlled affect regulation; 2) replication with the same types of regulation strategies; 3) more studies experimentally manipulating sleep to examine its impact on affect regulation and vice versa in order to infer cause and effect; and 4) more studies looking at sleep's impact on next-day affect regulation (not just overnight change in affect reactivity).
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Affiliation(s)
- Laura D. Straus
- San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, CA, USA
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Maia ten Brink
- Department of Psychology, Stanford University, Stanford, CA, USA
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Pilleriin Sikka
- Department of Psychology, Stanford University, Stanford, CA, USA
- Department of Psychology and Speech-Language Pathology, University of Turku, Finland
- Department of Cognitive Neuroscience and Philosophy, University of Skövde, Sweden
| | | | - James J. Gross
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Peter J. Colvonen
- San Diego VA Health Care System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
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Desai D, Momin A, Hirpara P, Jha H, Thaker R, Patel J. Exploring the Role of Circadian Rhythms in Sleep and Recovery: A Review Article. Cureus 2024; 16:e61568. [PMID: 38962617 PMCID: PMC11221196 DOI: 10.7759/cureus.61568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/03/2024] [Indexed: 07/05/2024] Open
Abstract
Sleep is essential for every living organism. Humans spend about one-third of their lives sleeping. Sleep has been studied extensively, and the role of sleep in psychological, mental, and physical well-being is established to be the best. The rhythm of the brain between wakefulness and sleep is called the circadian rhythm, which is mainly controlled by melatonin and the pineal gland. The imbalance of this rhythm can lead to devastating effects on health. Vigorous workouts close to bedtime can interfere with falling asleep. Meal timing and composition can significantly affect sleep quality. It is advised to avoid large meals, caffeine, and alcohol before bedtime. Heavy meals close to bedtime can lead to poor sleep and hormone disruption. By following these guidelines enumerated in the article, individuals can improve sleep quality and overall health. Sleep cycles, especially rapid eye movement sleep, have a profound influence on mental and physical health. Adhering to recommended sleep practices enhances bodily restoration, fortifies the immune system, and upholds metabolic equilibrium. Sleep hygiene aligned with circadian rhythms is crucial for disease prevention and well-being. Healthcare professionals should prioritize sleep optimization strategies for patient care and public health.
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Affiliation(s)
- Dev Desai
- Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Aryan Momin
- Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Priya Hirpara
- Internal Medicine, Gujarat Medical Education and Research Society Medical College, Vadnagar, IND
| | - Hemali Jha
- Internal Medicine, Integral Institute of Medical Sciences and Research Centre, Lucknow, IND
| | - Ravi Thaker
- Physiology, Dr. Narendra Dharmsinh Desai Faculty of Medical Science and Research, Dharmsinh Desai University, Nadiad, IND
| | - Jitendra Patel
- Physiology, Gujarat Medical Education and Research Society Medical College, Vadnagar, IND
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12
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Licata F, Maruca R, Citrino EA, Bianco A. Insight into sleep quality and its relationship with emotional intelligence: results of a cross-sectional study among Italian university students. Front Public Health 2024; 12:1392571. [PMID: 38813404 PMCID: PMC11133748 DOI: 10.3389/fpubh.2024.1392571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/15/2024] [Indexed: 05/31/2024] Open
Abstract
Background This study aimed to investigate sleep habits and examine the relationship between sleep quality and its potential predictors, namely Emotional Intelligence (EI) and perceived health status. Methods The present cross-sectional study was conducted between February 13 and February 28, 2023, at the "Magna Græcia" University of Catanzaro, in the Southern part of Italy. The study involved undergraduate students who were 18 years or older, proficient in the Italian language, and with no restrictions on the major attended. They completed a self-administered survey on socio-demographic information, health status, sleep quality (Pittsburgh Sleep Quality Index-PSQI), EI, and perceived health status. Results The majority of the sample (59.6%) was enrolled in medical or life science majors. The results showed a high prevalence of poor sleep quality and sleep latency was identified as the most affected aspect of it. The female gender and the self-perceived health status were the strongest predictors of poor sleep quality. Poor sleepers showed lower emotional clarity, emotional repair, and total EI scores. Moreover, as age increased, the odds of being classified as a poor sleeper increased by 7%. Conclusion The survey highlights that poor sleep health is still a significant issue and empowering individuals to make proactive decisions to adopt healthy lifestyles in the early phase of life is of paramount importance. The study exhibited the interesting role of EI in influencing sleep quality, highlighting that when emotional events are insufficiently regulated, it may result in sleep disturbances. Therefore, the promotion of sleep quality requires an integrated yet innovative approach including emotion regulation.
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Affiliation(s)
- Francesca Licata
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
| | - Riccardo Maruca
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
| | - Emma Antonia Citrino
- Department of Medical and Surgical Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
| | - Aida Bianco
- Department of Medical and Surgical Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
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13
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Mu FZ, Liu J, Lou H, Zhu WD, Wang ZC, Li B. Influence of physical exercise on negative emotions in college students: chain mediating role of sleep quality and self-rated health. Front Public Health 2024; 12:1402801. [PMID: 38765486 PMCID: PMC11100322 DOI: 10.3389/fpubh.2024.1402801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Background Negative emotions in college students are a significant factor affecting mental health, with suicide behaviors caused by negative emotions showing an annual increasing trend. Existing studies suggest that physical exercise is essential to alleviate negative feelings, yet the intrinsic mechanisms by which it affects negative emotions have not been fully revealed. Objective Negative emotions in college students represent a significant issue affecting mental health. This study investigates the relationship between physical exercise and negative emotions among college students, incorporating sleep quality and self-rated health (SRH) as mediators to analyze the pathway mechanism of how physical exercise affects students' negative emotions. Methods A cross-sectional study design was utilized, employing online questionnaires for investigation. The scales included the Physical Activity Rating Scale-3 (PARS-3), the Depression Anxiety Stress Scales-21 (DASS-21), the Pittsburgh Sleep Quality Index (PSQI), and the 12-Item Short Form Health Survey (SF-12), resulting in the collection of 30,475 valid questionnaires, with a validity rate of 91%. Chain mediation tests and Bootstrap methods were applied for effect analysis. Results The proportions of university students engaged in low, medium, and high levels of physical exercise were 77.6, 13.1, and 9.3%, respectively. The proportions of students experiencing "very severe" levels of stress, anxiety, and depression were 4.5, 10.9, and 3.6%, respectively. Physical exercise was significantly positively correlated with self-rated health (r = 0.194, p < 0.01), significantly negatively correlated with sleep quality (r = -0.035, p < 0.01), and significantly negatively correlated with stress, anxiety, and depression (r = -0.03, p < 0.01; r = -0.058, p < 0.01; r = -0.055, p < 0.01). Sleep quality was significantly negatively correlated with self-rated health (r = -0.242, p < 0.01). Mediation effect testing indicated that sleep quality and self-rated health partially mediated the relationship between physical exercise and negative emotions, with total effect, total direct effect, and total indirect effect values of -1.702, -0.426, and - 1.277, respectively. Conclusion College students primarily engage in low-intensity physical activity. Sleep quality and self-rated health mediate the impact of physical exercise on students' negative emotions. A certain level of physical activity can directly affect students' emotional states and indirectly influence their negative emotions via sleep and self-rated health. Regular engagement in physical activities primarily positively impacts emotional states by enhancing mood stability and overall emotional resilience.
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Affiliation(s)
- Fan-zheng Mu
- Institute of Sports Science, Nantong University, Nantong, China
| | - Jun Liu
- Institute of Sports Science, Nantong University, Nantong, China
| | - Hu Lou
- Institute of Sports Science, Nantong University, Nantong, China
| | - Wei-dong Zhu
- Institute of Sports Science, Nantong University, Nantong, China
| | - Zhen-cheng Wang
- School of Basic Medicine, Nanjing Medical University, Nanjing, China
| | - Bo Li
- Institute of Sports Science, Nantong University, Nantong, China
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14
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Dickman KD, Thomas MC, Chin BN, Kamarck TW. Bidirectional Associations Between Loneliness, Emotional Support, and Sleep in Daily Life. Psychosom Med 2024; 86:252-260. [PMID: 38724036 PMCID: PMC11090452 DOI: 10.1097/psy.0000000000001291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
OBJECTIVE Evidence suggests a link between positive social relationship perceptions and improved sleep (e.g., quality, efficiency) across the life span. Less work has probed the directionality of these relationships. Here, we report findings from the first study to examine bidirectional between- and within-person associations between loneliness and emotional support with daily life measures of sleep. METHODS Participants were 389 healthy adults aged 40 to 64 years (61% female) who completed hourly surveys assessing loneliness and perceptions of emotional support over the course of 4 days. Measures of actigraphy-assessed sleep and nightly sleep quality were also assessed for 7 to 10 days. RESULTS Individuals with lower average daily loneliness showed higher sleep quality and efficiency than individuals with higher loneliness (r = -0.19, p < .001; r = -0.14, p = .008, respectively), and greater average emotional support was likewise linked with better sleep quality (r = 0.18, p < .001). Controlling for neuroticism attenuated the effects of average loneliness on sleep. Within-person analyses showed unexpected bidirectional effects. Specifically, days in which people felt relatively lonelier were followed by nights with greater sleep efficiency (γ = 1.08, p = .015), and nights when people reported relatively poorer sleep quality were followed by days with greater emotional support (γ = -0.04, p = .013). These unexpected findings are probed in exploratory analyses. CONCLUSIONS Individuals with higher loneliness and lower emotional support report poorer sleep quality and efficiency, on average. Day-to-day fluctuations in perceptions of social relationships may affect the following night's sleep, and vice versa.
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Affiliation(s)
- Kristina D Dickman
- From the Department of Psychology, University of Pittsburgh (Dickman, Kamarck); VISN4 Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System (Thomas), Pittsburgh, Pennsylvania; and Department of Psychology, Trinity College (Chin), Hartford, Connecticut
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15
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Chen Y, Zhang L, Yin H. Different emotion regulation strategies mediate the relations of corresponding connections within the default-mode network to sleep quality. Brain Imaging Behav 2024; 18:302-314. [PMID: 38057650 DOI: 10.1007/s11682-023-00828-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
Despite a long history of interest in the relation of emotion regulation to sleep quality, how different strategies link with sleep quality at the neural level is still poorly understood. Thus, we utilized the process model of emotion regulation as an organizing framework for examining the neurological underpinning of the links between the two emotion regulation strategies and sleep quality. 183 young adults (51.7% females, Mage = 22.16) were guided to undergo the MRI scans and then complete the Pittsburgh Sleep Quality Index (PSQI) and the emotion regulation Questionnaire (ERQ) formed by two dimensions: cognitive reappraisal and expressive suppression. Results found that emotion regulation mediated the association between functional connectivity within the intrinsic default-mode network (DMN) and sleep quality. Specifically, rsFC analysis showed that cognitive reappraisal was positively correlated with rsFC within DMN, including left superior temporal gyrus (lSTG)-left lateral occipital cortex (lLOC), lSTG-left anterior cingulate gyrus (lACG), right lateral occipital cortex (rLOC)-left middle frontal gyrus (lMFG), and rLOC-lSTG. Further mediation analysis indicated a mediated role of cognitive reappraisal in the links between the four connectivity within the DMN and sleep quality. In addition, expressive suppression was positively correlated with rsFC within DMN, including left precuneus cortex (lPrcu)-right Temporal Pole (rTP) and lPrcu- lSTG. Further mediation analysis indicated a mediated role of expressive suppression in the links between the two connectivity within the DMN and sleep quality. Overall, this finding supports the process model of emotion regulation in that the effects of reappraisal and suppression have varying neural circuits that impact that strategy's effect on sleep quality.
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Affiliation(s)
- Yang Chen
- Department of Psychology, School of Education Science, Hunan Normal University, 36 Lushan Road, Changsha, Hunan, 410081, China
- Centre for Mind & Brain Science, Hunan Normal University, Changsha, China
| | - Li Zhang
- Department of Psychology, School of Education Science, Hunan Normal University, 36 Lushan Road, Changsha, Hunan, 410081, China
- Centre for Mind & Brain Science, Hunan Normal University, Changsha, China
| | - Huazhan Yin
- Department of Psychology, School of Education Science, Hunan Normal University, 36 Lushan Road, Changsha, Hunan, 410081, China.
- Centre for Mind & Brain Science, Hunan Normal University, Changsha, China.
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16
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Jetiyanuwat S, Kawilapat S, Narkpongphun A, Pojanapotha P. Association between Family Functioning, Child Emotional and Behavioral Problems, and Parental Stress during the COVID-19 Pandemic in Thailand. Behav Sci (Basel) 2024; 14:270. [PMID: 38667066 PMCID: PMC11047722 DOI: 10.3390/bs14040270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 04/29/2024] Open
Abstract
The COVID-19 pandemic has had a huge impact on people of all ages, especially children. This is a cross-sectional study in Thailand to explore the emotional and behavioral problems of school-aged children and associated factors during the lockdown. An online survey was conducted with 942 parents of school-age children. Strengths and Difficulties Questionnaire (SDQ) scores showed that total difficulties and all subscale difficulties (hyperactivity, conduct problems, peer problems, and emotional problems) were increased, whereas prosocial behaviors were decreased in the pandemic period. The factors significantly associated with higher parental stress were higher emotional and peer problems after the COVID-19 outbreak, high family difficulty, and sleep problems. Sleep problems were associated with all children's difficulties, except prosocial behavior. High score in family difficulty subscale was associated with increased emotional problems, whereas poor family communication was associated with increased hyperactivity. Appetite change was negatively associated with parental stress and some children's difficulties. Higher household income, family time, physical activities, and recreational activities were associated with a decreased level of some difficulties and family functioning problems, but positively with an increase in the prosocial behavior of children. Additionally, higher screen time was associated with a higher level of hyperactivity, conduct problems, and poor family communication. This study demonstrated that Thai children were at high risk of developing mental health problems during the pandemic lockdown. We suggest that intervention to promote physical activities and reduce screen time is needed. Moreover, efficient monetary policy is urgently required. The limitations here include a recall bias with no baseline to compare and a potential selection bias due to parental selection and a webpage announcement.
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Affiliation(s)
| | - Suttipong Kawilapat
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (A.N.)
| | - Assawin Narkpongphun
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (A.N.)
| | - Pichaya Pojanapotha
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (A.N.)
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17
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Meneo D, Samea F, Tahmasian M, Baglioni C. The emotional component of insomnia disorder: A focus on emotion regulation and affect dynamics in relation to sleep quality and insomnia. J Sleep Res 2023; 32:e13983. [PMID: 37394234 DOI: 10.1111/jsr.13983] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 06/16/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023]
Abstract
Theoretical models of insomnia disorder recognise an emotional component in the maintenance of the disorder. Nonetheless, the field of emotions is vast and different processes are involved in psychological well-being. The present narrative review focusses on emotion regulation and affect dynamics, synthesising some of the most recent and relevant evidence on emotions in relation to the quality of sleep and to insomnia disorder. The literature underlines the close association between impaired sleep quality and difficulties in regulating emotions. Impaired sleep quality is also associated with reduced positive affect and increased negative affect, but little evidence supports a bi-directional association between affective states and sleep. Affect variability in relation to sleep has been less investigated. Initial evidence suggests that high variability in positive affect has a negative impact on sleep. Neurobiological and behavioural evidence indicates that insomnia disorder is associated with emotion dysregulation, negative affect, and a distinct daily profile of affective states. More research is needed on the affective experience of patients with insomnia disorder, adopting multiple sampling of affect across the day and the week. Understanding how the unfolding of emotions over time interact with sleep alterations may help to improve the tailoring and monitoring of treatments addressing disturbed emotional processes in insomnia disorder.
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Affiliation(s)
- Debora Meneo
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Fateme Samea
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Masoud Tahmasian
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Chiara Baglioni
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Clinic for Sleep Psychotherapy, School of Cognitive Psychotherapy, Rome, Italy
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18
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Power CJ, Fox JL, Elliott-Sale KJ, Bender AM, Dalbo VJ, Scanlan AT. Waking Up to the Issue! Research Inattention and Sex-Related Differences Warrant More Sleep Studies in Female Athletes. Sports Med 2023:10.1007/s40279-023-01963-5. [PMID: 37989830 DOI: 10.1007/s40279-023-01963-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/23/2023]
Abstract
Understanding sleep patterns and behaviors of athletes is essential for developing targeted sleep-based interventions for implementation in practice. However, more than double the number of sleep studies have examined male athletes compared with female athletes, making the current understanding of sleep patterns, behaviors, and interventions among athletes disproportionately indicative of men. Consequently, this review demonstrates the need for more female-specific sleep data among athlete populations due to research inattention and sex-related differences. Specifically, this review identifies variations in sleep patterns and behaviors between male and female athletes, as well as physiological and lifestyle factors that potentially affect sleep patterns and behaviors across the lifespan, specifically in female athletes. In this regard, evidence suggests some female athletes experience longer sleep durations and better objective sleep quality, but similar or worse subjective sleep quality compared with male athletes. Additionally, scheduling training in the morning or throughout the day may benefit sleep in some female athletes. Considering sleep disorders, women may be at greater risk for insomnia and restless legs syndrome compared with men, which may be attributed to pregnancy, as well as a higher prevalence of anxiety and depressive symptoms, iron deficiency without anemia, and use of psychotropic medication among women. Finally, the menstrual cycle, menstrual disorders, oral contraceptive use, and the postpartum period have been shown to exert detrimental effects on sleep patterns and behaviors and should theoretically be considered when monitoring and managing sleep in female athletes.
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Affiliation(s)
- Cody J Power
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia.
| | - Jordan L Fox
- Rural Clinical School, The University of Queensland, Rockhampton, QLD, Australia
| | - Kirsty J Elliott-Sale
- Department of Sport and Exercise Sciences, Institute of Sport, Manchester Metropolitan University, Manchester, UK
| | - Amy M Bender
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Absolute Rest, Austin, TX, USA
| | - Vincent J Dalbo
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
| | - Aaron T Scanlan
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, QLD, Australia
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19
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Viselli L, Festucci F, Pino MC, D’Atri A, Salfi F, Amicucci G, Corigliano D, Naccarato F, Ferrara M, Tempesta D. Assessing Resilience to Sleep Loss Among the Italian Population: A 13-Item Model of the Iowa Resistance to Sleeplessness Test (iREST). Nat Sci Sleep 2023; 15:811-821. [PMID: 37850196 PMCID: PMC10577249 DOI: 10.2147/nss.s426255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/10/2023] [Indexed: 10/19/2023] Open
Abstract
Purpose The present study aimed to validate the Italian version of the Iowa Resistance to Sleeplessness Test (iREST), a 16-item self-report assessing resilience to sleep debt in the affective, cognitive, and somatic domains. Participants and Methods We examined its factor structure, assessed internal consistency and criterion validity, and established test-retest reliability on 768 Italian native speakers (65.8% of women) with a mean age of 25.98 years old. Results Confirmatory factor analysis (CFA) revealed a new 13-item structure for the Italian iREST (iREST-13), demonstrating more satisfactory goodness-of-fit values, and exhibiting good internal consistency (Cronbach's α ranging from 0.73 to 0.89), relative to the 16-item original version. Results supported the iREST convergent validity, showing significant independence from established measures of sleep; low correlations with conceptually unrelated measures supported divergent validity, indicating that the iREST effectively measures resistance to sleeplessness without confounding with other constructs. Lastly, test-retest reliability was evaluated by administering the iREST to the same sample with a 2-week interval: the significant correlations supported its temporal stability. Conclusion Further studies are needed to evaluate the applicability of the iREST in diverse populations and explore its relationship with objective sleep measures. Nevertheless, the Italian iREST provides a valuable tool for assessing resistance to sleep loss, offering insights into individual differences in resilience. Additionally, the iREST can assist in identifying individuals who require interventions to enhance resilience to sleep debt, as well as help clinicians evaluate the impact of chronic sleep disruption and deliver targeted interventions.
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Affiliation(s)
- Lorenzo Viselli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Fabiana Festucci
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Maria Chiara Pino
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Aurora D’Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Giulia Amicucci
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Domenico Corigliano
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Federica Naccarato
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Daniela Tempesta
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
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20
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Bakth FN, Chen M, Wang Y. Adolescents' experiences of peer ethnic/racial victimization and school engagement in everyday life: sleep as a moderator. Sleep Health 2023; 9:322-330. [PMID: 36872166 DOI: 10.1016/j.sleh.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 12/09/2022] [Accepted: 01/10/2023] [Indexed: 03/06/2023]
Abstract
STUDY OBJECTIVES Stressful ethnic/racial experiences, such as peer ethnic/racial victimization, may harm adolescents' adjustment. Using a daily diary design, the current study examined how same-night and previous-night sleep may moderate the within-person associations between peer ethnic/racial victimization and school engagement. METHODS The analytic sample consisted of 133 ninth graders (Mage = 14.54 years old; 44% Black, 21% White, 16% Latinx, 5% Native, 4% Asian, and 9% other). Adolescents reported their peer ethnic/racial victimization experiences and school engagement every day for 14 consecutive days. Sleep was measured objectively by actigraphy watches daily during the 14 days. RESULTS Multilevel analyses identified significant interactions between peer ethnic/racial victimization and same-night time in bed and latency for next-day engagement. The negative association between victimization and next-day school engagement was only significant when adolescents had shorter time in bed and longer latency than their typical levels that night, supporting the recovery role of sleep (ie, same-night sleep helps adolescents recover from victimization). There was also a significant interaction between previous-night time in bed and today's peer ethnic/racial victimization for same-day school engagement. The negative association between victimization and same-day school engagement was only significant when adolescents had shorter time in bed than their typical levels the previous night, supporting a preparatory hypothesis of sleep (ie, sleep helps prepare adolescents for next-day victimization). Neither previous-night nor same-night sleep efficiency moderated the association between victimization and school engagement. CONCLUSIONS Findings highlighted sleep as an important bioregulatory protective factor that may alleviate the challenges associated with ethnic/racial victimization.
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Affiliation(s)
- Faizun N Bakth
- Department of Developmental Science, Wayne State University, Detroit, Michigan, USA
| | - Mingzhang Chen
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Yijie Wang
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA.
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21
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Foroughi A, Farokhi F, Rahatabad FN, Kashaninia A. Deep convolutional architecture-based hybrid learning for sleep arousal events detection through single-lead EEG signals. Brain Behav 2023; 13:e3028. [PMID: 37199053 PMCID: PMC10275555 DOI: 10.1002/brb3.3028] [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: 12/16/2022] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION Detecting arousal events during sleep is a challenging, time-consuming, and costly process that requires neurology knowledge. Even though similar automated systems detect sleep stages exclusively, early detection of sleep events can assist in identifying neuropathology progression. METHODS An efficient hybrid deep learning method to identify and evaluate arousal events is presented in this paper using only single-lead electroencephalography (EEG) signals for the first time. Using the proposed architecture, which incorporates Inception-ResNet-v2 learning transfer models and optimized support vector machine (SVM) with the radial basis function (RBF) kernel, it is possible to classify with a minimum error level of less than 8%. In addition to maintaining accuracy, the Inception module and ResNet have led to significant reductions in computational complexity for the detection of arousal events in EEG signals. Moreover, in order to improve the classification performance of the SVM, the grey wolf algorithm (GWO) has optimized its kernel parameters. RESULTS This method has been validated using pre-processed samples from the 2018 Challenge Physiobank sleep dataset. In addition to reducing computational complexity, the results of this method show that different parts of feature extraction and classification are effective at identifying sleep disorders. The proposed model detects sleep arousal events with an average accuracy of 93.82%. With the lead present in the identification, the method becomes less aggressive in recording people's EEG signals. CONCLUSION According to this study, the suggested strategy is effective in detecting arousals in sleep disorder clinical trials and may be used in sleep disorder detection clinics.
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Affiliation(s)
- Andia Foroughi
- Department of Biomedical Engineering, Central Tehran BranchIslamic Azad UniversityTehranIran
| | - Fardad Farokhi
- Department of Biomedical Engineering, Central Tehran BranchIslamic Azad UniversityTehranIran
| | | | - Alireza Kashaninia
- Department of Electrical Engineering, Central Tehran BranchIslamic Azad UniversityTehranIran
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22
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Bueno-Junior L, Ruckstuhl M, Lim M, Watson B. The temporal structure of REM sleep shows minute-scale fluctuations across brain and body in mice and humans. Proc Natl Acad Sci U S A 2023; 120:e2213438120. [PMID: 37094161 PMCID: PMC10161068 DOI: 10.1073/pnas.2213438120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/07/2023] [Indexed: 04/26/2023] Open
Abstract
Rapid eye movement sleep (REM) is believed to have a binary temporal structure with "phasic" and "tonic" microstates, characterized by motoric activity versus quiescence, respectively. However, we observed in mice that the frequency of theta activity (a marker of rodent REM) fluctuates in a nonbinary fashion, with the extremes of that fluctuation correlating with phasic-type and tonic-type facial motricity. Thus, phasic and tonic REM may instead represent ends of a continuum. These cycles of brain physiology and facial movement occurred at 0.01 to 0.06 Hz, or infraslow frequencies, and affected cross-frequency coupling and neuronal activity in the neocortex, suggesting network functional impact. We then analyzed human data and observed that humans also demonstrate nonbinary phasic/tonic microstates, with continuous 0.01 to 0.04-Hz respiratory rate cycles matching the incidence of eye movements. These fundamental properties of REM can yield insights into our understanding of sleep health.
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Affiliation(s)
| | - Maxwell S. Ruckstuhl
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI48109
| | - Miranda M. Lim
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI48109
- VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC); Veterans Affairs Portland Health Care System, Portland, OR97239
- NIA-Layton Oregon Alzheimer’s Disease Center, Department of Neurology, Oregon Health & Science University, Portland, OR97239
| | - Brendon O. Watson
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI48109
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Gao P, Mosazadeh H, Nazari N. The Buffering Role of Self-compassion in the Association Between Loneliness with Depressive Symptoms: A Cross-Sectional Survey Study Among Older Adults Living in Residential Care Homes During COVID-19. Int J Ment Health Addict 2023:1-21. [PMID: 36776917 PMCID: PMC9904273 DOI: 10.1007/s11469-023-01014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 02/10/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is an ongoing geriatric health emergency with a substantial increase in the prevalence of medical and mental health issues, particularly among older adults living in residential care homes. The knowledge of the risk and protective factors related to the psychological impact of the COVID-19 pandemic on older adults living in residential care homes is based on limited data. This study aimed to investigate whether loneliness mediates the effects of fear generated by a pandemic on depression. Additionally, we hypothesized that self-compassion moderates the effect of loneliness on depression. A sample comprised 323 older adults (females: n = 141, males: n = 182) with mean age = 74.98 years (standard deviation = 6.59, age 65-90) completed a survey comprising the Fear of COVID-19 Scale, De Jung Gierveld Loneliness Scale, the nine-item Patient Health Questionnaire, and the Self-compassion Scale. The results revealed that the total effect of fear on depression was statistically significant, with a medium effect size (Cohen's f 2 = .14) and this association was partially mediated by loneliness (β = .11, SE = .04, P < .001, t = 2.91, 95% CI 0.04-0.19). The self-compassion also moderated the loneliness effect on depression. The findings of this study support COVID-19 evidence, indicating that a greater level of fear generated by the pandemic is linked to depression and loneliness. The findings support the notion that self-compassion mitigates the adverse effects of stressful events in older adults. Customized self-compassion programs may be effective loneliness-mitigating interventions for older adults living in residential care homes. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-023-01014-0.
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Affiliation(s)
- Pengfei Gao
- School of Public Administration, East China Normal University, Shanghai, 200062 China
| | - Hasan Mosazadeh
- Department of Psychology, Kazimierz Wielki University, Bydgoszcz, Poland
| | - Nabi Nazari
- Faculty of Human Sciences, Department of Psychology, Lorestan University, Khorramabad, Iran
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24
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Li Y, Nazari N, Sadeghi M. Internet delivered, non-inferiority, two-arm, assessor-blinded intervention comparing mindfulness-based stress reduction and cognitive-behavioral treatment for insomnia: a protocol study for a randomized controlled trial for nursing staff with insomnia. Trials 2022; 23:1020. [PMID: 36527137 PMCID: PMC9756716 DOI: 10.1186/s13063-022-06986-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 12/06/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Insomnia and poor sleep quality are highly prevalent conditions related to coronavirus disease 2019 (COVID-19) complications among clinical nurses. Although cognitive behavioral therapy for insomnia (CBT-I) is a first-line treatment, CBT-I suffers from several major drawbacks. This study investigates whether the application of the internet-delivered mindfulness-based stress reduction (iMBSR) intervention will produce effects that are non-inferior to the internet-delivered CBT-I (iCBT-I) intervention in reducing the severity of insomnia in clinical nurses with insomnia at the end of the study. METHODS This study protocol presents an internet-delivered, parallel-groups, assessor-blinded, two-arm, non-inferiority randomized controlled trial. The primary outcome is sleep quality, assessed by the Insomnia Severity Index. Secondary outcomes include depression, dysfunctional beliefs, five facets of mindfulness, and client satisfaction. CONCLUSION It is expected that this study may address several gaps in the literature. The non-inferiority study design is a novel approach to evaluating whether a standardized, complementary treatment (i.e., MBSR) is as practical as a gold standard treatment rather than its potential benefits. This approach may lead to expanded evidence-based practice and improve patient access to effective treatments. TRIAL REGISTRATION Trial registration number: ISRCTN36198096 . Registered on 24th May 2022.
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Affiliation(s)
- Yaling Li
- Mental Health Education and Counseling Center, Shenzhen Technology University, Shenzhen, 518118, Guangdong, China
| | - Nabi Nazari
- Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran.
| | - Masoud Sadeghi
- Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran
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25
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Witvliet CVO, Blank SL, Gall AJ. Compassionate reappraisal and rumination impact forgiveness, emotion, sleep, and prosocial accountability. Front Psychol 2022; 13:992768. [DOI: 10.3389/fpsyg.2022.992768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022] Open
Abstract
Sufficient sleep quality and quantity are important for biopsychosocial well-being. Correlational research has linked trait forgiveness to better sleep. Prior experimental evidence also demonstrated contrasting effects of offense rumination versus compassionate reappraisal on forgiveness and psychophysiological responses, suggesting the value of testing effects on sleep. The present study assessed 180 participants (90 M, 90 F). First, we replicated an individual difference model of forgiveness, rumination, depressed and anxious affect, and sleep. Second, we conducted a quasi-experiment inducing offense rumination and compassionate reappraisal on two consecutive nights. Compassionate reappraisal (vs. rumination) replicated past research by prompting more empathic, forgiving, positive, and social responses, with less negative emotion including anger. New findings revealed that compassionate reappraisal (vs. rumination) was also associated with faster sleep onset, fewer sleep disturbances, and fewer sleep impairing offense intrusions. The morning after compassionate reappraisal, participants reported less rumination and intrusive impact of the offense, with more hedonic well-being and accountability to others. Compared to rumination, compassionate reappraisal was associated with more empathy and forgiveness, better sleep, well-being, and prosociality.
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26
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Demichelis OP, Grainger SA, Burr L, Henry JD. Emotion regulation mediates the effects of sleep on stress and aggression. J Sleep Res 2022; 32:e13787. [PMID: 36384216 DOI: 10.1111/jsr.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 11/18/2022]
Abstract
It is well established that poor sleep directly increases stress and aggression, but potential mediators of this relationship remain poorly understood. The present study provided the first direct test of whether capacity for emotion regulation mediated the relationship between sleep with stress. It also aimed to extend current understanding of whether emotion regulation might mediate the association between sleep and aggression, by assessing four distinct subcomponents of aggression (anger, hostility, verbal aggression, and physical aggression). In service of these goals, 740 participants completed validated measures of sleep, stress, aggression, and emotion regulation. Results showed that emotion regulation partially mediated the relationship between sleep quality with stress, anger, hostility, and verbal aggression, and fully mediated the relationship between sleep with physical aggression. These data provide novel evidence that emotion regulation abilities may serve as a protective factor against the negative consequences of sleep disturbances.
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Affiliation(s)
| | - Sarah A. Grainger
- School of Psychology The University of Queensland Brisbane Queensland Australia
| | - Lucy Burr
- School of Medicine The University of Queensland Brisbane Queensland Australia
| | - Julie D. Henry
- School of Psychology The University of Queensland Brisbane Queensland Australia
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27
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Almarzouki AF, Mandili RL, Salloom J, Kamal LK, Alharthi O, Alharthi S, Khayyat N, Baglagel AM. The Impact of Sleep and Mental Health on Working Memory and Academic Performance: A Longitudinal Study. Brain Sci 2022; 12:1525. [PMID: 36358451 PMCID: PMC9688482 DOI: 10.3390/brainsci12111525] [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: 10/01/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 04/06/2024] Open
Abstract
Sleep and mental health can affect cognition and academic performance. The present study aimed to investigate the relationships between sleep, mental health, working memory, and academic performance. We collected demographic data from university students during the non-academic summer period and the academic term. We also measured academic performance (GPA), sleep (PSQI), depression (PHQ-9), anxiety (GAD-7), and disordered social media use (SMDS). Working memory was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB). We assessed 83 students (42.2% male) with a mean age of 21 years. Compared to the non-academic summer period, students had significantly worse sleep and distress scores in the academic term. Anxiety, depression, and distress scores were significantly correlated with worse sleep quality. Despite worse mental health and sleep in the academic term, working memory improved compared to the non-academic summer period and was also correlated with a higher GPA. However, a higher GPA was significantly associated with longer sleep latency, increased sleep disturbances, and increased use of sleep medication. Students experiencing poor sleep suffered from poor mental health, although they maintained high GPA and working memory scores. Cognitive resilience, including higher working memory, may mask poor sleep quality and mental health among university students.
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Affiliation(s)
- Abeer F. Almarzouki
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Rahaf L. Mandili
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Joud Salloom
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Lujain K. Kamal
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Omimah Alharthi
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Samah Alharthi
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Nusaiba Khayyat
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Alaa M. Baglagel
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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28
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Yousefzadehfard Y, Wechsler B, DeLorenzo C. Human circadian rhythm studies: Practical guidelines for inclusion/exclusion criteria and protocol. Neurobiol Sleep Circadian Rhythms 2022; 13:100080. [PMID: 35989718 PMCID: PMC9382328 DOI: 10.1016/j.nbscr.2022.100080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/03/2022] Open
Abstract
As interest in circadian rhythms and their effects continues to grow, there is an increasing need to perform circadian studies in humans. Although the constant routine is the gold standard for these studies, there are advantages to performing more naturalistic studies. Here, a review of protocols for such studies is provided along with sample inclusion and exclusion criteria. Sleep routines, drug use, shift work, and menstrual cycle are addressed as screening considerations. Regarding protocol, best practices for measuring melatonin, including light settings, posture, exercise, and dietary habits are described. The inclusion/exclusion recommendations and protocol guidelines are intended to reduce confounding variables in studies that do not involve the constant routine. Given practical limitations, a range of recommendations is provided from stringent to lenient. The scientific rationale behind these recommendations is discussed. However, where the science is equivocal, recommendations are based on empirical decisions made in previous studies. While not all of the recommendations listed may be practical in all research settings and with limited potential participants, the goal is to allow investigators to make well informed decisions about their screening procedures and protocol techniques and to improve rigor and reproducibility, in line with the objectives of the National Institutes of Health.
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Affiliation(s)
- Yashar Yousefzadehfard
- Center for Understanding Biology Using Imaging Technology, Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA.,Department of Psychiatry, Texas Tech University Health Science Center, Midland, TX, USA
| | - Bennett Wechsler
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
| | - Christine DeLorenzo
- Center for Understanding Biology Using Imaging Technology, Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
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29
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Duncan MJ, Riazi NA, Faulkner G, Gilchrist JD, Leatherdale ST, Patte KA. The association of physical activity, sleep, and screen time with mental health in Canadian adolescents during the COVID-19 pandemic: A longitudinal isotemporal substitution analysis. Ment Health Phys Act 2022; 23:100473. [PMID: 36156917 PMCID: PMC9482721 DOI: 10.1016/j.mhpa.2022.100473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The impact of COVID-19 on adolescent mental health is a global concern. Increased screen time and reduced physical activity due to the lockdown measures have been linked to detrimental mental health outcomes; however, the literature remains limited by cross-sectional and retrospective designs, and consideration of behaviours in isolation. Prospective evidence is necessary to examine whether moderate-to-vigorous physical activity (MVPA), sleep and screen time influenced changes in mental health. METHOD Analyses used data from a prospective cohort study of secondary school students in Canada with baseline data from the 2018-2019 school year and linked follow-up data from online surveys completed during the initial COVID-19 outbreak (May-July 2020). Multilevel linear regression models were used to evaluate the within- and between-person isotemporal substitution effects of sleep, MVPA and screen time behaviours on depression, anxiety, subjective well-being, and trait emotional dysregulation. RESULTS Linked longitudinal data from 2645 students attending 44 schools were available. Between-person effects indicated that individuals who engaged in more MVPA and sleep while minimizing screen time had lower depression scores, less severe emotional dysregulation, and better subjective well-being. While controlling for between-person effects, within-person year-on-year change suggests those who increased screen time while decreasing either MVPA or sleep experienced mental health decline on all outcomes. CONCLUSION MVPA and sleep were associated with youth mental health during the early COVID-19 lockdown. Increasing MVPA and sleep (or at least mitigating the increase of screen time) compared to the prior year was associated with better mental health during the early pandemic. A limitation to consider is that the screen time measure represents a combination of screen behaviours, and effects of replacing screen time may have varied if distinctions were made.
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Affiliation(s)
- Markus Joseph Duncan
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
| | - Negin Alivia Riazi
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Lower Mall Research Station,2259 Lower Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Jenna Diane Gilchrist
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Scott Thomas Leatherdale
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Karen Allison Patte
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, Saint Catharines, ON, L2S 3A1, Canada
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30
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Raju A, Nithiya DR, Tipandjan A. Relationship between burnout, effort-reward imbalance, and insomnia among Informational Technology professionals. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:296. [PMID: 36439009 PMCID: PMC9683435 DOI: 10.4103/jehp.jehp_1809_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Work in informational technology (IT) professionals is highly competitive and stressful, leading to job stress. This can lead to burnout, effort-reward imbalance (ERI), and poor sleep quality. MATERIALS AND METHODS The present study examined associations of ERI, burnout, and poor sleep quality among IT professionals using data from 200 software engineers (mean age of 29.3 ± 4 years, 32% women). ERI and overcommitment were assessed using Siegrist's "effort-reward" questionnaire. The Oldenburg Burnout Inventory (OLBI) was used to assess burnout and Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. RESULTS ERI, burnout and poor sleep quality were present in 72%, 60%, and 70%, respectively. Females had higher ERI, burnout, and poor sleep quality compared to males. ERI is significantly associated with burnout (r = 0.45, P < 0.01) and poor sleep quality (r = 0.31, P < 0.01). Linear regression to assess the ability of ERI to predict levels of burnout yielded a statistically significant (R 2 = 0.206, P < 0.01) indicating ERI to be a unique incremental predictor of burnout (b = 0.454, t = 7.16, P < 0.01). ERI tends to be a predictive factor of poor sleep quality with Odd's ratio = 3.5, 95%CI (1.81-6.73), P < 0.01. CONCLUSION In summary, Intervention programs both at the individual and at the organization level have to be designed to combat ERI, burnout, and poor sleep quality among IT professionals.
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Affiliation(s)
- Aruna Raju
- Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - Devi R. Nithiya
- Department of Physiology, Indira Gandhi Medical College and Research Institute, Puducherry, India
| | - Arun Tipandjan
- Psychologist, International Center for Psychological Counselling and Social Research, Puducherry, India
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31
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Reffi AN, Drake CL, Kalmbach DA, Jovanovic T, Norrholm SD, Roth T, Casement MD, Cheng P. Pre-pandemic sleep reactivity prospectively predicts distress during the COVID-19 pandemic: The protective effect of insomnia treatment. J Sleep Res 2022; 32:e13709. [PMID: 36053867 PMCID: PMC9537903 DOI: 10.1111/jsr.13709] [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] [Received: 04/26/2022] [Revised: 06/24/2022] [Accepted: 07/12/2022] [Indexed: 02/03/2023]
Abstract
The COVID-19 pandemic is a rare stressor that has precipitated an accompanying mental health crisis. Prospective studies traversing the pandemic's onset can elucidate how pre-existing disease vulnerabilities augured risk for later stress-related morbidity. We examined how pre-pandemic sleep reactivity predicted maladaptive stress reactions and depressive symptoms in response to, and during, the pandemic. This study is a secondary analysis of a randomised controlled trial from 2016 to 2017 comparing digital cognitive behavioural therapy for insomnia (dCBT-I) against sleep education (N = 208). Thus, we also assessed whether dCBT-I moderated the association between pre-pandemic sleep reactivity and pandemic-related distress. Pre-pandemic sleep reactivity was measured at baseline using the Ford Insomnia Response to Stress Test. In April 2020, participants were recontacted to report pandemic-related distress (stress reactions and depression). Controlling for the treatment condition and the degree of COVID-19 impact, higher pre-pandemic sleep reactivity predicted more stress reactions (β = 0.13, ± 0.07 SE, p = 0.045) and depression (β = 0.22, ± 0.07 SE, p = 0.001) during the pandemic. Further, the odds of reporting clinically significant stress reactions and depression during the pandemic were over twice as high in those with high pre-pandemic sleep reactivity. Notably, receiving dCBT-I in 2016-2017 mitigated the relationship between pre-pandemic sleep reactivity and later stress reactions (but not depression). Pre-pandemic sleep reactivity predicted psychological distress 3-4 years later during the COVID-19 pandemic, and dCBT-I attenuated its association with stress reactions, specifically. Sleep reactivity may inform prevention and treatment efforts by identifying individuals at risk of impairment following stressful events.
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Affiliation(s)
- Anthony N. Reffi
- Sleep Disorders & Research CenterHenry Ford Health SystemDetroitMichiganUSA
| | | | - David A. Kalmbach
- Sleep Disorders & Research CenterHenry Ford Health SystemDetroitMichiganUSA
| | - Tanja Jovanovic
- Neuroscience Center for Anxiety, Stress, and Trauma (NeuroCAST), Department of Psychiatry and Behavioral NeurosciencesWayne State University School of MedicineDetroitMichiganUSA
| | - Seth D. Norrholm
- Neuroscience Center for Anxiety, Stress, and Trauma (NeuroCAST), Department of Psychiatry and Behavioral NeurosciencesWayne State University School of MedicineDetroitMichiganUSA
| | - Thomas Roth
- Sleep Disorders & Research CenterHenry Ford Health SystemDetroitMichiganUSA
| | | | - Philip Cheng
- Sleep Disorders & Research CenterHenry Ford Health SystemDetroitMichiganUSA
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32
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Hormozi BK, Khosravi Z, Sabzi N. Parental burnout and sleep problems in Iranian mothers of primary school-aged children: Exploring the mediation effect of emotional schemas. Brain Behav 2022; 12:e2688. [PMID: 35849708 PMCID: PMC9392524 DOI: 10.1002/brb3.2688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/05/2022] [Accepted: 06/15/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Sleep is crucial for mental well-being. Evidence suggests sleep problems in mothers can result from parental burnout. The possible mediators that link parental burnout to sleep problems have not been investigated. This study seeks to explore the mediational role of emotional schemas as psychological constructs, which relate parental burnout to sleep problems in mothers of school-aged children. METHOD A total of 224 mothers participated voluntarily in this cross-sectional study. Data were collected online. The participants completed Parental Burnout Assessment (PBA) scale, Mini Sleep Questionnaire-Persian Version (MSQ-P), and Leahy Emotional Schema Scale (LESS II). Structural equation modeling (SEM) was performed using the bootstrap method to assess the mediation model. RESULTS The findings of this research indicate a positive correlation exists between parental burnout, emotional schemas, and insomnia/hypersomnia. The mediation analysis confirmed parental burnout and insomnia/ hypersomnia are related indirectly through emotional schemas. CONCLUSION Implications of the findings is that when parental burnout is present, the psychological treatment of sleep problems may benefit from targeting emotional schemas. However, further research is needed to determine whether similar mediational effects are replicated.
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Affiliation(s)
- Bessat Kalantar Hormozi
- Faculty of Education and Psychology, Department of Psychology, Alzahra University, Tehran, Iran
| | - Zohreh Khosravi
- Faculty of Education and Psychology, Department of Psychology, Alzahra University, Tehran, Iran
| | - Narges Sabzi
- Faculty of Education and Psychology, Department of Psychology, Alzahra University, Tehran, Iran
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33
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Besedovsky L, Cordi M, Wißlicen L, Martínez-Albert E, Born J, Rasch B. Hypnotic enhancement of slow-wave sleep increases sleep-associated hormone secretion and reduces sympathetic predominance in healthy humans. Commun Biol 2022; 5:747. [PMID: 35882899 PMCID: PMC9325885 DOI: 10.1038/s42003-022-03643-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Sleep is important for normal brain and body functioning, and for this, slow-wave sleep (SWS), the deepest stage of sleep, is assumed to be especially relevant. Previous studies employing methods to enhance SWS have focused on central nervous components of this sleep stage. However, SWS is also characterized by specific changes in the body periphery, which are essential mediators of the health-benefitting effects of sleep. Here we show that enhancing SWS in healthy humans using hypnotic suggestions profoundly affects the two major systems linking the brain with peripheral body functions, i.e., the endocrine and the autonomic nervous systems (ANS). Specifically, hypnotic suggestions presented at the beginning of a 90-min afternoon nap to promote subsequent SWS strongly increased the release of growth hormone (GH) and, to a lesser extent, of prolactin and aldosterone, and shifted the sympathovagal balance towards reduced sympathetic predominance. Thus, the hypnotic suggestions induced a whole-body pattern characteristic of natural SWS. Given that the affected parameters regulate fundamental physiological functions like metabolism, cardiovascular activity, and immunity, our findings open up a wide range of potential applications of hypnotic SWS enhancement, in addition to advancing our knowledge on the physiology of human SWS. The hypnotic enhancement of slow wave sleep, the deepest stage of sleep, goes beyond the central nervous system, causing changes at the level of the endocrine and the autonomic nervous systems.
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Affiliation(s)
- Luciana Besedovsky
- Institute of Medical Psychology, LMU Munich, Munich, Germany. .,Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany.
| | - Maren Cordi
- Department of Psychology, Division of Biopsychology and Methods, University of Fribourg, Fribourg, Switzerland
| | - Laura Wißlicen
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Estefanía Martínez-Albert
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Jan Born
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Björn Rasch
- Department of Psychology, Division of Biopsychology and Methods, University of Fribourg, Fribourg, Switzerland.
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34
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Vieira LS, Machado WDL, Dal Pai D, Magnago TSBDS, Azzolin KDO, Tavares JP. Burnout and resilience in intensive care Nursing professionals in the face of COVID-19: A multicenter study. Rev Lat Am Enfermagem 2022; 30:e3589. [PMID: 35649092 DOI: 10.1590/1518-8345.5778.3589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/13/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the relationship between the Burnout dimensions and the work resilience of intensive care Nursing professionals in the COVID-19 pandemic in four hospitals from southern Brazil. METHOD this is a multicenter and cross-sectional study, composed of 153 nurses and nursing technicians of the Intensive Care Units. Sociodemographic, health and work-related questions were collected, and the Maslach Burnout Inventory and Resilience at Work Scale 20 instruments were applied. The data were submitted to descriptive analysis and to bivariate and partial correlations (network analysis). RESULTS work resilience presented an inverse correlation to emotional exhaustion (r=-0.545; p=0.01) and depersonalization (r=-0.419; p=0.01) and a direct one to professional achievement (r=0.680; p=0.01). The variable with the greatest influence on the correlation network was the perception of the impact of the pandemic on mental health. CONCLUSION resilience interferes in the emotional exhaustion and low professional achievement domains of Burnout. Emotional exhaustion is conducted through minor psychological disorders, with an impact on the workers' physical and mental health variables. The development of institutional resilience should be encouraged in order to moderate the illness.
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Affiliation(s)
- Lizandra Santos Vieira
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Wagner de Lara Machado
- Pontifícia Universidade Católica do Rio Grande do Sul, Faculdade de Psicologia, Porto Alegre, RS, Brasil
| | - Daiane Dal Pai
- Universidade Federal do Rio Grande do Sul, Departamento de Enfermagem Médico-Cirúrgica, Porto Alegre, RS, Brasil
| | | | - Karina de Oliveira Azzolin
- Universidade Federal do Rio Grande do Sul, Departamento de Enfermagem Médico-Cirúrgica, Porto Alegre, RS, Brasil
| | - Juliana Petri Tavares
- Universidade Federal do Rio Grande do Sul, Departamento de Enfermagem Médico-Cirúrgica, Porto Alegre, RS, Brasil
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Hruska B, Anderson L, Barduhn MS. Multilevel analysis of sleep quality and anger in emergency medical service workers. Sleep Health 2022; 8:303-310. [PMID: 35450834 DOI: 10.1016/j.sleh.2022.02.005] [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: 08/06/2021] [Revised: 02/15/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Poor sleep quality characterizes the emergency medical service (EMS) profession. Anger is particularly affected by sleep disturbance and may be related to sleep quality at both between- and within-person levels, yet this has never been examined. The current study performed a multilevel analysis of the relationship between sleep quality and anger among EMS workers. DESIGN Ecological momentary assessment PARTICIPANTS: Seventy-nine EMS workers employed at an emergency medical service provider in Central New York. MEASUREMENTS Participants completed 8 daily assessments that inquired about sleep quality and anger. RESULTS EMS workers who typically experienced poorer sleep quality reported greater anger levels; for instance, workers who routinely experienced poor sleep quality reported anger levels that were 18%-35% higher compared to workers receiving fair sleep quality. Regardless of their typical sleep quality, days when workers experienced poorer sleep than usual was characterized by higher levels of anger: on a day when a worker experienced poorer sleep quality than usual for them, their anger levels were 5% higher on that day regardless of their typical sleep quality. CONCLUSIONS EMS workers regularly experiencing poor sleep quality experience more anger. However, even workers who typically have better sleep quality experience anger elevations following poor sleep. These findings suggest that interventions targeting both between- and within-person factors impacting sleep may be important for addressing sleep quality's influence on anger in the EMS profession.
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Affiliation(s)
- Bryce Hruska
- Department of Public Health, Syracuse University, Syracuse, NY, USA.
| | - Lauren Anderson
- Department of Public Health, Syracuse University, Syracuse, NY, USA
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Baker PM, Mathis V, Lecourtier L, Simmons SC, Nugent FS, Hill S, Mizumori SJY. Lateral Habenula Beyond Avoidance: Roles in Stress, Memory, and Decision-Making With Implications for Psychiatric Disorders. Front Syst Neurosci 2022; 16:826475. [PMID: 35308564 PMCID: PMC8930415 DOI: 10.3389/fnsys.2022.826475] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/10/2022] [Indexed: 01/02/2023] Open
Abstract
In this Perspective review, we highlight some of the less explored aspects of lateral habenula (LHb) function in contextual memory, sleep, and behavioral flexibility. We provide evidence that LHb is well-situated to integrate different internal state and multimodal sensory information from memory-, stress-, motivational-, and reward-related circuits essential for both survival and decision making. We further discuss the impact of early life stress (ELS) on LHb function as an example of stress-induced hyperactivity and dysregulation of neuromodulatory systems within the LHb that promote anhedonia and motivational deficits following ELS. We acknowledge that recent technological advancements in manipulation and recording of neural circuits in simplified and well-controlled behavioral paradigms have been invaluable in our understanding of the critical role of LHb in motivation and emotional regulation as well as the involvement of LHb dysfunction in stress-induced psychopathology. However, we also argue that the use of ethologically-relevant behaviors with consideration of complex aspects of decision-making is warranted for future studies of LHb contributions in a wide range of psychiatric illnesses. We conclude this Perspective with some of the outstanding issues for the field to consider where a multi-systems approach is needed to investigate the complex nature of LHb circuitry interactions with environmental stimuli that predisposes psychiatric disorders.
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Affiliation(s)
- Phillip M. Baker
- Department of Psychology, Seattle Pacific University, Seattle, WA, United States
- *Correspondence: Phillip M. Baker,
| | - Victor Mathis
- CNRS UPR 3212, Institut des Neurosciences Cellulaires et Intégratives, Center National de la Recherche Scientifique, University of Strasbourg, Strasbourg, France
| | - Lucas Lecourtier
- CNRS, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), UMR 7364, Université de Strasbourg, Strasbourg, France
- Lucas Lecourtier,
| | - Sarah C. Simmons
- Department of Pharmacology and Molecular Therapeutics, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Fereshteh S. Nugent
- Department of Pharmacology and Molecular Therapeutics, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States
- Fereshteh S. Nugent,
| | - Sierra Hill
- Department of Psychology, Seattle Pacific University, Seattle, WA, United States
| | - Sheri J. Y. Mizumori
- Department of Psychology, University of Washington, Seattle, WA, United States
- Sheri J. Y. Mizumori,
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Ricketts EJ, Montalbano GE, Burgess HJ, McMakin DL, Coles ME, Piacentini J, Colwell CS. Sleep and chronotype in adults with persistent tic disorders. J Clin Psychol 2022; 78:1516-1539. [PMID: 35150595 DOI: 10.1002/jclp.23323] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/22/2021] [Accepted: 01/14/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study examined sleep disorders and sleep medication use rates, nighttime tics, and sleep and chronotype in relation to tic and co-occurring symptoms in adults with persistent tic disorders (PTDs), including Tourette's disorder (TD). METHODS One hundred twenty-five adult internet survey respondents rated sleep history, sleep, chronotype, tic severity, impairment, attention deficit hyperactivity disorder, obsessive-compulsive symptoms, anxiety, depression, and emotional and behavioral dyscontrol. RESULTS Bruxism, insomnia, tic-related difficulty falling asleep, and melatonin use were commonly endorsed. Sleep disturbance correlated with impairment, obsessive-compulsive symptoms, and emotional and behavioral dyscontrol. Eveningness correlated with vocal and total tic severity only in TD. Controlling for age and sex, age, impairment, and obsessive-compulsive symptoms predicted sleep disturbance, and age and tic severity predicted chronotype. CONCLUSIONS Impairment and obsessive-compulsive symptoms play a role in sleep disturbance in adults with PTDs, and may be intervention targets. Eveningness relates to tic severity, which may suggest the utility of interventions to advance chronotype.
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Affiliation(s)
- Emily J Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Gabrielle E Montalbano
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, Florida, USA.,Department of Neurology, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Meredith E Coles
- Department of Psychology, State University of New York-Binghamton, Binghamton, New York, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Christopher S Colwell
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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Nazari N, Sadeghi M, Samusenkov V, Aligholipour A. Factors associated with insomnia among frontline nurses during COVID-19: a cross-sectional survey study. BMC Psychiatry 2022; 22:40. [PMID: 35038999 PMCID: PMC8763304 DOI: 10.1186/s12888-022-03690-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/06/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Research predominantly suggests that nurses are at high risk of developing psychopathology. The empirical data show that the occurrence rate of problem-related sleep quality among clinical nurses is high. Therefore, this study was conducted to address the lack of information on the relationship between the coronavirus disease 2019 (COVID-19) pandemic and insomnia. METHODS A convenience sample of nurses (n = 680) completed an online survey that included the Insomnia severity index, the COVID-19-related psychological distress scale, the general health questionnaire, neuroticism, dysfunctional beliefs, attitudes about sleep scale, and difficulties in emotion regulation scale. RESULTS The results showed that 35.8% (n = 253) of nurses were classified as individuals with moderate to severe clinical insomnia. The results showed that the psychological distress generated by COVID-19 predicted insomnia (β = .47, SE = 0.02, P < .001, t = 13.27, 95% CI 0.31-0.46). Additionally, the association is mediated by psychopathology vulnerabilities, emotion dysregulation, dysfunctional beliefs about sleep, and neuroticism. Moreover, female nurses exhibited higher levels of insomnia (Cohen's d = .37), neuroticism (Cohen's d = 30), psychopathology vulnerability (Cohen's d = .26), and COVID-19-related psychological distress (Cohen's d = .23). CONCLUSION The present study's findings help to explain how pandemic consequences can be associated with insomnia. Additionally, the findings make a significant contribution to better understanding the role of neuroticism, emotion dysregulation, beliefs, and psychopathology vulnerability in the development of insomnia among nurses. The findings suggest the potential influence of cognitive behavioral therapy for insomnia (CBT-I) and transdiagnostic integrated therapies that could be incorporated into therapeutic programs designed to develop as a way of inhibiting or preventing insomnia among clinical nurses.
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Affiliation(s)
- Nabi Nazari
- Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran.
| | - Masoud Sadeghi
- Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran
| | - Vadim Samusenkov
- Department of Prosthetic Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Akram Aligholipour
- Departments of Psychology, Faculty of Human Sciences, Allameh Tabatabai University, Tehran, Iran
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Vieira LS, Machado WDL, Dal Pai D, Magnago TSBDS, Azzolin KDO, Tavares JP. Burnout y resiliencia en profesionales de enfermería de cuidados intensivos ante el COVID-19: estudio multicéntrico. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5778.3588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumen Objetivo: analizar la relación entre las dimensiones del Burnout y la resiliencia en el trabajo de los profesionales de enfermería de cuidados intensivos durante la pandemia de COVID-19, en cuatro hospitales del sur de Brasil. Método: se trata de un estudio multicéntrico, transversal, compuesto por 153 enfermeros y técnicos en enfermería de las Unidades de Cuidados Intensivos. Se recolectaron datos sociodemográficos, de salud y laborales y se aplicaron los instrumentos Maslach Burnout Inventory y Resilience at Work Scale 20. Los datos fueron sometidos a análisis descriptivo y a correlaciones bivariadas y parciales (análisis de redes). Resultados: la resiliencia en el trabajo tiene una correlación inversa con el agotamiento emocional (r= -0,545; p=0,01) y la despersonalización (r= -0,419; p=0,01) y directa con la realización profesional (r= 0,680; p=0,01). La variable con mayor influencia en la red de correlaciones fue la percepción del impacto de la pandemia en la salud mental. Conclusión: la resiliencia afecta los dominios agotamiento emocional y baja realización profesional del Burnout. El agotamiento emocional se manifiesta a través de trastornos psíquicos menores e impacta en las variables de salud física y mental de los trabajadores. Se debe fomentar el desarrollo de la resiliencia a nivel institucional para moderar la enfermedad.
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Affiliation(s)
- Lizandra Santos Vieira
- Universidade Federal do Rio Grande do Sul, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Musetti A, Gori A, Alessandra A, Topino E, Terrone G, Plazzi G, Cacioppo M, Franceschini C. The Interplay Between Problematic Online Pornography Use, Psychological Stress, Emotion Dysregulation and Insomnia Symptoms During the COVID-19 Pandemic: A Mediation Analysis. Nat Sci Sleep 2022; 14:83-92. [PMID: 35082545 PMCID: PMC8786338 DOI: 10.2147/nss.s348242] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/13/2022] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Although a link between problematic online pornographic use (POPU) and insomnia symptoms has been established, psychological and psychopathological mechanisms underlying this relationship are still not clear. Psychological stress and emotion dysregulation have been pointed out as relevant in the development and maintenance of insomnia. This study aims to explore the associations between POPU, psychological stress, emotion dysregulation and insomnia symptoms and to understand the mediating role of psychological stress and emotion dysregulation in the relationship between POPU and insomnia symptoms. PARTICIPANTS AND METHODS A sample of 776 Italian adults aged 19-48 years (51.4% female; M age = 28.49; SD = 7.33) completed questionnaires regarding demographics, COVID-19-related variables, POPU, psychological stress, emotion dysregulation, and insomnia symptoms. RESULTS After controlling for demographic covariates and COVID-19-related variables, multiple mediation model showed that higher psychological stress and emotion dysregulation fully mediated the link between POPU and insomnia. CONCLUSION The findings underscore the significance of the negative consequences of POPU and underline the importance of working on this and its effects on psychological stress and emotion dysregulation to limit insomnia.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Alessio Gori
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Eleonora Topino
- Department of Human Sciences, Lumsa University of Rome, Rome, Italy
| | - Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,IRCCS Institute of Neurological Sciences of Bologna (ISNB), Bologna, Italy
| | - Marco Cacioppo
- Department of Human Sciences, Lumsa University of Rome, Rome, Italy
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De Los Santos JAA, Labrague LJ, Falguera CC. Fear of COVID-19, poor quality of sleep, irritability, and intention to quit school among nursing students: A cross-sectional study. Perspect Psychiatr Care 2022; 58:71-78. [PMID: 33792054 PMCID: PMC8251196 DOI: 10.1111/ppc.12781] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/06/2021] [Accepted: 03/10/2021] [Indexed: 12/20/2022] Open
Abstract
PURPOSE This study aims to assess the fear of coronavirus disease 2019 (COVID-19) and its influence on the students' fear of COVID-19 and intention to leave nursing school. DESIGN AND METHODS This study employed a cross-sectional design using self-report questionnaires distributed to 261 nursing students from the Philippines. FINDINGS The first-year nursing students are found to be the most fearful among the group. The students' fear of COVID-19 is associated with their high irritability, poor sleep quality, and desire to quit nursing school. PRACTICE IMPLICATIONS Students are perturbed by the pandemic and teachers should implement supportive, teaching-learning strategies to address the student's needs.
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Affiliation(s)
| | | | - Charlie C. Falguera
- Department of NursingUniversity of the Philippines Manila‐ School of Health SciencesPalo LeytePhilippines
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Vieira LS, Machado WDL, Dal Pai D, Magnago TSBDS, Azzolin KDO, Tavares JP. Burnout and resilience in intensive care Nursing professionals in the face of COVID-19: A multicenter study. Rev Lat Am Enfermagem 2022. [PMID: 35649092 PMCID: PMC9150431 DOI: 10.1590/1518-8345.5778.3537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective: to analyze the relationship between the Burnout dimensions and the work resilience of intensive care Nursing professionals in the COVID-19 pandemic in four hospitals from southern Brazil. Method: this is a multicenter and cross-sectional study, composed of 153 nurses and nursing technicians of the Intensive Care Units. Sociodemographic, health and work-related questions were collected, and the Maslach Burnout Inventory and Resilience at Work Scale 20 instruments were applied. The data were submitted to descriptive analysis and to bivariate and partial correlations (network analysis). Results: work resilience presented an inverse correlation to emotional exhaustion (r=-0.545; p=0.01) and depersonalization (r=-0.419; p=0.01) and a direct one to professional achievement (r=0.680; p=0.01). The variable with the greatest influence on the correlation network was the perception of the impact of the pandemic on mental health. Conclusion: resilience interferes in the emotional exhaustion and low professional achievement domains of Burnout. Emotional exhaustion is conducted through minor psychological disorders, with an impact on the workers’ physical and mental health variables. The development of institutional resilience should be encouraged in order to moderate the illness.
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Affiliation(s)
- Lizandra Santos Vieira
- Universidade Federal do Rio Grande do Sul, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Cordoza M, Koons B, Perlis ML, Anderson BJ, Diamond JM, Riegel B. Self-reported poor quality of sleep in solid organ transplant: A systematic review. Transplant Rev (Orlando) 2021; 35:100650. [PMID: 34534733 DOI: 10.1016/j.trre.2021.100650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/25/2021] [Accepted: 09/05/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND High quality sleep of sufficient duration is vital to overall health and wellbeing. Self-reported poor quality of sleep, sleep reported as irregular in timing, marked by frequent awakenings, or shortened in duration, is common across the solid-organ transplant trajectory. AIM This Systematic Review aimed to summarize available literature on rates of self-reported poor quality of sleep among solid organ transplant candidates and recipients. METHODS A systematic search of published literature was conducted in PubMed/MEDLINE, Embase, Web of Science, CINHAL, and PsychInfo databases with no date restrictions. Original articles in the English language describing self-reported quality of sleep using standardized questionnaires in adults either waitlisted for, or who received a solid organ transplant (heart, lung, kidney, liver, pancreas, or multi-solid organ) were included. RESULTS Of a potential 2054 articles identified, 44 were included (63.6% renal transplant, 20.5% liver transplant, 11.4% lung transplant, and 4.5% included multiple organ transplant populations), with the majority (68.2%) focusing only on post-transplant populations. No included articles focused solely on heart or pancreas transplant populations. On average, the transplant population with the greatest improvement in quality of sleep (reported as poor sleep quality, insomnia, sleep disturbance, or sleep dissatisfaction) from transplant candidacy to post-transplantation were renal transplant (from 53.5% pre, to 38.9% post) followed by liver transplant patients (from 52.8% pre, to 46.3% post), while lung transplant patients remained similar pre- to post-transplantation (55.6% pre, to 52% post). Poor quality of sleep was frequently associated with anxiety and depression, poorer quality of life, restless legs syndrome, and higher comorbidity. CONCLUSIONS Reports of poor quality of sleep are highly prevalent across all solid-organ transplant populations, both pre- and post-transplantation. Future studies should assess quality of sleep longitudinally throughout all phases of the transplantation trajectory, with more research focusing on how to optimize sleep in solid organ transplant populations.
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Affiliation(s)
- Makayla Cordoza
- School of Nursing, University of Pennsylvania, Claire M. Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104, USA.
| | - Brittany Koons
- M. Lousie Fitzpatrick College of Nursing, Villanova University, 800 E. Lancaster Ave, Villanova, PA 19085 and Clinical Nurse, Heart and Vascular ICU, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| | - Michael L Perlis
- Behavioral Sleep Medicine Program, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104, USA.
| | - Brian J Anderson
- Hospital of the University of Pennsylvania, 3400 Spruce Street, 5036 Gates Building, Philadelphia, PA 19104, USA.
| | - Joshua M Diamond
- Lung Transplantation, Hospital of the University of Pennsylvania, 3400 Spruce Street, 9039 West Gates, Philadelphia, PA 19104, USA.
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Claire M. Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104, USA.
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Automatic Sleep-Arousal Detection with Single-Lead EEG Using Stacking Ensemble Learning. SENSORS 2021; 21:s21186049. [PMID: 34577255 PMCID: PMC8467870 DOI: 10.3390/s21186049] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/24/2021] [Accepted: 09/06/2021] [Indexed: 12/18/2022]
Abstract
Poor-quality sleep substantially diminishes the overall quality of life. It has been shown that sleep arousal serves as a good indicator for scoring sleep quality. However, patients are conventionally asked to perform overnight polysomnography tests to collect their physiological data, which are used for the manual judging of sleep arousals. Even worse, not only is this process time-consuming and cumbersome, the judgment of sleep-arousal events is subjective and differs widely from expert to expert. Therefore, this work focuses on designing an automatic sleep-arousal detector that necessitates only a single-lead electroencephalogram signal. Based on the stacking ensemble learning framework, the automatic sleep-arousal detector adopts a meta-classifier that stacks four sub-models: one-dimensional convolutional neural networks, recurrent neural networks, merged convolutional and recurrent networks, and random forest classifiers. This meta-classifier exploits both advantages from deep learning networks and conventional machine learning algorithms to enhance its performance. The embedded information for discriminating the sleep-arousals is extracted from waveform sequences, spectrum characteristics, and expert-defined statistics in single-lead EEG signals. Its effectiveness is evaluated using an open-accessed database, which comprises polysomnograms of 994 individuals, provided by PhysioNet. The improvement of the stacking ensemble learning over a single sub-model was up to 9.29%, 7.79%, 11.03%, 8.61% and 9.04%, respectively, in terms of specificity, sensitivity, precision, accuracy, and area under the receiver operating characteristic curve.
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Melatonin as a Potential Adjuvant Treatment for COVID-19 beyond Sleep Disorders. Int J Mol Sci 2021; 22:ijms22168623. [PMID: 34445329 PMCID: PMC8395320 DOI: 10.3390/ijms22168623] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023] Open
Abstract
Melatonin is registered to treat circadian rhythm sleep–wake disorders and insomnia in patients aged 55 years and over. The essential role of the circadian sleep rhythm in the deterioration of sleep quality during COVID-19 confinement and the lack of an adverse effect of melatonin on respiratory drive indicate that melatonin has the potential to be a recommended treatment for sleep disturbances related to COVID-19. This review article describes the effects of melatonin additional to its sleep-related effects, which make this drug an attractive therapeutic option for treating patients with COVID-19. The preclinical data suggest that melatonin may inhibit COVID-19 progression. It may lower the risk of the entrance of the SARS-CoV-2 virus into cells, reduce uncontrolled hyper-inflammation and the activation of immune cells, limit the damage of tissues and multiorgan failure due to the action of free radicals, and reduce ventilator-induced lung injury and the risk of disability resulting from fibrotic changes within the lungs. Melatonin may also increase the efficacy of COVID-19 vaccination. The high safety profile of melatonin and its potential anti-SARS-CoV-2 effects make this molecule a preferable drug for treating sleep disturbances in COVID-19 patients. However, randomized clinical trials are needed to verify the clinical usefulness of melatonin in the treatment of COVID-19.
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de Almondes KM, Marín Agudelo HA, Jiménez-Correa U. Impact of Sleep Deprivation on Emotional Regulation and the Immune System of Healthcare Workers as a Risk Factor for COVID 19: Practical Recommendations From a Task Force of the Latin American Association of Sleep Psychology. Front Psychol 2021; 12:564227. [PMID: 34093295 PMCID: PMC8172768 DOI: 10.3389/fpsyg.2021.564227] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 04/13/2021] [Indexed: 01/14/2023] Open
Abstract
Healthcare workers who are on the front line of coronavirus disease 2019 (COVID-19) and are also undergoing shift schedules face long work hours with few pauses, experience desynchronization of their circadian rhythm, and an imbalance between work hours effort and reward in saving lives, resulting in an impact on work capacity, aggravated by the lack of personal protective equipment (PPE), few resources and precarious infrastructure, and fear of contracting the virus and contaminating family members. Some consequences are sleep deprivation, chronic insomnia, stress-related sleep disorders, and post-traumatic stress disorder. These sleep alterations critically affect mental health, precipitating or perpetuating anxiety, stress, and depression, resulting in the inability to regulate positive and negative emotions. Pre-existing sleep disorders are an important risk factor for the development and maintenance of PSTD when individuals are exposed to an important stressor such as a COVID-19 pandemic. At the same time, how an individual regulates the emotion associated with worries during daytime functioning impacts nighttime sleep, precipitating and perpetuating difficulties in sleeping. All of these changes in sleep and emotional regulation also alter the immune system. Sleep deprivation is commonly associated with chronic inflammatory diseases, due to the desynchronizations in circadian rhythms, causing possible psychophysiological disorders and impaired neuroimmune-endocrine homeostasis. From this perspective, we clarify in this article how sleep disorders affect the immune system and emotional regulation, explaining their phenomenological and neurobiological mechanisms, and discussing elements of cognitive and behavioral coping for health professionals to adopt and manage a healthier sleep pattern in the COVID-19 outbreak.
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Affiliation(s)
- Katie Moraes de Almondes
- AMBSONO Sleep Clinic, Department of Psychology and Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Ulises Jiménez-Correa
- Sleep Disorders Clinic, Research Division, Medicine Faculty, National Autonomous University of Mexico, Mexico City, Mexico
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Mei S, Hu Y, Sun M, Fei J, Li C, Liang L, Hu Y. Association between Bullying Victimization and Symptoms of Depression among Adolescents: A Moderated Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3316. [PMID: 33806969 PMCID: PMC8005068 DOI: 10.3390/ijerph18063316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/06/2021] [Accepted: 03/19/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Bullying victimization and its effect on symptoms of depression have received attention from researchers, but few studies have considered the potential mechanism. The aim of this study was to examine a moderated mediation model for the association between bullying victimization and depressive symptoms in terms of it being mediated by social anxiety, and investigated whether sleep duration would show moderating effects in this relationship. METHODS In this study, there were 2956 students, who completed three questionnaires, including a bullying victimization scale, as well as a social anxiety and epidemiologic studies depression scale. RESULTS Bullying victimization's effects on depressive symptoms were mediated by social anxiety. Furthermore, sleep duration moderated the relationship between bullying victimization and depressive symptoms. CONCLUSIONS The research contributes by clarifying the mechanisms underlying the relationship between bullying victimization and depressive symptoms.
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Affiliation(s)
- Songli Mei
- Department of Child and Adolescent Health, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China;
| | - Yueyang Hu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Mengzi Sun
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China;
| | - Junsong Fei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Chuanen Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Leilei Liang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Yuanchao Hu
- Department of Child and Adolescent Health, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China;
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Gross EC, Putananickal N, Orsini AL, Vogt DR, Sandor PS, Schoenen J, Fischer D. Mitochondrial function and oxidative stress markers in higher-frequency episodic migraine. Sci Rep 2021; 11:4543. [PMID: 33633187 PMCID: PMC7907128 DOI: 10.1038/s41598-021-84102-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 02/12/2021] [Indexed: 01/31/2023] Open
Abstract
Increasing evidence points towards the role of mitochondrial functioning, energy metabolism, and oxidative stress in migraine. However not all previous research has been conclusive and some mitochondrial function/oxidative stress markers have not yet been examined. To this end, alpha-lipoic acid (ALA), total thiols, total plasma antioxidant capacity (TAC), lipid peroxide (PerOx), oxidised LDL (oxLDL), HbA1c and lactate were determined in the serum of 32 higher frequency episodic migraineurs (5-14 migraine days/ months, 19 with aura, 28 females) in this cross-sectional study. The majority of patients had abnormally low ALA and lactate levels (87.5% and 78.1%, respectively). 46.9% of the patients had abnormally high PerOx values, while for thiols and TAC over one third of patients had abnormally low values (31.2% and 37.5%, respectively). 21.9% of patients had abnormally low HbA1c and none had an HbA1c level above 5.6%. oxLDL was normal in all but one patient. This study provides further evidence for a role of oxidative stress and altered metabolism in migraine pathophysiology, which might represent a suitable therapeutic target. ALA, being too low in almost 90% of patients, might represent a potential biomarker for migraine. Further research is needed to replicate these results, in particular a comparison with a control group.This study is part of the trial registration: ClinicalTrials.gov: NCT03132233, registered on 27.04.2017, https://clinicaltrials.gov/ct2/show/NCT03132233 .
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Affiliation(s)
- Elena C Gross
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.
| | - Niveditha Putananickal
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - Anna-Lena Orsini
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
- Neurology Department, University Hospital Basel (USB), University of Basel, Basel, Switzerland
| | - Deborah R Vogt
- Clinical Trail Unit (CTU), Department of Clinical Research, University Hospital Basel (USB), University of Basel, Basel, Switzerland
| | - Peter S Sandor
- RehaClinic Group, Bad Zurzach, University of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Jean Schoenen
- Headache Research Unit, Dept of Neurology-Citadelle Hospital., University of Liège, Liège, Belgium
| | - Dirk Fischer
- Division of Paediatric Neurology, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
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Pavlopoulou G. A Good Night's Sleep: Learning About Sleep From Autistic Adolescents' Personal Accounts. Front Psychol 2021; 11:583868. [PMID: 33469436 PMCID: PMC7814098 DOI: 10.3389/fpsyg.2020.583868] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/24/2020] [Indexed: 12/24/2022] Open
Abstract
Background Sleep is a strong predictor of quality of life and has been related to cognitive and behavioral functioning. However, research has shown that most autistic people experience sleep problems throughout their life. The most common sleep problems include sleep onset delay, frequent night-time wakings and shorter total sleep time. Despite the importance of sleep on many domains, it is still unclear from first-hand accounts what helps autistic people to sleep. The purpose of this study is to explore together with autistic adolescents their sleep-related practices before bedtime and during the day which contribute to a good night’s sleep. Methods Fifty-four autistic adolescents collaborated with an academic researcher in a novel adapted photo-elicitation methodology, rooted in a Lifeworld framework. The adolescents were invited to collect and analyze their data. The data were also presented in a community knowledge exchange event. Results Several self-reported practices that facilitate better nocturnal sleep were identified. Those were organized into two thematics: Evening/bedtime factors and Day time factors. These included practices such as personalized sensory and relaxation tools before bed and during night-time, engaging in a range of physical activities during daytime and accommodating personal time to engage with highly preferred and intense focus activities and hobbies. It also included spending time in predictable and fun ways with family members before bedtime. Conclusion This is the first time that a study uses a novel methodological approach based on personal accounts elicited by photos rooted in a Lifeworld framework to describe personal sleep-related practices before bedtime and during the day to identify a “good night of sleep” in autistic adolescents. The outcomes from the current study showed that sleep facilitating factors are in a direct contrast to the sleep hygiene recommendations. Therefore, it is thus important for the sleep practitioners and healthcare providers to move beyond providing standardized sleep hygiene interventions. A Lifeworld led care model that pays attention to personal experiences, promotes sense of agency, evaluates both autism-specific strengths and struggles could and should complement biomedical approaches. Lay Summary This is the first study to examine autistic adolescents’ self-reported sleep habits and factors which facilitate autistic adolescents’ sleep by employing adapted photo-elicitation interviews. This study is innovative in at least three ways. First, it examines the factors that may facilitate a good night’s sleep through personal accounts of autistic adolescents. Second, this is the first sleep study to adopt a collaborative, flexible approach to understanding positive sleep factors in the lives of autistic adolescents. This study employed a personalized approach into collecting, categorizing, coding, and analyzing qualitative data allowing autistic adolescents and the researcher to work together across key stages of data collection and data analysis. Third, we adopted a theoretical framework that allows us to consider autistic adolescents in both agency and vulnerability positions when it comes to their sleep difficulties. Our results highlight that sleep should be treated individually and in relation to the environmental and personal factors that affect each autistic person. Hence, researchers and professionals may benefit from working collaboratively with autistic adolescents with the aim to identify individual strengths and adopt a positive narrative around sleep. Furthermore, it is important to further examine both the daytime and evening factors that may affect bedtime and the quality and quantity of sleep as well as the role of intense focused interests and physical activities that cultivate positive feelings and help autistic people to relax before bedtime.
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Affiliation(s)
- Georgia Pavlopoulou
- Department of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom.,Anna Freud National Centre for Children and Families, London, United Kingdom
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Grecucci A, Sığırcı H, Lapomarda G, Amodeo L, Messina I, Frederickson J. Anxiety Regulation: From Affective Neuroscience to Clinical Practice. Brain Sci 2020; 10:E846. [PMID: 33198228 PMCID: PMC7697078 DOI: 10.3390/brainsci10110846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 12/11/2022] Open
Abstract
According to psychoanalysis, anxiety signals a threat whenever a forbidden feeling emerges. Anxiety triggers defenses and maladaptive behaviors, thus leading to clinical problems. For these reasons, anxiety regulation is a core aspect of psychodynamic-oriented treatments to help clients. In the present theoretical paper, we review and discuss anxiety generation and dysregulation, first from a neural point of view, presenting findings from neuroimaging and psychophysiological studies. The aim is to trace parallels with psychodynamic theories of anxiety. Then, we discuss the psychological mechanisms and neural bases of emotion regulation in the laboratory, and possible neurobiological mechanisms of anxiety regulation in psychotherapy. We describe two different approaches to emotion/anxiety regulation, one based on the standard cognitive model of emotion regulation, the other based on psychodynamic principles and affective neuroscience. We then illustrate in detail a dynamic experiential approach to regulation. This model claims that emotions arise before cognition and are not inherently dysregulated. Dysregulation emerges from co-occurrences of emotions and associated anxiety. Technical consequences of this model are discussed and include strategies to regulate anxiety.
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Affiliation(s)
- Alessandro Grecucci
- Department of Psychology and Cognitive Sciences, Clinical and Affective Neuroscience Lab, University of Trento, 38068 Rovereto, Italy; (H.S.); (G.L.); (L.A.)
| | - Hüseyin Sığırcı
- Department of Psychology and Cognitive Sciences, Clinical and Affective Neuroscience Lab, University of Trento, 38068 Rovereto, Italy; (H.S.); (G.L.); (L.A.)
| | - Gaia Lapomarda
- Department of Psychology and Cognitive Sciences, Clinical and Affective Neuroscience Lab, University of Trento, 38068 Rovereto, Italy; (H.S.); (G.L.); (L.A.)
| | - Letizia Amodeo
- Department of Psychology and Cognitive Sciences, Clinical and Affective Neuroscience Lab, University of Trento, 38068 Rovereto, Italy; (H.S.); (G.L.); (L.A.)
| | - Irene Messina
- Department of Psychiatry and Psychotherapy III, University of Ulm, 89069 Ulm, Germany;
| | - Jon Frederickson
- Washington School of Psychiatry, 5028 Wisconsin Ave NW, Washington, DC 20016, USA;
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