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Song J, Jeronimus BF, Fisher AJ. Sleep, event appraisal, and affect: An ecological momentary assessment study. J Affect Disord 2024; 361:376-382. [PMID: 38885846 DOI: 10.1016/j.jad.2024.06.034] [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: 03/21/2023] [Revised: 05/15/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Appraisal theory posits that emotions result from cognitive appraisals of events and situations. Experimental work suggests that sleep influences cognitive processes and event appraisal, which the present study examines in real life. Poor sleep influences brain regions involved in the appraisal-to-emotion process, and tired participants showed more conservative appraisal and reported less positive and more negative affect. In the present study, we tested whether sleep duration and/or quality predicted more pleasant event appraisal and whether sleep moderated the association between event appraisal and affect. METHODS Participants (N = 892) from the general Dutch population reported thrice daily on event appraisal and various emotions for 30 days and once daily on sleep duration and quality. We constructed multilevel models to account for the nested structure of our data (observations within participants). RESULTS Multilevel regression analyses showed that on days when participants reported having slept longer and better than their average, their event appraisal was more positive. Subjective sleep duration and quality did not influence the relationship between event appraisal and affect. Hence, poor sleep predicted changes in cognitive functioning, as people appraised situations as more unpleasant. LIMITATIONS We measured subjective sleep duration and quality with two single items and focused on only pleasantness dimension of event appraisal. CONCLUSIONS Results match perspectives on emotions as multicomponent systems involving appraisal processes. Understanding the elements of event appraisal may help unravel the detrimental effects of poor sleep on mental health and well-being.
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Affiliation(s)
- Jiyoung Song
- Department of Psychology, University of California, Berkeley, United States of America.
| | - Bertus F Jeronimus
- Department of Developmental Psychology, University of Groningen, Groningen, Netherlands
| | - Aaron J Fisher
- Department of Psychology, University of California, Berkeley, United States of America
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2
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Burger P, Steur LMH, Polderman JAW, Twisk JWR, Lindeboom R, Gemke RJBJ. Sleep disturbances in hospitalized children: a wake-up call. Eur J Pediatr 2024; 183:4063-4072. [PMID: 38958694 PMCID: PMC11322318 DOI: 10.1007/s00431-024-05660-x] [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: 04/16/2024] [Revised: 06/05/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Abstract
Although sleep is essential for (recovery of) health, it is adversely affected by hospitalization, due to disease discomfort, environmental noise, and care routines, causing reduced sleep and increased disturbances. This study evaluates factors affecting sleep quality and quantity in hospitalized children and compares inpatient sleep with sleep at home. Using an observational, prospective study design, we assessed sleep in hospitalized children aged 1-12 years, admitted to a tertiary center, and compared this with home 6-8 weeks after discharge. We measured total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency, awakenings, and subjective sleep quality, using actigraphy, sleep diaries, and PROMIS questionnaires. We explored an array of sleep-disturbing factors. Regression analyses identified key determinants affecting sleep patterns, while mixed linear models compared sleep in hospital to sleep at home. Out of 621 eligible patients, 467 were invited, and 272 (58%) consented to participate. Key determinants of sleep included pain, number of previous admissions, (underlying) chronic illness, and environment-, staff-, and disease-related factors. Parents reported lower perceived sleep quality in the hospital compared to at home, 97-min (SE 9) lower TST, 100-min (5) longer WASO, more difficulties with falling asleep, lower sleep satisfaction, and more awakenings. Actigraphy outcomes revealed shorter TST (20 min (6)), but better sleep efficiency and fewer awakenings in the hospital. Conclusion: Sleep in hospital was compromised in comparison to sleep at home, primarily due to disturbances related to treatment, environment, and staff. These findings underscore the necessity and potential of relative simple interventions to improve sleep quality and minimize sleep disturbances in hospitalized children.
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Affiliation(s)
- Pia Burger
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Lindsay M H Steur
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Jos W R Twisk
- Department of Clinical Epidemiology and Data Science, Amsterdam Public Health, Amsterdam UMC, Amsterdam, The Netherlands
| | - Robert Lindeboom
- Department of Clinical Epidemiology and Data Science, Amsterdam Public Health, Amsterdam UMC, Amsterdam, The Netherlands
| | - Reinoud J B J Gemke
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands.
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.
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3
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Luo X, Shen Y, Sun L, Qi X, Hong J, Wang Y, Che X, Lei Y. Investigating the effects and efficacy of self-compassion intervention on generalized anxiety disorders. J Affect Disord 2024; 359:308-318. [PMID: 38795780 DOI: 10.1016/j.jad.2024.05.117] [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: 12/25/2023] [Revised: 05/19/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is the least successfully treated anxiety disorder. This clinical trial investigated the effects and efficacy of a novel self-compassion intervention in GAD. METHODS A total of 75 GAD patients were assigned to a self-compassion intervention group (n = 25), a mindfulness intervention group (n = 25), or a treat-as-usual group (n = 25). Patients in the two active groups received eight intervention sessions in two weeks in addition to usual treatment i.e., pharmacotherapy. Primary outcomes were anxiety and worry, assessed at pre-intervention, post-intervention, and three-month follow-up. Secondary outcomes included depression, sleep, as well as self-compassion and mindfulness. RESULTS Both the self-compassion and mindfulness intervention induced a more rapid decrease in anxiety and depression than pharmacological treatment alone with excellent response and remission rate. Self-compassion intervention also induced a more rapid improvement in sleep quality compared to mindfulness intervention and pharmacological treatment alone. We also presented a mechanism for the self-compassion intervention in which decreased anxiety led to improvement in sleep quality. There was also a higher pleasure, acceptance, and willingness to re-attend in the self-compassion compared to the mindfulness intervention. LIMITATIONS This study was single blinded and nonrandomized which may bring risks of bias. CONCLUSIONS Overall, we provided novel evidence that self-compassion intervention is an alternative psychotherapy for GAD with excellent response and acceptability.
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Affiliation(s)
- Xi Luo
- School of Nursing, Hangzhou Medical College, Hangzhou 310059, China
| | - Yonghui Shen
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310013, China
| | - Lijun Sun
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310013, China
| | - Xuejun Qi
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310013, China
| | - Jie Hong
- Heilongjiang Academy of Traditional Chinese Medicine, Harbin 150036, China
| | - Ying Wang
- Centre for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou 311121, China
| | - Xianwei Che
- Centre for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou 311121, China; TMS Centre, Deqing Hospital of Hangzhou Normal University, Hangzhou 311121, China
| | - Yi Lei
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610054, China.
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Tighe CA, Phares A, Weiner DK, Beehler GP, VanSwearingen J, Harvey AG, Hilgeman MM, Buysse DJ, Forman DE. Adapting and Evaluating the Feasibility and Acceptability of a Behavioral Intervention to Promote Sleep Health in Cardiac Rehabilitation. Behav Sleep Med 2024:1-16. [PMID: 39120442 DOI: 10.1080/15402002.2024.2386602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
OBJECTIVES Study objectives were to: 1) iteratively adapt the Transdiagnostic Sleep and Circadian Intervention (TranS-C) for patients in cardiac rehabilitation (CR; Phase 1) and 2) conduct a preliminary single group pre-post intervention test to a) evaluate procedural feasibility and intervention acceptability and b) to explore preliminary pre-post changes in self-reported sleep, disability, and health-related quality of life (HRQoL; Phase 2). METHOD In Phase 1, 12 individuals in CR and six content experts completed interviews to inform TranS-C adaptations. Interviews were analyzed using rapid qualitative analysis. In Phase 2, eight individuals in CR completed a baseline assessment, the adapted TranS-C intervention, and a post-intervention assessment. Intervention acceptability was assessed via questionnaire and interview. Sleep, disability, and HRQoL outcomes were assessed using questionnaires. Descriptive statistics were calculated for quantitative measures; interviews were analyzed using rapid qualitative analysis. RESULTS Phase 1 participants were receptive to the premise and structure of the adapted intervention. In Phase 2, participants endorsed positive attitudes toward the intervention. Seven of eight participants demonstrated improvements in sleep outcomes. Disability and HRQoL results did not consistently improve. CONCLUSION The adapted TranS-C intervention was acceptable to CR patients and could yield improvements in subjective sleep outcomes. Larger-scale testing in CR is warranted.
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Affiliation(s)
- Caitlan A Tighe
- VISN 4 Mental Illness Research, Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Psychology, Providence College, Providence, RI, USA
| | - Angela Phares
- VISN 4 Mental Illness Research, Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Debra K Weiner
- Geriatric Research Education and Clinical Center (GRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gregory P Beehler
- Center for Integrated Healthcare, VA Center for Integrated Healthcare, Buffalo, NY, USA
- Community Health and Health Behavior, School of Public Health and Health Professions, University of Buffalo, Buffalo, NY, USA
| | - Jessie VanSwearingen
- Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Allison G Harvey
- Psychology Department, University of California Berkeley, Berkeley, CA, USA
| | - Michelle M Hilgeman
- Research & Development Service, Tuscaloosa VA Medical Center, Tuscaloosa, AL, USA
- Department of Medicine, Division of Gerontology, Geriatrics, & Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Psychology and Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, AL, USA
| | - Daniel J Buysse
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Daniel E Forman
- Center for Health Equity Research and Promotion (CHERP), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Geriatric Research Education and Clinical Center (GRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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5
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Upenieks L, Hill TD, Orfanidis C. Crisis of Faith and Sleep Quality in the United States: A Literal Dark Night of the Soul? JOURNAL OF RELIGION AND HEALTH 2024; 63:3066-3087. [PMID: 38095765 DOI: 10.1007/s10943-023-01958-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/04/2023] [Indexed: 08/13/2024]
Abstract
A crisis of faith is an intrapersonal struggle with ultimate meaning that occurs when one's supramundane reality is called in question. We propose a theoretical model which suggests that a crisis of faith will contribute to poorer sleep quality by undermining a general sense of meaning and purpose in life, especially among women. We use national survey data from the Wave 5 of the Baylor Religion Survey United States (N = 1395). Ordinary least squares regression models with robust standard errors are utilized. Sobel-Goodman mediation techniques are used to test the proposed mediating pathway. Our results suggest that a crisis of faith is associated with lower sleep quality, and that this pathway is partially mediated by a lower sense of meaning and purpose in life. Finally, we found that the relationship between a crisis of faith and lower sleep quality was weaker for women. We discuss the implications of our results and suggest how future research may explore the relevance of a crisis of faith for well-being as well as other aspects of the human condition.
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Affiliation(s)
- Laura Upenieks
- Department of Sociology, Baylor University, 97326 One Bear Place, Waco, TX, 76798, USA.
| | - Terrence D Hill
- Department of Sociology, University of Texas at San Antonio, San Antonio, USA
| | - Christos Orfanidis
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
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Sobol M, Błachnio A, Meisner M, Szyszkowska J, Jankowski KS. Sleep, circadian activity patterns and postpartum depression: A systematic review and meta-analysis of actigraphy studies. J Sleep Res 2024; 33:e14116. [PMID: 38095248 DOI: 10.1111/jsr.14116] [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: 07/28/2023] [Revised: 10/15/2023] [Accepted: 11/14/2023] [Indexed: 01/16/2024]
Abstract
Transition to motherhood is a period full of challenges and demands. In this review, we focused on the associations of sleep and circadian activity patterns during and after pregnancy with postpartum mental health factors. A systematic review and meta-analysis were conducted (PROSPERO reference 316,505). A search for articles was performed using PsycARTICLES, PsycINFO, PubMed, MEDLINE, Scopus, Cochrane, DARE, hand search, and citation tracking. The search was meant to identify peer-reviewed, experimental and observational studies reporting on women over 18 years old that assessed sleep and circadian activity patterns during pregnancy or postpartum using actigraphy, and investigated postpartum mental health factors. Nineteen relevant publications were selected. Postpartum total sleep at night was the indicator that was most closely related to the psychological functioning of women after childbirth. The results of the systematic review indicated that postpartum total sleep at night was related to postpartum fatigue, and the results of the meta-analysis suggested that total sleep at night was most strongly linked with postpartum depression. More studies are needed to estimate the associations of sleep-wake rhythm during pregnancy and in the postpartum period with postpartum mental health factors.
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Affiliation(s)
| | - Agata Błachnio
- Department of Psychology, Catholic University of Lublin, Lublin, Poland
| | - Michał Meisner
- Department of Psychology, University of Warsaw, Warsaw, Poland
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7
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Willroth EC, Pfund GN, Rule PD, Hill PL, John A, Kyle K, Hassenstab J, James BD. A review of the literature on wellbeing and modifiable dementia risk factors. Ageing Res Rev 2024; 99:102380. [PMID: 38880341 PMCID: PMC11260526 DOI: 10.1016/j.arr.2024.102380] [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: 03/11/2024] [Revised: 05/31/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024]
Abstract
Wellbeing-defined broadly as experiencing one's life as enjoyable and fulfilling-has been associated with lower risk for Alzheimer's disease and related dementias. The mechanisms underlying this association are largely unknown. However, prior research and theory suggest that wellbeing impacts health behaviors and biological systems that are relevant to cognitive and brain health. Several of these factors have also been identified by the 2020 Lancet Commission on Dementia Prevention, Intervention, and Care as modifiable dementia risk factors. In the current review, we summarize and evaluate the evidence for associations between wellbeing and each of the 12 Lancet Commission risk factors. We found relatively consistent evidence for associations between higher wellbeing and lower levels of most of the risk factors: physical inactivity, social isolation, smoking, depression, hypertension, diabetes, hearing loss, traumatic brain injury, and air pollution. By contrast, we found evidence for only modest associations between wellbeing and education and mixed evidence for associations of wellbeing with alcohol use and body weight. Although most of the reviewed evidence was observational, longitudinal and experimental evidence suggests that many of the observed associations are likely bidirectional. These findings suggest that modifiable dementia risk factors may be mediators (i.e., intermediate steps in the causal chain) and/or confounders (i.e., variables that impact both wellbeing and dementia, and thus could induce a spurious association) of the association between wellbeing and dementia. We conclude by discussing next steps to test mediation hypotheses and to account for potential confounding in the relation between wellbeing and dementia.
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Affiliation(s)
- Emily C Willroth
- Department of Psychological & Brain Sciences, Washington University in St. Louis, United States.
| | - Gabrielle N Pfund
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, United States
| | - Payton D Rule
- Department of Psychological & Brain Sciences, Washington University in St. Louis, United States
| | - Patrick L Hill
- Department of Psychological & Brain Sciences, Washington University in St. Louis, United States
| | - Amber John
- Department of Clinical, Educational, and Health Psychology, University College London, United Kingdom
| | - Kalista Kyle
- Department of Psychology, University of Toronto, Canada
| | - Jason Hassenstab
- Department of Psychological & Brain Sciences, Washington University in St. Louis, United States; Department of Neurology, Washington University in St. Louis, United States
| | - Bryan D James
- Rush Alzheimer's Disease Center, Department of Internal Medicine, Rush University Medical Center, United States; Rush Alzheimer's Disease Center, United States
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8
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Aboaja AM, Dewa LH, Perry AE, Carey JF, Steele R, Abdelsamie A, Alhasan GTA, Sharma IS, Watson F, Cairney SA. Sleep interventions for adults admitted to psychiatric inpatient settings: A systematic scoping review. Sleep Med Rev 2024; 76:101950. [PMID: 38788520 DOI: 10.1016/j.smrv.2024.101950] [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: 12/15/2022] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
Sleep disturbances are common, affecting over half of adults with a mental disorder. For those admitted to a psychiatric ward, difficulties with sleep, particularly insomnia, are compounded by factors relating to the inpatient setting. We conducted a scoping review of sleep intervention studies involving adults admitted to psychiatric settings. We categorised the different types of sleep interventions and identified the effects on sleep and other mental and physical health outcomes. Instruments used to measure sleep were also examined. The search strategy yielded 4780 studies, of which 28 met the inclusion criteria. There was evidence of more non-pharmacological than pharmacological interventions having been tested in inpatient settings. Results indicated that non-pharmacological interventions based on cognitive behaviour therapy for insomnia improve sleep and may improve mental and physical health. Several distinct sleep measures were used in the studies. Gaps in the literature were identified, highlighting the importance of research into a wider range of sleep interventions tested against robust controls, using validated measures of sleep with evaluation of additional mental and physical health outcomes among a large sample size of adults in the psychiatric inpatient settings.
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Affiliation(s)
- Anne M Aboaja
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK; Mental Health and Addictions Research Group, University of York, York, UK.
| | - Lindsay H Dewa
- School of Public Health, Imperial College London, London, UK; NIHR Imperial Biomedical Research Centre, London, UK
| | - Amanda E Perry
- Mental Health and Addictions Research Group, University of York, York, UK
| | - Jon F Carey
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Rachel Steele
- Library and Information Services, Tees, Esk and Wear Valleys, NHS Foundation Trust, UK
| | - Ahmed Abdelsamie
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Gies T A Alhasan
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Ishwari S Sharma
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Florence Watson
- Forensic Service, Tees, Esk and Wear Valleys NHS Foundation Trust, UK
| | - Scott A Cairney
- Department of Psychology, University of York, UK; York Biomedical Research Institute (YBRI), University of York, UK
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Hariri M, Shamshirgaran SM, Amini A, Abasi H, Gholami A. Sleep duration and quality are associated with health-related quality of life in adults aged 60 years and older. Ir J Med Sci 2024; 193:1929-1937. [PMID: 38489125 DOI: 10.1007/s11845-024-03656-y] [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: 11/25/2023] [Accepted: 02/27/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND The current study aimed to determine the association between sleep duration and quality with health-related quality of life (HRQoL) among the Iranian older persons. METHODS This study was conducted on a representative sample of 3452 Iranian older people (≥ 60 years) who participated in the Iranian Longitudinal Study on Ageing (IRLSA) launched in Neyshabur (Razavi Khorasan province, northeastern Iran). The Persian versions of 12-Item Short Form Survey (SF-12) and Pittsburgh Sleep Quality Index (PSQI) were utilized to measure the level of HRQoL and the level of sleep duration and quality, respectively. Multiple linear regression model was performed to analyze the data and clarify the independent association of sleep duration and quality with HRQoL. RESULTS More than half of the study population (52.4%) suffered from poor sleep quality. 57.3% and 3.9% of individuals were short sleepers (< 7 h) and long sleepers (equal or more than 9 h), respectively. The total score of HRQoL was achieved 65.87 ± 20.55. After adjusting the covariates, the results indicated that short sleep duration was negatively associated with HRQoL (P < 0.05), whereas no significant associations were found between long sleep duration and HRQoL (P > 0.05). Interestingly, the results of multiple linear regression model revealed a significant negative association between poor sleep quality and HRQoL (P < 0.001). CONCLUSION The current study confirmed that short sleep duration and poor sleep quality were independently associated with lower HRQoL in the older persons. Therefore, interventional courses should be planned to enrich sleep-related healthcare and general HRQoL in the older persons.
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Affiliation(s)
- Mitra Hariri
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Seyed Morteza Shamshirgaran
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Asieh Amini
- Department of English Language Teaching, Razi University, Kermanshah, Iran
| | - Hamid Abasi
- Public Health Department, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran.
- Department of Epidemiology and Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran.
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10
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Liu X, Li C, Chen X, Tian F, Liu J, Liu Y, Liu X, Yin X, Wu X, Zuo C, He C. Social support and sleep quality in people with schizophrenia living in the community: the mediating roles of anxiety and depression symptoms. Front Public Health 2024; 12:1414868. [PMID: 39139661 PMCID: PMC11319290 DOI: 10.3389/fpubh.2024.1414868] [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: 04/09/2024] [Accepted: 07/19/2024] [Indexed: 08/15/2024] Open
Abstract
Introduction Research has demonstrated that higher social support is associated with better psychological health, quality of life, cognition, activities of daily living, and social participation, but the relationship between social support and sleep quality remains unknown. This study aims to investigate the mediating effects of anxiety and depression in the relationship between social support and sleep among community-dwelling patients with schizophrenia. Method Purposive sampling was used to collect face-to-face data from 1,107 community-dwelling patients with schizophrenia in Chengdu, Sichuan Province, China, between April and July 2023. The Athens Insomnia Scale (AIS) was used to assess sleep quality; the Generalized Anxiety Disorder 7-item scale (GAD-7) was utilized to evaluate anxiety symptoms; and the Patient Health Questionnaire-9 (PHQ-9) was employed to assess depressive symptoms. The mediating effect of anxiety and depression symptoms was assessed using the bootstrap method via Model 6 (Serial multiple mediator model) of the SPSS PROCESS macro. Results Among the 1,107 participants, the proportions of people with schizophrenia experiencing anxiety, depressive symptoms, and poor sleep quality were 22.8, 37.7, and 42.1%, respectively. Mediation analyses indicated that although social support had no direct effect on sleep quality, anxiety and depressive symptoms fully mediated the relationship between social support and sleep quality. Conclusion Patients with schizophrenia experience low levels of social support and poor sleep quality. To enhance the sleep quality of individuals with schizophrenia, all levels of society (government, medical institutions, and communities) must pay more attention to mental health. Implementing diverse intervention measures to strengthen social support and improve symptoms of anxiety and depression should be considered. This approach may potentially lead to an improvement in sleep quality among individuals with schizophrenia.
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Affiliation(s)
- Xin Liu
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Chao Li
- The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Xushu Chen
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Fengxiang Tian
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Juan Liu
- Western Theater General Hospital, Chengdu, China
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaolan Yin
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiangrui Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chuanlong Zuo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Changjiu He
- The Fourth People’s Hospital of Chengdu, Chengdu, China
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11
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Mingins JE, Tarver J, Pearson E, Edwards G, Bird M, Crawford H, Oliver C, Shelley L, Waite J. Development and psychometric properties of the Clinical Anxiety Scale for People with Intellectual Disabilities (ClASP-ID). J Neurodev Disord 2024; 16:43. [PMID: 39068415 PMCID: PMC11283710 DOI: 10.1186/s11689-024-09554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND There is a critical need for the development of dependable and valid anxiety assessment tools suitable for people with moderate to severe intellectual disabilities, particularly those who speak few or no words. Distinguishing anxiety from distress caused by physical discomfort (pain) or characteristics associated with autism, prevalent in this population, necessitates specialised assessment tools. This study (a) developed a parent-report anxiety questionnaire tailored for individuals with severe to moderate intellectual disabilities, potentially with a co-diagnosis of autism, and (b) evaluated the psychometric attributes of this novel measure. METHODS A comprehensive approach involving literature reviews, inspection of existing tools, and interviews with clinicians and parents guided the creation of the Clinical Anxiety Scale for People with Intellectual Disabilities. The tool was completed by parents or caregivers (N = 311) reporting on individuals aged 4 or older with intellectual disabilities. RESULTS Exploratory factor analysis indicated a four-factor structure encompassing anxiety, pain, low energy/withdrawal, and consolability. The anxiety factor explained the most variance in scores (26.3%). The anxiety, pain, low energy/withdrawal subscales demonstrated robust internal consistency (α = 0.81-0.92), and convergent, divergent, and discriminant validity. Robustness of these subscales was further evidenced by test-retest reliability (ICC = 0.79-0.88) and inter-rater reliability (ICC = 0.64-0.71). Subgroup analyses consistently demonstrated strong psychometric properties among individuals diagnosed with non-syndromic autism (N = 98), children (N = 135), adults (N = 175), and across diverse communication abilities within the sample. Moreover, individuals diagnosed with both autism and anxiety exhibited significantly higher scores on the anxiety subscale compared to those without an anxiety diagnosis, while showing no difference in autism characteristic scores. CONCLUSIONS The findings indicate that the Clinical Anxiety Scale for People with Intellectual Disabilities is a promising measure for use across diverse diagnostic groups, varying communication abilities, and with people with moderate to severe intellectual disabilities.
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Affiliation(s)
- Jessica Eliza Mingins
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom.
| | - Joanne Tarver
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
| | - Effie Pearson
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
| | - Georgina Edwards
- School of Health and Care, Coventry University, Priory St, Coventry, CV1 5FB, England
| | - Megan Bird
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, England
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, England
| | - Lauren Shelley
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
| | - Jane Waite
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, B4 7 ET, United Kingdom
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12
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Regli J, Sadeghi-Bahmani D, Rigotti V, Stanga Z, Ülgür II, Fichter C, Lang UE, Brühl AB, Brand S. Psychiatric Characteristics, Symptoms of Insomnia and Depression, Emotion Regulation, and Social Activity among Swiss Medical Students. J Clin Med 2024; 13:4372. [PMID: 39124639 PMCID: PMC11313248 DOI: 10.3390/jcm13154372] [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: 06/19/2024] [Revised: 07/19/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Almost by default, young adult students are at increased risk of suffering from mental health issues, and this holds particularly true for medical students. Indeed, compared to the general population and non-medical students, medical students report higher scores for symptoms of depression. For Swiss medical students, research on the associations between psychiatric characteristics and symptoms of depression and insomnia, including cognitive-emotional processes and social activity, has been lacking so far. Given this, the aims of the present study were to relate self-declared psychiatric characteristics to symptoms of depression, insomnia, emotion regulation, and social activity. Methods: A total of 575 medical students (mean age: 22.4 years; 68.9% females) completed an online survey covering sociodemographic information (age and gender), study context (year of study), self-declared psychiatric characteristics and symptoms of depression, insomnia, emotion regulation (cognitive reappraisal vs. emotion suppression), and social activity. Data on insomnia sum scores and categories of historical samples (862 non-medical students and 533 police and emergency response service officers) were used for comparison. Results: Of the 575 participants, 190 participants (33%) self-declared psychiatric issues, such as major depressive disorder; anxiety disorders, including PTSD and adjustment disorders; eating disorders; ADHD; or a combination of such psychiatric issues. Self-reporting a psychiatric issue was related to higher symptoms of depression and insomnia and lower symptoms of social activity and cognitive reappraisal (always with significant p-values and medium effect sizes). Compared to historical data for non-medical students and police and emergency response service officers, medical students reported higher insomnia scores. In a regression model, current self-declared psychiatric issues, female gender, higher scores for insomnia, and lower scores for social activity were associated with higher scores for depression. Conclusions: Among a sample of Swiss medical students, the occurrence of self-declared psychiatric issues was associated with higher scores for depression and insomnia and lower cognitive reappraisal and social activity. Further, insomnia scores and insomnia categories were higher when compared to non-medical students and to police and emergency response service officers. The data suggest that medical schools might introduce specifically tailored intervention and support programs to mitigate medical students' mental health issues. This holds particularly true for insomnia, as standardized and online-delivered treatment programs for insomnia (eCBTi) are available.
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Affiliation(s)
- Jonas Regli
- Faculty of Medicine, University of Basel, 4001 Basel, Switzerland
| | - Dena Sadeghi-Bahmani
- Department of Psychology, Stanford University, Stanford, CA 94305, USA;
- Department of Epidemiology & Population Health, Stanford University, Stanford, CA 94305, USA
| | - Viola Rigotti
- Outpatient Medical Clinic, University Hospital of Basel, 4031 Basel, Switzerland;
| | - Zeno Stanga
- Centre of Competence for Military and Disaster Medicine, Swiss Armed Forces, 3008 Bern, Switzerland; (Z.S.); (I.I.Ü.)
- Division of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, University Hospital, University of Berne, 3012 Berne, Switzerland
| | - Ismail I. Ülgür
- Centre of Competence for Military and Disaster Medicine, Swiss Armed Forces, 3008 Bern, Switzerland; (Z.S.); (I.I.Ü.)
| | - Christian Fichter
- Department of Psychology, Kalaidos University of Applied Sciences, 8050 Zurich, Switzerland;
| | - Undine E. Lang
- Adult Psychiatric Hospital of the University of Basel, 4002 Basel, Switzerland;
| | - Annette B. Brühl
- Center for Affective, Stress and Sleep Disturbances, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
| | - Serge Brand
- Center for Affective, Stress and Sleep Disturbances, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, 4052 Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 1417653761, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
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13
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Zeng Y, Song J, Zhang Y, Guo X, Xu X, Fan L, Zhao L, Song H, Jiang L. Life changes and symptoms of depression and anxiety among Chinese children and adolescents before, during, and after the COVID-19 pandemic lockdown: a combination of cross-sectional, longitudinal, and clustering studies. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02533-4. [PMID: 39060517 DOI: 10.1007/s00787-024-02533-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
The measures to prevent COVID-19 pandemic had caused significant life changes, which may have caused stress on the mental health of children and adolescents. We aimed to evaluate the short- and long-term effects of life changes on children's mental health in a large Chinese cohort. Survey-based life changes during COVID-19 lockdown were measured among 7,829 Chinese students at Grade 1-9, including social contacts, lifestyles and family financial status. Clustering analysis was applied to identify potential patterns of these changes. Depressive and anxiety symptoms were measured using the Center for Epidemiologic Studies Depression Scale and Screen for Child Anxiety Related Emotional Disorders. Logistic regression models were used to investigate the associations between these changes, their patterns and the presence of depression/anxiety symptoms using both cross-sectional and longitudinal designs. We found that the prevalence of depression and anxiety symptoms decreased during pandemic (34.6-32.6%). However, during and shortly after lockdown, students who reported negative impacts on their study, social and outside activities, and diet had increased risks of depressive/anxiety symptoms. Decreased electronic time and sugar-sweetened consumption, as well as family income decline and unemployment, were also associated with higher risks of these symptoms. Additionally, students with changed sleep time had increased depressive symptoms. These associations attenuated or disappeared one year later. Similar patterns were observed in clustering analysis, while only the group with severe impact on family financial status showed a sustained increase in depression symptoms. In summary, restrictive measures that changed children and adolescents' daily life during COVID-19 lockdown showed negative effects on their mental health, with some commonalities and distinctions patterns in the manifestation of depression and anxiety symptoms.
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Affiliation(s)
- Yu Zeng
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Jie Song
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Yanan Zhang
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Xinyu Guo
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xinmao Xu
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Linlin Fan
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Huan Song
- Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Lihua Jiang
- Teaching & Research Section of General Practice, The General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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14
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Danish M, Dratva MA, Lui KK, Heyworth N, Wang X, Malhotra A, Hartman SJ, Lee EE, Sundermann EE, Banks SJ. Intersections of Modifiable Risks: Loneliness is Associated with Poor Subjective Sleep Quality in Older Women at Risk for Alzheimer's Disease. Int J Aging Hum Dev 2024:914150241255888. [PMID: 39054949 DOI: 10.1177/00914150241255888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
We examined the relationship between subjective and objective sleep outcomes and loneliness in older women at risk for Alzheimer's disease (AD). Our sample consisted of 39 participants (aged 65+) with mild cognitive deficits who completed the UCLA Loneliness Scale, the Pittsburgh Sleep Quality Index (PSQI), and an at home sleep test, to determine presence of obstructive sleep apnea. Based on sleep quality scores, individuals categorized as "poor sleepers" had significantly higher loneliness scores than "good sleepers." However, total loneliness scores did not significantly differ between groups with or without sleep apnea. We found that higher loneliness was significantly associated to lower habitual sleep efficiency and sleep duration and was also influenced by use of sleep medication. Our findings suggest that increased loneliness relates to worse subjective sleep quality, but not to sleep apnea. These findings suggest that combined interventions targeting loneliness and sleep quality may be important for older women.
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Affiliation(s)
- Madina Danish
- MADURA ADAR Program, University of California, San Diego, La Jolla, CA, USA
| | - Melanie A Dratva
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Kitty K Lui
- Joint Doctoral Program in Clinical Psychology, SDSU/UC San Diego, San Diego, CA, USA
| | - Nadine Heyworth
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Xin Wang
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Atul Malhotra
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Sheri J Hartman
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Ellen E Lee
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Erin E Sundermann
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Sarah J Banks
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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15
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Schneider KE, Martin EM, Urquhart GJ, Sisson LN, Rouhani S, Morris M, Spira AP, Sherman SG. Sleep-related impairment among people who use opioids: The critical role of structural vulnerability. Sleep Health 2024:S2352-7218(24)00160-8. [PMID: 39068134 DOI: 10.1016/j.sleh.2024.07.003] [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: 02/01/2023] [Revised: 06/20/2024] [Accepted: 07/02/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE People who use opioids are vulnerable to sleep disturbances due to a range of factors, including the substances they use and the various structural vulnerabilities they face. We aimed to understand the burden of sleep-related impairment and problems pertaining to sleep context and schedule among people who use opioids. METHODS We explored sleep quality and problems among a suburban sample of people who use opioids experiencing extensive structural vulnerabilities (N = 170). Participants reported their most urgent concern in the past week (e.g., sleep, drug use, housing), their sleep context, sleep problems, sleep schedules, and scores on the PROMIS Sleep-Related Impairment measure. We then quantified associations between Sleep-Related Impairment scores and sociodemographics and substance use. RESULTS Participants were primarily men (66%) and non-Hispanic Black (67%) with a mean age of 42 (SD: 12.1). Many experienced hunger (44%) and literal homelessness (40%). One-quarter (28%) reported that sleep was their most urgent concern in the past week. The most common problems when falling or staying asleep were mental health-related symptoms (81%) and pain/discomfort (32%). Literal homelessness (β = 2.2, 95% CI: 0.6, 3.7), hunger (β = 2.3, 95% CI: 1.0, 3.6), and frequent alcohol use (β = 1.5, 95% CI: 0.2, 2.7) were significantly associated with Sleep-Related Impairment scores. CONCLUSIONS Homelessness and hunger are associated with sleep-related impairment in people who use opioids. Poor sleep quality, substance use, structural vulnerability, and mental health problems are all interrelated sources of functional impairment in this population. Interventions that address poverty as an underlying cause of sleep-related impairment and provide safe sleeping environments are needed.
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Affiliation(s)
- Kristin E Schneider
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
| | - Emily M Martin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Glenna J Urquhart
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura N Sisson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Saba Rouhani
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, New York University School of Global Public Health, New York, New York, USA
| | - Miles Morris
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Center on Aging and Health, Baltimore, Maryland, USA
| | - Susan G Sherman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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16
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Dong M, Zhang X, Cao F. Psychopathology symptoms of frontline nurses under sudden public health crisis: A network analysis. Stress Health 2024:e3451. [PMID: 39046923 DOI: 10.1002/smi.3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 05/27/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024]
Abstract
Public health crises can significantly impact the emotional well-being of healthcare workers. Network analysis is a novel approach to exploring interactions between mental disorders at the symptom level. This study aimed to elucidate the characteristics of post-traumatic stress disorder (PTSD), anxiety, depression, and insomnia symptoms network among frontline nurses under sudden public health crisis. A cross-sectional survey was conducted online among 556 frontline nurses through convenience sampling in Hubei Province, China, from 21 February 2020, to 10 March 2020. Symptoms of PTSD, anxiety, depression, and insomnia were assessed by the Post-Traumatic Stress Disorder Checklist (PCL-5), Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9) and Insomnia Severity Index, respectively. Central symptoms (the most important symptoms, activation has the strongest influence the other nodes) and bridge symptoms (nodes where deactivation can prevent activation from spreading from one disorder to another) were identified via centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. We found that the correlation between PHQ-9 item 9 'suicidal thoughts' and PCL-5 item 16 'reckless or self-destructive behaviour' was the strongest. Moreover, 'reckless or self-destructive behaviour' was the strongest central symptom, and PHQ-9 item 3 'sleep problems' was the most important bridge symptom. Other major symptoms included GAD-7 item 6 'uncontrollable anxiety' and PHQ-9 item 2 'depressed or sad mood'. Timely, systemic targeting interventions on central symptoms and bridge symptoms may effectively alleviate co-occurring experiences of psychopathological symptoms among frontline nurses.
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Affiliation(s)
- Mengyuan Dong
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Xuan Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
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17
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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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18
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Tinney EM, España-Irla G, Warren AEL, Whitehurst LN, Stillman AM, Hillman CH, Morris TP. Axonal injury, sleep disturbances, and memory following traumatic brain injury. Ann Clin Transl Neurol 2024. [PMID: 39031956 DOI: 10.1002/acn3.52145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/22/2024] Open
Abstract
OBJECTIVES Traumatic brain injury (TBI) is associated with sleep deficits, but it is not clear why some report sleep disturbances and others do not. The objective of this study was to assess the associations between axonal injury, sleep, and memory in chronic and acute TBI. METHODS Data were acquired from two independent datasets which included 156 older adult veterans (69.8 years) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) with prior moderate-to-severe TBIs and 90 (69.2 years) controls and 374 (39.6 years) from Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) with a recent mild TBI (mTBI) and 87 controls (39.6 years), all who completed an MRI, memory assessment, and sleep questionnaire. RESULTS Older adults with a prior TBI had a significant association between axonal injury and sleep disturbances [β = 9.52, 95% CI (4.1, 14.9), p = 0.01]. Axonal injury predicted changes in memory over 1-year in TBI [β = -8.72, 95% CI (-18, -2.7), p = 0.03]. We externally validated those findings in TRACK-TBI where axonal injury within 2 weeks after mTBI was significantly associated with higher sleep disturbances in the TBI group at 2 weeks[β = -7.2, 95% CI (-14, -0.50), p = 0.04], 6 months [β = -16, 95% CI (-24, -7.6), p ≤ 0.01], and 12 months post-injury [β = -11, 95% CI (-19, -0.85), p = 0.03]. These associations were not significant in controls. INTERPRETATIONS Axonal injury, specifically to the left anterior internal capsule is robustly associated with sleep disturbances in multiple TBI populations. Early assessment of axonal injury following mTBI could identify those at risk for persistent sleep disturbances following injury.
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Affiliation(s)
- Emma M Tinney
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
- Center for Cognitive & Brain Health, Northeastern University, Boston, Massachusetts, USA
| | - Goretti España-Irla
- Center for Cognitive & Brain Health, Northeastern University, Boston, Massachusetts, USA
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Aaron E L Warren
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alexandra M Stillman
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Charles H Hillman
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
- Center for Cognitive & Brain Health, Northeastern University, Boston, Massachusetts, USA
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Timothy P Morris
- Center for Cognitive & Brain Health, Northeastern University, Boston, Massachusetts, USA
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
- Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
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19
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Hickman R, D’Oliveira TC, Davies A, Shergill S. Monitoring Daily Sleep, Mood, and Affect Using Digital Technologies and Wearables: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:4701. [PMID: 39066098 PMCID: PMC11280943 DOI: 10.3390/s24144701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
Background: Sleep and affective states are closely intertwined. Nevertheless, previous methods to evaluate sleep-affect associations have been limited by poor ecological validity, with a few studies examining temporal or dynamic interactions in naturalistic settings. Objectives: First, to update and integrate evidence from studies investigating the reciprocal relationship between daily sleep and affective phenomena (mood, affect, and emotions) through ambulatory and prospective monitoring. Second, to evaluate differential patterns based on age, affective disorder diagnosis (bipolar, depression, and anxiety), and shift work patterns on day-to-day sleep-emotion dyads. Third, to summarise the use of wearables, actigraphy, and digital tools in assessing longitudinal sleep-affect associations. Method: A comprehensive PRISMA-compliant systematic review was conducted through the EMBASE, Ovid MEDLINE(R), PsycINFO, and Scopus databases. Results: Of the 3024 records screened, 121 studies were included. Bidirectionality of sleep-affect associations was found (in general) across affective disorders (bipolar, depression, and anxiety), shift workers, and healthy participants representing a range of age groups. However, findings were influenced by the sleep indices and affective dimensions operationalised, sampling resolution, time of day effects, and diagnostic status. Conclusions: Sleep disturbances, especially poorer sleep quality and truncated sleep duration, were consistently found to influence positive and negative affective experiences. Sleep was more often a stronger predictor of subsequent daytime affect than vice versa. The strength and magnitude of sleep-affect associations were more robust for subjective (self-reported) sleep parameters compared to objective (actigraphic) sleep parameters.
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Affiliation(s)
- Robert Hickman
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK;
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London SE5 8AF, UK
| | - Teresa C. D’Oliveira
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK;
- School of Psychology and Life Sciences, Canterbury Christ Church University, North Holmes Road, Canterbury CT1 1QU, UK
- Kent and Medway Medical School, Canterbury Christ Church University and the University of Kent, Canterbury CT2 7NZ, UK;
| | - Ashleigh Davies
- Kent and Medway Medical School, Canterbury Christ Church University and the University of Kent, Canterbury CT2 7NZ, UK;
| | - Sukhi Shergill
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK;
- Kent and Medway Medical School, Canterbury Christ Church University and the University of Kent, Canterbury CT2 7NZ, UK;
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20
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Yupanqui-Lorenzo DE, Caycho-Rodríguez T, Baños-Chaparro J, Arauco-Lozada T, Palao-Loayza L, Rivera MEL, Barrios I, Torales J. Mapping of the network connection between sleep quality symptoms, depression, generalized anxiety, and burnout in the general population of Peru and El Salvador. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:27. [PMID: 39009857 PMCID: PMC11250734 DOI: 10.1186/s41155-024-00312-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 07/08/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND A meta-analysis of randomized controlled trials has suggested a bidirectional relationship between sleep problems and mental health issues. Despite these findings, there is limited conclusive evidence on the relationship between sleep quality, depression, anxiety, and burnout. OBJECTIVE The current study aimed to evaluate the relationships between sleep quality symptoms, anxiety, depression, and burnout in samples of adult individuals from two Latin American countries, Peru and El Salvador, through network analysis and to identify key symptoms that reinforce the correlation and intensify the syndromes. METHODS A total of 1012 individuals from El Salvador and Peru participated, with an average age of 26.5 years (SD = 9.1). Symptom networks were constructed for both countries based on data from the Jenkins Sleep Scale, Patient Health Questionnaire-2, General Anxiety Disorder-2, and a single burnout item. RESULTS The results indicated that Depressed Mood, Difficulty Falling Asleep, and Nervousness were the most central symptoms in a network in the participating countries. The strongest conditional associations were found between symptoms belonging to the same construct, which were similar in both countries. Thus, there is a relationship between Nervousness and Uncontrollable Worry, Anhedonia and Depressed Mood, and Nighttime Awakenings and Difficulty in Staying Asleep. It was observed that burnout is a bridge symptom between both countries and presents stronger conditional associations with Tiredness on Awakening, Depressed Mood, and Uncontrollable Worry. Other bridge symptoms include a Depressed Mood and Nervousness. The network structure did not differ between the participants from Peru and El Salvador. CONCLUSION The networks formed by sleep quality, anxiety, depression, and burnout symptoms play a prominent role in the comorbidity of mental health problems among the general populations of Peru and El Salvador. The symptom-based analytical approach highlights the different diagnostic weights of these symptoms. Treatments or interventions should focus on identifying central and bridge symptoms.
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Affiliation(s)
| | - Tomás Caycho-Rodríguez
- Universidad Científica del Sur, Facultad de Psicología, Campus Villa II, Ctra. Panamericana S 19, Villa El Salvador, Lima, Perú.
| | - Jonatan Baños-Chaparro
- Universidad Científica del Sur, Facultad de Psicología, Campus Villa II, Ctra. Panamericana S 19, Villa El Salvador, Lima, Perú
| | | | | | | | - Iván Barrios
- Universidad Sudamericana, Facultad de Ciencias de la Salud, Salto del Guairá, Paraguay
- Universidad Nacional de Asunción, Facultad de Ciencias Médicas, Filial Santa Rosa del Aguaray, Cátedra de Bioestadística, Santa Rosa del Aguaray, Paraguay
| | - Julio Torales
- Universidad Nacional de Asunción, Facultad de Ciencias Médicas, Cátedra de Psicología Médica, San Lorenzo, Paraguay
- Universidad Sudamericana, Facultad de Ciencias de la Salud, Salto del Guairá, Paraguay
- Universidad Nacional de Caaguazú, Instituto Regional de Investigación en Salud, Coronel Oviedo, Paraguay
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21
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Al-Garni AM, Alamri HS, Asiri WMA, Abudasser AM, Alawashiz AS, Badawi FA, Alqahtani GA, Ali Alnasser SS, Assiri AM, Alshahrani KTS, Asiri OAS, Moalwi OH, Alqahtani MS, Alqhatani RS. Social Media Use and Sleep Quality Among Secondary School Students in Aseer Region: A Cross-Sectional Study. Int J Gen Med 2024; 17:3093-3106. [PMID: 39049834 PMCID: PMC11268709 DOI: 10.2147/ijgm.s464457] [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: 02/17/2024] [Accepted: 07/03/2024] [Indexed: 07/27/2024] Open
Abstract
Background Use of different social media platforms has increased radically over the past decade, emerging as an important part of adolescents and young people's everyday life. This might exert potential adverse effects on sleep quality and daytime performance of young adults. Aim of Study To assess the relation between use of social media platforms and sleep quality among public secondary school students. Methods A cross-sectional study was conducted on 961 students in Aseer region, Saudi Arabia. Students were asked to fill in a structured interview questionnaire covering personal data, pattern of social media use, sleep quality using The Pittsburgh Sleep Quality Index (PSQI) and their mental health status using the depression, anxiety and stress scale (DASS-21). Results Students' ages ranged from 15 to 20 years with a mean age of 16.7 ± 2.1 years old. A total of 570 (59.3%) students were females. Tiktok (80%), Snapchat (77.9%), Instagram (63.8%) and YouTube (58.8%) were the most reported platforms used. Regarding their sleep quality, 34.7% of students were poor sleepers. TikTok use (OR 1.33, 95% CI 1.01-1.77), hours spent on social media (OR 1.26, 95% CI 1.16-1.37) and having moderate to severe depressive symptoms (OR 1.69, 95% CI 1.19-2.40) were significant independent predictors of poor sleep among the studied sample. Conclusion The present study emphasized the association between prolonged use of social media and poor sleep quality among Saudi adolescents. Awareness and behavioral change strategies and activities concerning the drawbacks of poor sleep and proper use of social media are urgently called for to control mental and physical health consequences of poor sleep and social media addiction.
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Affiliation(s)
- Abdulaziz M Al-Garni
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia
| | - Hasan S Alamri
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia
| | - Waddah M Alalmaei Asiri
- Department of Internal Medicine, College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia
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22
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Rameshkumar S, Arizmendi BJ, Salwen-Deremer JK. The role of arousal in maintaining the relationship between insomnia and gastrointestinal conditions. Transl Gastroenterol Hepatol 2024; 9:41. [PMID: 39091658 PMCID: PMC11292074 DOI: 10.21037/tgh-23-126] [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: 12/23/2023] [Accepted: 04/30/2024] [Indexed: 08/04/2024] Open
Abstract
The relationship between gastrointestinal (GI) conditions and sleep disturbance has been well established. With a higher-than-average prevalence of sleep disturbance in individuals with GI conditions, it is imperative to better understand the maintaining factors driving this comorbidity. Although there are separate, ongoing investigations into both the biological mechanisms and interventions for the sleep and GI relationship, there is a considerable need to further specify common and mutually influential pathways. In our review, we highlight arousal as both a unifying feature of insomnia and various GI conditions as well as a possible mechanism for action for the bidirectional relationship. This review aims to summarize the relationship between arousal, insomnia, and GI conditions, specifically examining sources of arousal across four broad domains: psychosocial factors, physical health factors, daily living factors, and sociocultural factors. Online databases, including PubMed, PsychInfo, and Google Scholar, were searched for full-text English language articles focused on patients with insomnia and/or GI conditions and involving mental health, physical comorbidities, and social factors. Understanding the nature of this bidirectional relationship between sleep and GI through the lens of arousal as a common mechanism will lend itself to using a multidisciplinary approach to treatment and care.
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Affiliation(s)
| | - Brian J. Arizmendi
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Jessica K. Salwen-Deremer
- Department of Psychiatry & Center for Digestive Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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23
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Christian LM, Kiecolt-Glaser JK, Cole SW, Burd CE, Madison AA, Wilson SJ, Rosko AE. Psychoneuroimmunology in multiple myeloma and autologous hematopoietic stem cell transplant: Opportunities for research among patients and caregivers. Brain Behav Immun 2024; 119:507-519. [PMID: 38643954 DOI: 10.1016/j.bbi.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/23/2024] Open
Abstract
Multiple myeloma (MM) is an incurable cancer and is the leading indication for autologous hematopoietic stem cell transplantation (HSCT). To be eligible for HSCT, a patient must have a caregiver, as caregivers play a central role in HSCT preparation and recovery. MM patients remain on treatment indefinitely, and thus patients and their caregivers face long-term challenges including the intensity of HSCT and perpetual therapy after transplant. Importantly, both patients and their caregivers show heightened depressive and anxiety symptoms, with dyadic correspondence evidenced and caregivers' distress often exceeding that of patients. An extensive psychoneuroimmunology (PNI) literature links distress with health via immune and neuroendocrine dysregulation as well as biological aging. However, data on PNI in the context of multiple myeloma - in patients or caregivers - are remarkably limited. Distress in MM patients has been associated with poorer outcomes including higher inflammation, greater one year post-HSCT hospital readmissions, and worse overall survival. Further, anxiety and depression are linked to biological aging and may contribute to the poor long-term health of both patients and caregivers. Because MM generally affects older adults, individual differences in biological aging may represent an important modifier of MM biology and HSCT treatment outcomes. There are a number of clinical scenarios in which biologically younger people could be prescribed more intensive therapies, with potential for greater benefit, by using a personalized cancer therapy approach based on the quantification of physiologic reserve. Further, despite considerable psychological demands, the effects of distress on health among MM caregivers is largely unexamined. Within this context, the current critical review highlights gaps in knowledge at the intersection of HSCT, inflammation, and biological aging in the context of MM. Research in this area hold promise for opportunities for novel and impactful psychoneuroimmunology (PNI) research to enhance health outcomes, quality of life, and longevity among both MM patients and their caregivers.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210 USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
| | - Janice K Kiecolt-Glaser
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Steve W Cole
- Departments of Psychiatry and Biobehavioral Sciences and Medicine, Division of Hematology-Oncology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Christin E Burd
- Department of Cancer Biology and Genetics, The Ohio State University, Columbus, OH 43210, USA; Department of Molecular Genetics, The Ohio State University, Columbus, OH 43210, USA
| | - Annelise A Madison
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA; Department of Psychology, The Ohio State University, Columbus, OH 43210, USA; Veteran's Affairs Boston Healthcare System, Boston, MA 02130, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA
| | - Stephanie J Wilson
- Department of Psychology, Southern Methodist University, Dallas, TX 75206, USA
| | - Ashley E Rosko
- Division of Hematology, James Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
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24
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Maity A, Wang AW, Dreier MJ, Wallace V, Orchard F, Schleider JL, Loades ME, Hamilton JL. How do adolescents experience a newly developed Online Single Session Sleep Intervention? A Think-Aloud Study. Clin Child Psychol Psychiatry 2024; 29:1137-1158. [PMID: 37978949 PMCID: PMC11188559 DOI: 10.1177/13591045231205475] [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: 11/19/2023]
Abstract
BACKGROUND Sleep problems are common in adolescents and have detrimental impacts on physical and mental health and daily functioning. Evidence-based treatment like cognitive behaviour therapy for insomnia (CBT-I) is often hard to access, and adolescents may not engage in and adhere to longer, clinician-delivered interventions. Brief, self-guided, and accessible sleep interventions are needed. OBJECTIVE To explore the user experience of a prototype online self-help single session sleep intervention developed for adolescents. METHODS Eleven participants aged 17-19 years (8 females, 3 males) took part in online retrospective think-aloud interviews. Participants first completed the prototype intervention independently and were then shown the intervention page by page and asked to verbalise their thoughts and experiences. Transcripts were analyzed thematically. RESULTS Participants found the intervention helpful. Four themes were generated - 'Educative: Learning, but more fun', 'Effortless: Quicker and Easier', 'Personalization: Power of Choice', and 'Positivity: Just Good Vibes'. The theme 'Educative: Learning, but more fun' encompassed two sub-themes 'Opportunity to Learn' and 'Aesthetics and Learning'. These themes reflected participants' views that the intervention was educative, personalised, solution-oriented and easy to use, but could incorporate more graphics and visuals to aid in learning and could be made more effortless and positive through modifications to its design. CONCLUSIONS Findings convey the importance of ensuring educative well-designed content, personalization, a positive tone, and ease of use while designing interventions targeting adolescents's sleep and mental health. They also indicate areas for further developing the intervention.
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Affiliation(s)
- Ananya Maity
- Department of Psychology, University of Bath, Bath, UK
| | - Angela W Wang
- Department of Psychology, Rutgers University, New Brunswick, USA
| | - Melissa J Dreier
- Department of Psychology, Rutgers University, New Brunswick, USA
| | | | - Faith Orchard
- School of Psychology, University of Sussex, Brighton, UK
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25
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Coelho J, Montagni I, Micoulaud-Franchi JA, Taillard J, Philip P, Plancoulaine S, Tzourio C. Why circadian rhythmicity matters: Associations between sleep irregularity and mental health conditions during the Covid-19 health crisis. World J Biol Psychiatry 2024; 25:330-341. [PMID: 38803010 DOI: 10.1080/15622975.2024.2359975] [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: 02/26/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE To assess the association between sleep irregularity, anxiety, and depression while controlling for other sleep dimensions and using a longitudinal design. METHODS Longitudinal cohort study which started in April 2020 during the first French lockdown in the general population. Follow-up questionnaires were completed in June 2020, a period without lockdown measures. Participants were asked about their sleep (regularity, duration, timing, complaints) and their anxiety (General Anxiety Disorder-7) and depressive (Patient Health Questionnaire-9) symptoms. RESULTS A total of 3745 participants were included (mean age: 28.9 years) with 2945 women (78.6%). At baseline, 38.1% (1428) of participants reported irregular sleep timing, 23.8% (891) anxiety and 28.9% (1081) depressive symptoms. In cross-sectional analyses, irregular sleep timing was associated with a 2.5-fold higher likelihood of anxiety and a 4-fold higher likelihood of depressive symptoms compared to regular sleepers. Associations were not explained by the other sleep dimensions and persisted in a longitudinal analysis, with irregular sleep timing at baseline being associated with anxiety (OR = 3.27[1.58-6.76]) and depressive symptoms (OR = 3.45[1.66-7.19]) during follow-up. CONCLUSION The results show a strong association between sleep irregularity and mental health. Furthers studies are needed to explore how sleep regularity could promote good mental health in non-clinical populations.
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Affiliation(s)
- Julien Coelho
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Ilaria Montagni
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Jacques Taillard
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Pierre Philip
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Sabine Plancoulaine
- Université Paris Cité, INSERM, INRAE, Centre de Recherche en Epidémiologie et StatistiquesS (CRESS), Paris, France
| | - Christophe Tzourio
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
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26
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Peltz JS, Rogge R. Unintended consequences: college students' melatonin usage, sleep disturbance, and depressive symptoms. Sleep Biol Rhythms 2024; 22:313-321. [PMID: 38962794 PMCID: PMC11217232 DOI: 10.1007/s41105-023-00506-9] [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: 09/01/2023] [Accepted: 11/27/2023] [Indexed: 07/05/2024]
Abstract
With such high rates of undergraduate sleep problems, students have chosen to take melatonin, an over-the-counter supplement that can facilitate sleep. Questions remain as to the effectiveness of melatonin for sleep problems, and questions have emerged about its impact on mental health. Accordingly, the current study examined how ongoing melatonin usage might impact relative changes in college students' sleep disturbance and ultimately their depressive symptoms. The two-wave (baseline and 2-month follow-up), online sample consisted of 331 undergraduates (86% female; Mage = 21.3, SD = 2.4), who reported on melatonin usage, sleep disturbance, and depressive symptoms. Controlling for sleep hygiene, socio-economic status, and gender, our model demonstrated a significant indirect effect from ongoing melatonin usage to depressive symptoms. Specifically, melatonin consumption predicted relative increases in sleep disturbance, which, in turn, predicted corresponding increases in students' depressive symptoms. Given the increasing prevalence of melatonin usage, the potential for unforeseen consequences remains high. Results suggest that the negative consequences of melatonin use can include both college students' mental health and their sleep. Given the efficacy of addressing sleep problems with cognitive or behavioral strategies, it is essential that student support services highlight alternatives to melatonin and the potential problems associated with its use.
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Affiliation(s)
- Jack S. Peltz
- State University of New York (SUNY) at Brockport, 350 New Campus Dr., Brockport, NY 14420 USA
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27
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Lee S, Oh JW, Park KM, Ahn JY, Lee S, Lee E. The prevalence and moderating factors of sleep disturbances in people living with HIV: a systematic review and meta-analysis. Sci Rep 2024; 14:14817. [PMID: 38937605 PMCID: PMC11211430 DOI: 10.1038/s41598-024-65713-x] [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: 04/01/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
This systematic review and meta-analysis aimed to investigate the prevalence of self-reported sleep disturbances in people living with HIV considering the effects of age, depression, anxiety, CD4 cell counts, time since HIV diagnosis, study region, and the instruments used to measure sleep disturbances. We searched PubMed, PsycINFO, and EMBASE to include eligible articles. In this meta-analysis of 43 studies, the pooled prevalence of self-reported sleep disturbances was 52.29% (95% confidence interval 47.69-56.87). The subgroup analyses revealed that variations in the sleep measurements and study region significantly contributed to the observed heterogeneity. In the meta-regression analyses, higher proportions of participants with depression or anxiety and longer times since HIV diagnosis were significantly associated with a higher prevalence of self-reported sleep disturbances after adjusting for mean age. Our findings emphasise the substantial burden of sleep disturbances in people living with HIV and identified comorbid depression and anxiety and the time since HIV diagnosis as significant moderators. These results underscore the importance of considering these factors when designing tailored screening programmes for high-risk patients and implementing early interventions to prevent and mitigate sleep disturbances in people living with HIV.
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Affiliation(s)
- Suonaa Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jae Won Oh
- Department of Psychology, The University of Utah Asia Campus, Incheon, Republic of Korea
| | - Kyung Mee Park
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Jin Young Ahn
- Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - San Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea.
| | - Eun Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
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28
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Liyanage G, Rajapakshe DPRW, Wijayaratna DR, Jayakody JAIP, Gunaratne KAMC, Alagiyawanna AMADK. Psychological distress and sleep quality among Sri Lankan medical students during an economic crisis. PLoS One 2024; 19:e0304338. [PMID: 38917140 PMCID: PMC11198848 DOI: 10.1371/journal.pone.0304338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/10/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVES This study examined the evidence of the prevalence of psychological distress and poor sleep among medical students and its associations during an economic crisis. DESIGN This was a cross-sectional study using an online questionnaire. It included the Depression Anxiety Stress Scales and Pittsburgh Sleep Quality Index (PSQI). SETTING AND PARTICIPANTS This study included medical undergraduates from a large metropolitan university in Sri Lanka. PRIMARY AND SECONDARY OUTCOME MEASURES We assessed the prevalence of psychological distress, sleep quality, and factors associated with psychological distress. To evaluate the associations, we used logistic regression. RESULTS The majority (69.2%) had some form of distress (depression, anxiety or stress), while 23% had distress in all three. Anxiety was the most prevalent (50.7%). Poor sleep quality was reported in 41%. The highest contribution to global PSQI was from sleep latency, duration, and daytime dysfunction subscales. In bivariate analysis, sleep quality was directly related to depression (t245.65 = -6.75, p<0.001)., anxiety (t313.45 = -6.45, p <0.001), and stress (t94.22 = -5.14, p <0.001). In multinomial logistic regression models, sleep quality was independently associated with depression, anxiety and stress. In addition, frequent contact with friends was inversely associated with depression and anxiety. Also, social media use was inversely linked to depression, anxiety and stress. Clinical-year students had lower depression and anxiety than non-clinical students. Engaging in mindfulness activities was inversely associated with depression. However, models explained only a moderate amount of variance (Nagelkerke R-squared values were 0.21, 0.18, and 0.13 for depression, anxiety and stress, respectively). CONCLUSIONS Poor sleep quality and psychological distress are high among the undergraduates. The findings emphasize the importance of addressing sleep quality and psychological wellbeing in medical undergraduates. Further research with larger and more diverse samples is needed for a more comprehensive understanding of the factors associated with psychological distress among undergraduates.
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Affiliation(s)
- Guwani Liyanage
- Faculty of Medical Sciences, Department of Paediatrics, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | | | - D. R. Wijayaratna
- Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - J. A. I. P. Jayakody
- Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | | | - A. M. A. D. K. Alagiyawanna
- Faculty of Medical Sciences, Department of Community Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Zhang Y, Folarin AA, Dineley J, Conde P, de Angel V, Sun S, Ranjan Y, Rashid Z, Stewart C, Laiou P, Sankesara H, Qian L, Matcham F, White K, Oetzmann C, Lamers F, Siddi S, Simblett S, Schuller BW, Vairavan S, Wykes T, Haro JM, Penninx BWJH, Narayan VA, Hotopf M, Dobson RJB, Cummins N. Identifying depression-related topics in smartphone-collected free-response speech recordings using an automatic speech recognition system and a deep learning topic model. J Affect Disord 2024; 355:40-49. [PMID: 38552911 DOI: 10.1016/j.jad.2024.03.106] [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: 09/26/2023] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND Prior research has associated spoken language use with depression, yet studies often involve small or non-clinical samples and face challenges in the manual transcription of speech. This paper aimed to automatically identify depression-related topics in speech recordings collected from clinical samples. METHODS The data included 3919 English free-response speech recordings collected via smartphones from 265 participants with a depression history. We transcribed speech recordings via automatic speech recognition (Whisper tool, OpenAI) and identified principal topics from transcriptions using a deep learning topic model (BERTopic). To identify depression risk topics and understand the context, we compared participants' depression severity and behavioral (extracted from wearable devices) and linguistic (extracted from transcribed texts) characteristics across identified topics. RESULTS From the 29 topics identified, we identified 6 risk topics for depression: 'No Expectations', 'Sleep', 'Mental Therapy', 'Haircut', 'Studying', and 'Coursework'. Participants mentioning depression risk topics exhibited higher sleep variability, later sleep onset, and fewer daily steps and used fewer words, more negative language, and fewer leisure-related words in their speech recordings. LIMITATIONS Our findings were derived from a depressed cohort with a specific speech task, potentially limiting the generalizability to non-clinical populations or other speech tasks. Additionally, some topics had small sample sizes, necessitating further validation in larger datasets. CONCLUSION This study demonstrates that specific speech topics can indicate depression severity. The employed data-driven workflow provides a practical approach for analyzing large-scale speech data collected from real-world settings.
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Affiliation(s)
- Yuezhou Zhang
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Amos A Folarin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; University College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK; Health Data Research UK London, University College London, London, UK
| | - Judith Dineley
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; University of Augsburg, Augsburg, Germany
| | - Pauline Conde
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Valeria de Angel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Shaoxiong Sun
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Computer Science, University of Sheffield, Sheffield, UK
| | - Yatharth Ranjan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Zulqarnain Rashid
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Callum Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Petroula Laiou
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Heet Sankesara
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Linglong Qian
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Faith Matcham
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; School of Psychology, University of Sussex, Falmer, East Sussex, UK
| | - Katie White
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carolin Oetzmann
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam University Medical Centre, Vrije Universiteit and GGZ InGeest, Amsterdam, the Netherlands
| | - Sara Siddi
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - Sara Simblett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Björn W Schuller
- University of Augsburg, Augsburg, Germany; GLAM - Group on Language, Audio, & Music, Imperial College London, London, UK
| | | | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam University Medical Centre, Vrije Universiteit and GGZ InGeest, Amsterdam, the Netherlands
| | | | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Richard J B Dobson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; University College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK; Health Data Research UK London, University College London, London, UK
| | - Nicholas Cummins
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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McCurry KL, Toda-Thorne K, Taxali A, Angstadt M, Hardi FA, Heitzeg MM, Sripada C. Data-driven, generalizable prediction of adolescent sleep disturbances in the multisite Adolescent Brain Cognitive Development Study. Sleep 2024; 47:zsae048. [PMID: 38366843 PMCID: PMC11168765 DOI: 10.1093/sleep/zsae048] [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: 08/31/2023] [Revised: 01/21/2024] [Indexed: 02/18/2024] Open
Abstract
STUDY OBJECTIVES Sleep disturbances are common in adolescence and associated with a host of negative outcomes. Here, we assess associations between multifaceted sleep disturbances and a broad set of psychological, cognitive, and demographic variables using a data-driven approach, canonical correlation analysis (CCA). METHODS Baseline data from 9093 participants from the Adolescent Brain Cognitive Development (ABCD) Study were examined using CCA, a multivariate statistical approach that identifies many-to-many associations between two sets of variables by finding combinations for each set of variables that maximize their correlation. We combined CCA with leave-one-site-out cross-validation across ABCD sites to examine the robustness of results and generalizability to new participants. The statistical significance of canonical correlations was determined by non-parametric permutation tests that accounted for twin, family, and site structure. To assess the stability of the associations identified at baseline, CCA was repeated using 2-year follow-up data from 4247 ABCD Study participants. RESULTS Two significant sets of associations were identified: (1) difficulty initiating and maintaining sleep and excessive daytime somnolence were strongly linked to nearly all domains of psychopathology (r2 = 0.36, p < .0001); (2) sleep breathing disorders were linked to BMI and African American/black race (r2 = 0.08, p < .0001). These associations generalized to unseen participants at all 22 ABCD sites and were replicated using 2-year follow-up data. CONCLUSIONS These findings underscore interwoven links between sleep disturbances in early adolescence and psychological, social, and demographic factors.
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Affiliation(s)
| | | | - Aman Taxali
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Felicia A Hardi
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Chandra Sripada
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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31
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Bendall RCA, Elton SN, Hughes ATL. Expressive suppression mediates the relationship between sleep quality and generalized anxiety symptomology. Sci Rep 2024; 14:13575. [PMID: 38866858 PMCID: PMC11169225 DOI: 10.1038/s41598-024-63939-3] [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: 10/13/2023] [Accepted: 06/03/2024] [Indexed: 06/14/2024] Open
Abstract
Anxiety disorders are the most prevalent worldwide mental health disorder, resulting in high societal costs. Emotion regulation and sleep quality are associated with the development of psychopathologies including anxiety. However, it is unknown whether habitual emotion regulation strategy use can mediate the influence of sleep quality on anxiety symptomology. An opportunity sample in a healthy population completed the Pittsburgh Sleep Quality Index to provide a measure of sleep quality, the Emotion Regulation Questionnaire to assess habitual use of emotion regulation strategies, and the Generalized Anxiety Disorder Scale to record anxiety symptomology. Data were analysed using correlation and regression-based mediation analyses. Improved sleep quality was predictive of reduced habitual use of expressive suppression and reduced anxiety symptomology. Additionally, increased use of expressive suppression was predictive of greater anxiety symptomology. Cognitive reappraisal was not associated with sleep quality or anxiety severity. Further, novel findings using mediation analyses show that expressive suppression partially mediated the relationship between sleep quality and anxiety. Whilst longitudinal and experimental research are needed to establish causality, these findings suggest that simultaneously targeting improvements in sleep quality and the use of specific emotion regulation strategies, including expressive suppression, may improve the efficacy of interventions focussed on reducing anxiety-related symptomology.
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Affiliation(s)
- Robert C A Bendall
- Directorate of Psychology and Sport, School of Health and Society, University of Salford, Salford, UK.
- Centre for Applied Health Research, University of Salford, Salford, UK.
| | - Sophie N Elton
- Directorate of Psychology and Sport, School of Health and Society, University of Salford, Salford, UK
| | - Alun T L Hughes
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
- Institute of Health Research, Liverpool John Moores University, Liverpool, UK
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32
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Martignoni MM, Raulo A, Linkovski O, Kolodny O. SIR+ models: accounting for interaction-dependent disease susceptibility in the planning of public health interventions. Sci Rep 2024; 14:12908. [PMID: 38839831 PMCID: PMC11153654 DOI: 10.1038/s41598-024-63008-9] [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] [Received: 10/10/2023] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Abstract
Avoiding physical contact is regarded as one of the safest and most advisable strategies to follow to reduce pathogen spread. The flip side of this approach is that a lack of social interactions may negatively affect other dimensions of health, like induction of immunosuppressive anxiety and depression or preventing interactions of importance with a diversity of microbes, which may be necessary to train our immune system or to maintain its normal levels of activity. These may in turn negatively affect a population's susceptibility to infection and the incidence of severe disease. We suggest that future pandemic modelling may benefit from relying on 'SIR+ models': epidemiological models extended to account for the benefits of social interactions that affect immune resilience. We develop an SIR+ model and discuss which specific interventions may be more effective in balancing the trade-off between minimizing pathogen spread and maximizing other interaction-dependent health benefits. Our SIR+ model reflects the idea that health is not just the mere absence of disease, but rather a state of physical, mental and social well-being that can also be dependent on the same social connections that allow pathogen spread, and the modelling of public health interventions for future pandemics should account for this multidimensionality.
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Affiliation(s)
- Maria M Martignoni
- Department of Ecology, Evolution and Behavior, Faculty of Sciences, A. Silberman Institute of Life Sciences, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Aura Raulo
- Department of Biology, University of Oxford, Oxford, UK
- Department of Computing, University of Turku, Turku, Finland
| | - Omer Linkovski
- Department of Psychology and The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Oren Kolodny
- Department of Ecology, Evolution and Behavior, Faculty of Sciences, A. Silberman Institute of Life Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
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33
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Chen F, Lin H, Zhang Y, Zhang Y, Chen L. The mediating role of sleep disturbance in the relationship between depression and cardiovascular disease. Front Psychiatry 2024; 15:1417179. [PMID: 38903636 PMCID: PMC11188478 DOI: 10.3389/fpsyt.2024.1417179] [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] [Received: 04/14/2024] [Accepted: 05/27/2024] [Indexed: 06/22/2024] Open
Abstract
Background Studies suggest that both depression and disrupted sleep disturbance are linked to cardiovascular disease (CVD). However, the precise role of sleep disturbance in the connection between depression and CVD is poorly understood. Therefore, we sought to examine the associations among these factors and further explore the mediating role of sleep disturbance in the association between depression and CVD. Methods This study included data from 29,831 adults (≥20 years old). Multifactorial logistic regression analyses were conducted to examine the relationships among depression, sleep disturbance, and CVD. Additionally, bootstrap tests were used to investigate whether the association between depression and CVD was mediated by sleep disturbance. Results Our research showed that individuals who experienced depression or sleep disturbance had a notably greater likelihood of developing CVD than those who did not have these issues (depression: OR: 2.21, 95% CI=1.96-2.49; sleep disturbance: OR: 1.74, 95% CI=1.6-1.9). Even after adjusting for potential confounders, depression was still positively associated with the risk of sleep disturbance (OR: 4.07, 95% CI=3.73-4.44). Furthermore, sleep disturbance significantly mediated the association between depression and CVD, with a mediating effect of 18.1%. Conclusion Our study demonstrated that depression, sleep disturbance, and CVD are interrelated. The increased risk of CVD among patients with depression may be attributed to the mediating role of sleep disturbance. This finding underscores the importance of interventions focused on sleep disturbances as a means to address the connection between depression and CVD.
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Affiliation(s)
- Feng Chen
- Department of Child Healthcare, Wenzhou People’s Hospital, Wenzhou, Zhejiang, China
| | - Hao Lin
- Department of Gastroenterology, Pingyang Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuansi Zhang
- Department of Traditional Chinese Medicine, Wenzhou Yebo Proctology Hospital, Wenzhou, Zhejiang, China
| | - Yu Zhang
- Department of Child Healthcare, Wenzhou People’s Hospital, Wenzhou, Zhejiang, China
| | - Linlin Chen
- Department of Child Healthcare, Wenzhou People’s Hospital, Wenzhou, Zhejiang, China
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Giannotta F, Nilsson KW, Åslund C, Olofdotter S, Vadlin S, Larm P. Anxiety, Sleep Problems, and Vigorous Physical Activity: Bidirectional Associations from Early Adolescence to Early Adulthood in Swedish Adolescents. J Youth Adolesc 2024; 53:1355-1369. [PMID: 38580891 PMCID: PMC11045630 DOI: 10.1007/s10964-024-01980-1] [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: 12/22/2023] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.
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Affiliation(s)
- F Giannotta
- Division of Public Health, School of Health, Care and Social Welfare, Malardalen University, Box 883, Västerås, Sweden.
- Department of Public Health, Stockholm University, SE-106 91, Stockholm, Sweden.
- Department of Psychology, University of Turin, via Verdi 10, 10124, Turin, Italy.
| | - K W Nilsson
- Division of Public Health, School of Health, Care and Social Welfare, Malardalen University, Box 883, Västerås, Sweden
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - C Åslund
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - S Olofdotter
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
| | - S Vadlin
- Centre for Clinical Research, Västmanland County Hospital Västerås, Uppsala University, S-72189, Västerås, Sweden
| | - P Larm
- Department of Public Health, Stockholm University, SE-106 91, Stockholm, Sweden
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35
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Semenza DC, Silver IA, Stansfield R, Bamwine P. Local gun violence, mental health, and sleep: A neighborhood analysis in one hundred US Cities. Soc Sci Med 2024; 351:116929. [PMID: 38733888 DOI: 10.1016/j.socscimed.2024.116929] [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: 06/05/2023] [Revised: 11/29/2023] [Accepted: 04/29/2024] [Indexed: 05/13/2024]
Abstract
RATIONALE Community gun violence significantly shapes public health and collective well-being. Understanding how gun violence is associated with community health outcomes like mental health and sleep is crucial for developing interventions to mitigate disparities exacerbated by violence exposure. OBJECTIVE This study examines the associations between community gun violence , insufficient sleep, and poor mental health across neighborhoods in the United States. METHODS We utilized a novel database covering nearly 16,000 neighborhoods in 100 US cities from 2014 through 2019. Correlated trait fixed-effects models were employed to conduct all analyses while considering various neighborhood covariates such as concentrated disadvantage, demographic composition, population density, and proximity to trauma centers. RESULTS Our analysis revealed that greater gun violence is associated with both insufficient sleep and poor mental health in subsequent years. There is a reciprocal relationship between poor mental health and insufficient sleep, with each partially mediating the other's association with community gun violence. Notably, gun violence exhibits the strongest direct association with poor sleep rather than with poor mental health. We found a consistent reciprocal relationship between sleep and mental health at the community level. CONCLUSIONS The findings highlight a complex interplay between community violence, sleep, and mental health, underlining the importance of reducing community violence through numerous long-term interventions to address health disparities across the US.
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Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University - Camden, NJ, USA; Department of Urban-Global Public Health, Rutgers University, New Brunswick, NJ, USA; New Jersey Gun Violence Research Center, Rutgers University, NJ, USA.
| | - Ian A Silver
- Research Triangle Institute, Research Triangle Park, NC, USA
| | - Richard Stansfield
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University - Camden, NJ, USA
| | - Patricia Bamwine
- College of Social Work, University of Tennessee, Knoxville, TN, USA
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36
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Michielsen M, Böhmer MN, Vermeulen RCH, Vlaanderen JJ, Beekman ATF, Kooij JJS. ADHD, sleep, chronotype and health in a large cohort of Dutch nurses. J Psychiatr Res 2024; 174:159-164. [PMID: 38636152 DOI: 10.1016/j.jpsychires.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/05/2024] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Affiliation(s)
- M Michielsen
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands.
| | - M N Böhmer
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands
| | - R C H Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, Utrecht, the Netherlands
| | - J J Vlaanderen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, Utrecht, the Netherlands
| | - A T F Beekman
- Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center/VUmc, Oldenaller 1, 1081 HL, Amsterdam, the Netherlands
| | - J J S Kooij
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands; Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center/VUmc, Oldenaller 1, 1081 HL, Amsterdam, the Netherlands
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37
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Luyster FS, Baniak LM, Imes CC, Jeon B, Morris JL, Orbell S, Scott P. Association of comorbid obstructive sleep apnea and insomnia with risk of major adverse cardiovascular events in sleep medicine center patients. Sleep Health 2024; 10:335-341. [PMID: 38704352 DOI: 10.1016/j.sleh.2024.03.001] [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: 07/24/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES To investigate the association between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events, including myocardial infarction, unstable angina, congestive heart failure, and stroke, in adults with suspected sleep disorders who underwent sleep apnea testing. METHODS We conducted a retrospective analysis of electronic medical records data from patients with clinical encounters at sleep medicine centers to identify patients with comorbid obstructive sleep apnea and insomnia, obstructive sleep apnea only, insomnia only, and patients without a diagnosis of obstructive sleep apnea or insomnia (i.e., controls). Obstructive sleep apnea, insomnia, comorbidities, and new-onset major adverse cardiovascular events were ascertained by ICD-9-CM and ICD-10-CM codes. Multivariable adjusted Cox proportional regression models evaluated the risk of major adverse cardiovascular events over a 10-year follow-up period. RESULTS A total of 3951 patients, 226 controls, 2107 with obstructive sleep apnea only, 276 with insomnia only, and 1342 with comorbid obstructive sleep apnea and insomnia, were included in the analysis. Compared to controls, comorbid obstructive sleep apnea and insomnia were associated with a significantly higher risk of developing major adverse cardiovascular events (hazard ratio 3.60, 95 CI%: 2.33-5.91) in unadjusted analyses. The relationship between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events remained after adjustment for demographic and behavioral factors, but not after further adjustment for comorbidities. The greatest risk of major adverse cardiovascular events was found among younger adults with comorbid obstructive sleep apnea and insomnia. Obstructive sleep apnea only was associated with greater risk of major adverse cardiovascular events in unadjusted analyses only (hazard ratio 2.77, 95% CI: 1.80-4.54). Insomnia only was not significantly associated with increased risk of major adverse cardiovascular events. CONCLUSIONS Comorbid obstructive sleep apnea and insomnia may be a high-risk group for major adverse cardiovascular events, particularly younger adults. Further research is needed to better understand the association between comorbid obstructive sleep apnea and insomnia and major adverse cardiovascular events risk.
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Affiliation(s)
- Faith S Luyster
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
| | - Lynn M Baniak
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Christopher C Imes
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Bomin Jeon
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Jonna L Morris
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Staci Orbell
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Paul Scott
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Meher K, Mushtaq M, Fatima S. Death Anxiety and WellBeing in Doctors During COVID-19: The Explanatory and Boosting Roles of Sleep Quality and Work Locality. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:667-682. [PMID: 35331036 PMCID: PMC8958309 DOI: 10.1177/00302228221078074] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic, a global public health crisis, has triggered anxiety and fear of death in general public and particularly among health professionals. This study aimed to assess the direct and mediated associations between death anxiety, sleep quality, and subjective wellbeing in doctors working during the pandemic. A secondary aim was tested to analyze the interactive role of workplace locality in these associations. An indirect-effect model was tested on a sample of 244 doctors working during the pandemic. Findings revealed that the association between death anxiety and subjective wellbeing was mediated through sleep quality. Furthermore, death anxiety significantly and negatively predicted subjective wellbeing in doctors working in rural setups compared to those working in urban setups. The theoretical and practical implications of the findings are discussed.
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Affiliation(s)
- Komal Meher
- Riphah Institute of Clinical and Professional Psychology, RIPHAH International University, Lahore Campus, Pakistan
| | - Mamoona Mushtaq
- Higher Education Department, Riphah Institute of Clinical and Professional Psychology, RIPHAH International University, Lahore, Pakistan
| | - Shameem Fatima
- Department of Humanities, COMSATS University Islamabad, Lahore
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Çiftci N, Yildiz M, Uçar M. Relationship Between Posttraumatic Stress Disorder, Death Anxiety, and Insomnia in Adults After the Earthquake. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241256267. [PMID: 38785216 DOI: 10.1177/00302228241256267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
This study aimed to determine the relationship between posttraumatic stress disorder, death anxiety, and insomnia in adults after the earthquake. This study, designed in a relational-cross-sectional-descriptive model, was conducted with 624 adult individuals living in a province affected by the earthquake that occurred in Turkey on February 6, 2023. The study data were collected using a personal information form, Posttraumatic Stress Disorder Checklist, Turkish Death Anxiety Scale, and Bergen Insomnia Scale. The analysis of the study data was performed by using SPSS 25.0, AMOS 24.0, and G*Power 3.1 Statistical package software. A significant positive correlation was found between posttraumatic stress disorder and Insomnia and Death Anxiety (p < .05). There was a significant positive correlation between Death Anxiety and Insomnia (p < .05). It was determined that Death Anxiety has a mediating role in the impact of posttraumatic stress disorder on insomnia (95% Confidence Interval: 0.572/1.407) (p < .05). It was determined that the model created in line with the hypotheses was compatible and the model fit indices were within the desired limits, with x2/df = 1.795, RMSEA = 0.03, CFI = 0.95, GFI = 0.946, AGFI = 0.93, IFI = 0.95. It was determined that posttraumatic stress disorder increased death anxiety and insomnia after the earthquake. Conducting longitudinal studies on the post-earthquake period is recommended.
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Affiliation(s)
- Necmettin Çiftci
- Department of Nursing, Faculty of Health Sciences, Muş Alparslan University, Muş, Turkey
| | - Metin Yildiz
- Department of Midwifery, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Mehmet Uçar
- Department of Medical Services and Techniques, Varto Vocational School, Muş Alparslan University, Muş, Turkey
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40
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McEvoy M, Caccaviello G, Crombie A, Skinner T, Begg SJ, Faulkner P, McEvoy A, Masman K, Bamforth L, Parker C, Stanyer E, Collings A, Li X. Health and Wellbeing of Regional and Rural Australian Healthcare Workers during the COVID-19 Pandemic: Baseline Cross-Sectional Findings from the Loddon Mallee Healthcare Worker COVID-19 Study-A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:649. [PMID: 38791863 PMCID: PMC11120829 DOI: 10.3390/ijerph21050649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Coronavirus 19 (COVID-19) has created complex pressures and challenges for healthcare systems worldwide; however, little is known about the impacts COVID-19 has had on regional/rural healthcare workers. The Loddon Mallee Healthcare Worker COVID-19 Study (LMHCWCS) cohort was established to explore and describe the immediate and long-term impacts of the COVID-19 pandemic on regional and rural healthcare workers. METHODS Eligible healthcare workers employed within 23 different healthcare organisations located in the Loddon Mallee region of Victoria, Australia, were included. In this cohort study, a total of 1313 participants were recruited from November 2020-May 2021. Symptoms of depression, anxiety, post-traumatic stress, and burnout were measured using the Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), Impact of Events Scale-6 (IES-6), and Copenhagen Burnout Inventory (CBI), respectively. Resilience and optimism were measured using the Brief Resilience Scale and Life Orientation Test-Revised (LOT-R), respectively. Subjective fear of COVID-19 was measured using the Fear of COVID-19 Scale. RESULTS These cross-sectional baseline findings demonstrate that regional/rural healthcare workers were experiencing moderate/severe depressive symptoms (n = 211, 16.1%), moderate to severe anxiety symptoms (n = 193, 14.7%), and high personal or patient/client burnout with median total scores of 46.4 (IQR = 28.6) and 25.0 (IQR = 29.2), respectively. There was a moderate degree of COVID-19-related fear. However, most participants demonstrated a normal/high degree of resilience (n = 854, 65.0%). Based on self-reporting, 15.4% had a BMI from 18.5 to 24.9 kgm2 and 37.0% have a BMI of 25 kgm2 or over. Overall, 7.3% of participants reported they were current smokers and 20.6% reported alcohol consumption that is considered moderate/high-risk drinking. Only 21.2% of the sample reported consuming four or more serves of vegetables daily and 37.8% reported consuming two or more serves of fruit daily. There were 48.0% the sample who reported having poor sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI). CONCLUSION Regional/rural healthcare workers in Victoria, Australia, were experiencing a moderate to high degree of psychological distress during the early stages of the pandemic. However, most participants demonstrated a normal/high degree of resilience. Findings will be used to inform policy options to support healthcare workers in responding to future pandemics.
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Affiliation(s)
- Mark McEvoy
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia;
| | | | - Angela Crombie
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Timothy Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3550, Australia;
| | - Stephen J. Begg
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia;
| | - Peter Faulkner
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Anne McEvoy
- Kyabram District Health Service, Kyabram, VIC 3620, Australia;
| | - Kevin Masman
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Laura Bamforth
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Carol Parker
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Evan Stanyer
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Amanda Collings
- Bendigo Health, Bendigo, VIC 3550, Australia; (A.C.); (P.F.); (K.M.); (L.B.); (C.P.); (E.S.); (A.C.)
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, VIC 3550, Australia;
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Gernert CC, Falter-Wagner CM, Noreika V, Jachs B, Jassim N, Gibbs K, Streicher J, Betts H, Bekinschtein TA. Stress in autism (STREAM): A study protocol on the role of circadian activity, sleep quality and sensory reactivity. PLoS One 2024; 19:e0303209. [PMID: 38768146 PMCID: PMC11104633 DOI: 10.1371/journal.pone.0303209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 04/21/2024] [Indexed: 05/22/2024] Open
Abstract
Mental health issues are markedly increased in individuals with autism, making it the number one research priority by stakeholders. There is a crucial need to use personalized approaches to understand the underpinnings of mental illness in autism and consequently, to address individual needs. Based on the risk factors identified in typical mental research, we propose the following themes central to mental health issues in autism: sleep difficulties and stress. Indeed, the prevalence of manifold circadian disruptions and sleep difficulties in autism, alongside stress related to sensory overload, forms an integral part of autistic symptomatology. This proof-of-concept study protocol outlines an innovative, individualised approach towards investigating the interrelationships between stress indices, sleep and circadian activation patterns, and sensory sensitivity in autism. Embracing an individualized methodology, we aim to collect 14 days of data per participant from 20 individuals with autism diagnoses and 20 without. Participants' sleep will be monitored using wearable EEG headbands and a sleep diary. Diurnal tracking of heart rate and electrodermal activity through wearables will serve as proxies of stress. Those objective data will be synchronized with subjective experience traces collected throughout the day using the Temporal Experience Tracing (TET) method. TET facilitates the quantification of relevant aspects of individual experience states, such as stress or sensory sensitivities, by providing a continuous multidimensional description of subjective experiences. Capturing the dynamics of subjective experiences phase-locked to neural and physiological proxies both between and within individuals, this approach has the potential to contribute to our understanding of critical issues in autism, including sleep problems, sensory reactivity and stress. The planned strives to provide a pathway towards developing a more nuanced and individualized approach to addressing mental health in autism.
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Affiliation(s)
- Clara C. Gernert
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | | | - Valdas Noreika
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, United Kingdom
| | - Barbara Jachs
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Nazia Jassim
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Prediction and Learning Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | | | - Joaquim Streicher
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Hannah Betts
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Tristan A. Bekinschtein
- Consciousness and Cognition Lab, Department of Psychology, University of Cambridge, Cambridge, United Kingdom
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Armstrong GM, Hopper KM, Friedman HP, Bilsky SA. Adolescent Sleep Quality and Alcohol Use: An Initial Examination of the Serial Indirect Effects of Anxiety Symptoms and Coping Motives for Alcohol Use. Subst Use Misuse 2024; 59:1383-1393. [PMID: 38769730 DOI: 10.1080/10826084.2024.2352107] [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] [Indexed: 05/22/2024]
Abstract
Background: Insufficient sleep and insomnia are associated with alcohol use as well as anxiety during adolescence and young adulthood. A negative reinforcement path to explain the association between sleep difficulties and alcohol misuse has been proposed. Within this pathway, it is speculated that while sober, insomnia and insufficient sleep lead to increased anxiety as well as anxiolytic responses to alcohol, thereby increasing the risk for both alcohol use and alcohol use problems. No work to date has examined the negative reinforcement path to alcohol use among adolescents who have consumed alcohol. Objectives: The current study aims to address this gap in the literature by examining if sleep quality is related to adolescent alcohol use problems and frequency through serial indirect effects of adolescent anxiety symptoms and coping motives for alcohol use. A total of 147 adolescents between the ages of 13 and 18 years (Mage = 16.31; SD = 0.96) from all geographic regions in the US were recruited using social media platforms (i.e., Facebook and Instagram). Participants who reported having tried alcohol at least once completed self-report measures to examine sleep quality, anxiety symptoms, alcohol use problems, alcohol use frequency, and coping motives for alcohol use. Results: Adolescent sleep quality was found to be associated with higher levels of both alcohol use problems and alcohol use frequency through the serial indirect effect of anxiety symptoms and coping motives for alcohol use. Conclusions: Overall, these findings represent a step towards understanding the complex relationship between sleep quality, alcohol, anxiety, and coping motives among adolescents.
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Affiliation(s)
| | - Kayce M Hopper
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
| | - Hannah P Friedman
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
| | - Sarah A Bilsky
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
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Peng B, Foilb AR, Manasian Y, Li Y, Deng X, Meloni EG, Ressler KJ, Carlezon WA, Bolshakov VY. Intra-amygdala circuits of sleep disruption-induced anxiety in female mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.19.594863. [PMID: 38798391 PMCID: PMC11118584 DOI: 10.1101/2024.05.19.594863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Combining mouse genetics, electrophysiology, and behavioral training and testing, we explored how sleep disruption may affect the function of anxiety-controlling circuits, focusing on projections from the basolateral nucleus of the amygdala (BLA) to CRF-positive cells in the lateral division of the central amygdala (CeL). We found in Crh-IRES-Cre::Ai14(tdTomato) reporter female mice that 6 hours of sleep disruption during their non-active (light) cycle may be anxiogenic. Notably, the AMPAR/NMDAR EPSC amplitude ratio at the BLA inputs to CRF-CeL cells (CRF CeL ), assessed with whole-cell recordings in ex vivo experiments, was enhanced in slices from sleep-disrupted mice, whereas paired-pulse ratio (PPR) of the EPSCs induced by two closely spaced presynaptic stimuli remained unchanged. These findings indicate that sleep disruption-associated synaptic enhancements in glutamatergic projections from the BLA to CRF-CeL neurons may be postsynaptically expressed. We found also that the excitation/inhibition (E/I) ratio in the BLA to CRF CeL inputs was increased in sleep-disrupted mice, suggesting that the functional efficiency of excitation in BLA inputs to CRF CeL cells has increased following sleep disruption, thus resulting in their enhanced activation. The latter could be translated into enhanced anxiogenesis as activation of CRF cells in the CeL was shown to promote anxiety-like behaviors.
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Luo X, Zhang A, Li H, Li Y, Ying F, Wang X, Yang Q, Zhang Z, Huang G. The role of arts therapies in mitigating Sleep Initiation and Maintenance Disorders: a systematic review. Front Psychiatry 2024; 15:1386529. [PMID: 38818021 PMCID: PMC11137235 DOI: 10.3389/fpsyt.2024.1386529] [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] [Received: 02/15/2024] [Accepted: 05/01/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction Arts therapies offer effective non-pharmacological intervention for Sleep Initiation and Maintenance Disorders (SIMDs), encompassing both passive and active modalities. This review assesses their effectiveness and ethical considerations, focusing on music therapy, meditation, and Tai Chi. Methods Following PRISMA guidelines, a detailed search across PubMed, the Cochrane Library, Web of Science, and CNKI identified 17 relevant RCTs. Utilizing the Joanna Briggs Institute (JBI) quality criteria and the PICO(S) framework for data extraction ensured methodological integrity. Results Analysis shows arts therapies significantly improve sleep quality. Music therapy and meditation yield immediate benefits, while Tai Chi and Qigong require longer commitment for significant outcomes. Discussion The link between SIMDs and mental health issues like anxiety, stress, and depression suggests arts therapies not only enhance sleep quality but also address underlying mental health conditions. The evidence supports a wider adoption of arts therapies in treating SIMDs due to their dual benefits. Systematic review registration PROSPERO, ID: CRD42024506393.
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Affiliation(s)
- Xuexing Luo
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Aijia Zhang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Hong Li
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Yu Li
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macao, Macao SAR, China
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Fangtian Ying
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
- College of Computer Science and Technology Zhejiang University, Hangzhou, Zhejiang, China
- Operation Management Centre, Guangzhou Wanqu Cooperative Institute of Design, Guangzhou, Guangdong, China
| | - Xiaoli Wang
- Qinghai Province Cardiovascular and Cerebrovascdular Disease Specialist Hospital, Xining, Qinghai, China
| | - Qianxu Yang
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Zheyu Zhang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
| | - Guanghui Huang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Macao, Macao SAR, China
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Du C, Wang C, Liu Z, Bai N, Zhu J, Ali A, Geng Y, Zeng X, Yang Y, Li Z, Ma C. The relationship between sleeptime and depression among middle-aged and elderly Chinese participant during COVID-19 epidemic and non-epidemic phases. Front Psychiatry 2024; 15:1361184. [PMID: 38800066 PMCID: PMC11117139 DOI: 10.3389/fpsyt.2024.1361184] [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] [Received: 12/25/2023] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Background The global impact of the COVID-19 pandemic had significantly altered the daily routines of people worldwide. This study aimed to compare how sleeptime and depression among Chinese residents had differed between periods during and outside the epidemic. Furthermore, it delved into the interactive effect of age in this relationship. Method Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) study in 2015 and the recently released data from 2020, which covered the pandemic period. Depression was assessed using Center for Epidemiologic Studies Depression Scale (CESD-10), considering a score of 10 or higher as indicative of depression. Participants were categorized based on age, specifically those aged 60 years and older. multivariate logistic regression and interaction analyses were employed to assess the interplay of age, supported by subgroup and sensitivity analyses to reinforce our findings. Results The 2020 database comprised 19,331 participants, while the 2015 database had 10,507 participants. Our findings demonstrated a significant correlation between sleeptime and depression in both unadjusted models and models adjusted for all variables in both datasets (p<0.001). Upon stratifying by age and adjusting for relevant factors, we identified an interaction effect among age, sleeptime, and depression (p=0.004 for the interaction in the 2020 database, compared to 0.004 in 2015). The restricted cubic spline analysis in both datasets showcased a nonlinear relationship between sleeptime and depression. Conclusions During both epidemic and non-epidemic periods in China, there existed a correlation between sleep duration and depression, which interacts with age.
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Affiliation(s)
- Chaonan Du
- Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Cong Wang
- Nanjing Jinling Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Zhiwei Liu
- Nanjing Jinling Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Nan Bai
- Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Junhao Zhu
- Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Alleyar Ali
- Department of Neurosurgery, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing, China
| | - Yuanming Geng
- Department of Neurosurgery, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing, China
| | - Xinrui Zeng
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Yu Yang
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Zhenxing Li
- Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Chiyuan Ma
- Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Nanjing Jinling Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Neurosurgery, The Affiliated Jinling Hospital of Nanjing Medical University, Nanjing, China
- School of Medicine, Southeast University, Nanjing, Jiangsu, China
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Narayan AJ, Downey LA, Rose S, Di Natale L, Hayley AC. Cannabidiol for moderate-severe insomnia: a randomized controlled pilot trial of 150 mg of nightly dosing. J Clin Sleep Med 2024; 20:753-763. [PMID: 38174873 PMCID: PMC11063694 DOI: 10.5664/jcsm.10998] [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: 08/28/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024]
Abstract
STUDY OBJECTIVES Low-dose cannabidiol (CBD) has become readily available in numerous countries; however, little consensus exists on its efficacy as a sleep aid. This trial explored the efficacy of 150 mg of CBD (n = 15) compared with placebo (n = 15) as a sleep aid in primary insomnia. CBD supplementation was hypothesized to decrease insomnia symptoms and improve aspects of psychological health, relative to placebo. METHODS Using a randomized, placebo-controlled, parallel design featuring a single-blind placebo run-in week followed by a 2-week double-blind randomized dosing phase, participants consumed the assigned treatment sublingually 60 minutes before bed nightly. Wrist-actigraphy and sleep diaries measured daily sleep. Sleep quality, sleep effort, and well-being were measured weekly over 4 in-laboratory visits. Insomnia severity and trait anxiety were measured at screening and study conclusion. RESULTS Insomnia severity, self-reported sleep-onset latency, sleep efficiency, and wake after sleep onset did not differ between treatments throughout the trial (all P > .05). Compared with placebo, the CBD group reported greater well-being scores throughout the trial (trial end mean difference = 2.60; standard error: 1.20), transient elevated behavior following wakefulness scores after 1 week of treatment (mean difference = 3.93; standard error: 1.53), and had superior objective sleep efficiency after 2 weeks of treatment (mean difference = 6.85; standard error: 2.95) (all P < .05). No other significant treatment effects were observed. CONCLUSIONS Nightly supplementation of 150 mg CBD was similar to placebo regarding most sleep outcomes while sustaining greater well-being, suggesting more prominent psychological effects. Additional controlled trials examining varying treatment periods and doses are crucial. CLINICAL TRIAL REGISTRATION Registry: Australian New Zealand Clinical Trials Registry; Name: Cannabidiol (CBD) treatment for insomnia; URL: https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000070932; Identifier: ACTRN12620000070932. CITATION Narayan AJ, Downey LA, Rose S, Di Natale L, Hayley AC. Cannabidiol for moderate-severe insomnia: a randomized controlled pilot trial of 150 mg of nightly dosing. J Clin Sleep Med. 2024;20(5):753-763.
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Affiliation(s)
- Andrea J. Narayan
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Luke A. Downey
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia
- Institute for Breathing and Sleep, Austin Hospital, Melbourne, Australia
| | - Sarah Rose
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Lauren Di Natale
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Amie C. Hayley
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Australia
- Institute for Breathing and Sleep, Austin Hospital, Melbourne, Australia
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Shin H, Park C. Mastery is central: an examination of complex interrelationships between physical health, stress and adaptive cognition, and social connection with depression and anxiety symptoms. Front Psychiatry 2024; 15:1401142. [PMID: 38751422 PMCID: PMC11094708 DOI: 10.3389/fpsyt.2024.1401142] [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] [Received: 03/14/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Background Research has established the link between physical health, stress and cognition, and social connection with depression and anxiety. Nevertheless, an understanding of the comorbidity of depression and anxiety symptoms and their complex interrelationships with relevant factors remains still limited. This study investigated the complex pattern of interplay between depression and anxiety symptoms and pertinent physical, cognitive, and social factors and potential gender differences. Methods Using a sample of 600 middle-aged men and women, depression and anxiety as well as physical health, perceived stress and mastery, and social connection were assessed. The network structure of depression and anxiety symptoms and risk and resilience factors were characterized by examining interrelationships and the centrality indices of Strength and Bridge Strength. Gender differences were examined using the Network Comparison Test. Results Perceived stress and mastery were central bridge factors influencing comorbid depression and anxiety symptoms, and perceived stress, anhedonia, and mastery exhibited strong inter-connections to each other. The connections of physical health-anhedonia and sleep disturbance-irritability were stronger in men than in women, while social connection with family was linked to interpersonal problems only in women. Conclusions The results underscore that prevention and interventions targeting reducing perceptions of stress and promoting mastery would prevent onset or recurrence of depression and anxiety symptoms among middle-aged men and women. Engaging in behavioral activities to maintain physical health and ensuring adequate sleep could be particularly beneficial for men in reducing overall symptom severity.
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Affiliation(s)
- Huiyoung Shin
- Department of Psychology, Jeonbuk National University, Jeonju, Republic of Korea
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48
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Lueke NA, Assar A. Poor sleep quality and reduced immune function among college students: Perceived stress and depression as mediators. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1112-1119. [PMID: 35549834 DOI: 10.1080/07448481.2022.2068350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 03/02/2022] [Accepted: 04/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Sleep problems are highly prevalent among college students and are linked to a multitude of detrimental consequences, among which are heightened perceived stress and symptoms of depression. The present study investigated the effect of poor sleep quality on the immune function of college students. A serial mediation model was developed to test the prediction that perceived stress and depression sequentially mediate the relationship between poor sleep quality and reduced immune function among college students. PARTICIPANTS 137 undergraduates were recruited from a large Midwestern university (103Females, 34Males; Mage = 19.47, SDage = ± 1.54). METHODS Cross-sectional based online survey administered in Spring 2021. RESULTS Analyses revealed a significant total effect of sleep quality on immune function. Perceived stress and depression symptoms serially mediated the relationship between sleep quality and immune function. CONCLUSIONS Results underscore the importance of college students' sleep in relation to their mental health and subsequent immune function.
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Affiliation(s)
- Niloufar A Lueke
- Department of Psychological Science, Ball State University, Muncie, IN, USA
| | - Arash Assar
- Department of Psychological Science, Ball State University, Muncie, IN, USA
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49
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Li L, Feng X, Luo S, Lin L, Xiang H, Chen D, Qin K, Guo X, Chen W, Guo VY. Internet addiction and health-related quality of life in adolescents: The mediating role of sleep disturbance. Sleep Med 2024; 117:53-59. [PMID: 38507977 DOI: 10.1016/j.sleep.2024.03.007] [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: 06/30/2023] [Revised: 10/26/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Internet addiction (IA) has emerged as a recognized risk factor associated with impaired health-related quality of life (HRQOL) in adolescents. However, the role of sleep disturbance in this association remains unclear. This study aimed to investigate the association of IA with HRQOL in Chinese adolescents and to evaluate the potential mediating role of sleep disturbance. METHODS A cross-sectional study was conducted among adolescents attending six randomly selected middle schools in Guangzhou, China. Adolescents self-reported their internet use using the Young Diagnostic Questionnaire. HRQOL and sleep disturbance were assessed by the Pediatric Quality of Life Inventory version 4.0 and the Pittsburgh Sleep Quality Index, respectively. Multivariate linear regression analysis was employed to assess the association between IA and HRQOL. Baron and Kenny's causal steps method was used to examine the possible mediating role of sleep disturbance. RESULTS Of the 6473 adolescents included, 23.5% had maladaptive internet use (MIU) and 16.6% had pathological internet use (PIU). Compared to adolescents with adaptive internet use (AIU), those with IA had significantly lower scores across all HRQOL dimensions and summary scales. Mediation analysis revealed that sleep disturbance was a significant mediator. Specifically, sleep disturbance mediated 34.55% of the effects of MIU and 34.06% of the effects of PIU on the HRQOL total scale score , respectively. CONCLUSIONS IA was associated with poorer HRQOL, indicating the needs of preventing IA in Chinese adolescents. Additionally, our findings underscored the importance of enhancing sleep quality to mitigate the adverse impact of IA on adolescents' well-being.
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Affiliation(s)
- Lu Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Xiuqiong Feng
- Department of Public Health, Guangzhou Huangpu District Center for Disease Control and Prevention, Guangzhou, 510530, Guangdong, China
| | - Shengyu Luo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Hongyu Xiang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Dezhong Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Kang Qin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Xun Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
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Alger SE, Bennett C, Bennett N, Huebner MG, Lee JEC, Edge HJM, Simms A, Adler AB. Insufficient Sleep and Behavioral Health in the Military: A 5-Country Perspective. Curr Psychiatry Rep 2024; 26:229-239. [PMID: 38700836 PMCID: PMC11081997 DOI: 10.1007/s11920-024-01497-1] [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] [Accepted: 03/07/2024] [Indexed: 05/12/2024]
Abstract
PURPOSE OF REVIEW The goal of this paper was to highlight the degree to which sleep, behavioral health, and leader involvement were interrelated using data from militaries in five English-speaking countries: Australia, Canada, New Zealand, the UK, and the United States. RECENT FINDINGS Many service members reported sleeping fewer than the recommended 7 h/night: 34.9%, 67.2%, and 77.2% of respondents from New Zealand, Canada, and the United States, respectively. Countries reporting shorter sleep duration also reported fewer insomnia-related difficulties, likely reflecting higher sleep pressure from chronic sleep loss. Across all countries, sleep problems were positively correlated with behavioral health symptoms. Importantly, leader promotion of healthy sleep was positively correlated with more sleep and negatively correlated with sleep problems and behavioral health symptoms. Insufficient sleep in the military is ubiquitous, with serious implications for the behavioral health and functioning of service members. Leaders should attend to these risks and examine ways to promote healthy sleep in service members.
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Affiliation(s)
- Sara E Alger
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 29010, US.
| | - Clare Bennett
- Defence Health Directorate, New Zealand Defence Force, Wellington, New Zealand
| | - Neanne Bennett
- Australian Defence Force, Joint Health Command, Canberra, Australia
| | - Matthew G Huebner
- Director General Military Personnel Research and Analysis, Department of National Defence, Ottawa, Canada
| | - Jennifer E C Lee
- Director General Military Personnel Research and Analysis, Department of National Defence, Ottawa, Canada
| | - Heather J McCuaig Edge
- Director General Military Personnel Research and Analysis, Department of National Defence, Ottawa, Canada
| | - Amos Simms
- Academic Department of Military Mental Health, King's College London, London, UK
| | - Amy B Adler
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 29010, US
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