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Toenders YJ, van der Cruijsen R, Runze J, van de Groep S, Wierenga L, Crone EA. Mood variability during adolescent development and its relation to sleep and brain development. Sci Rep 2024; 14:8537. [PMID: 38609481 PMCID: PMC11014928 DOI: 10.1038/s41598-024-59227-9] [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: 11/04/2022] [Accepted: 04/08/2024] [Indexed: 04/14/2024] Open
Abstract
Mood swings, or mood variability, are associated with negative mental health outcomes. Since adolescence is a time when mood disorder onset peaks, mood variability during this time is of significant interest. Understanding biological factors that might be associated with mood variability, such as sleep and structural brain development, could elucidate the mechanisms underlying mood and anxiety disorders. Data from the longitudinal Leiden self-concept study (N = 191) over 5 yearly timepoints was used to study the association between sleep, brain structure, and mood variability in healthy adolescents aged 11-21 at baseline in this pre-registered study. Sleep was measured both objectively, using actigraphy, as well as subjectively, using a daily diary self-report. Negative mood variability was defined as day-to-day negative mood swings over a period of 5 days after an MRI scan. It was found that negative mood variability peaked in mid-adolescence in females while it linearly increased in males, and average negative mood showed a similar pattern. Sleep duration (subjective and objective) generally decreased throughout adolescence, with a larger decrease in males. Mood variability was not associated with sleep, but average negative mood was associated with lower self-reported energy. In addition, higher thickness in the dorsolateral prefrontal cortex (dlPFC) compared to same-age peers, suggesting a delayed thinning process, was associated with higher negative mood variability in early and mid-adolescence. Together, this study provides an insight into the development of mood variability and its association with brain structure.
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Affiliation(s)
- Yara J Toenders
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands.
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Renske van der Cruijsen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jana Runze
- Clinical Child and Family Studies, VU University Amsterdam, Amsterdam, The Netherlands
| | - Suzanne van de Groep
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Lara Wierenga
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Eveline A Crone
- Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Chachos E, Shen L, Yap Y, Maskevich S, Stone JE, Wiley JF, Bei B. Vulnerability to sleep-related affective disturbances? A closer look at dysfunctional beliefs and attitudes about sleep as a moderator of daily sleep-affect associations in young people. Sleep Health 2023; 9:672-679. [PMID: 37640630 DOI: 10.1016/j.sleh.2023.07.008] [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: 10/11/2022] [Revised: 06/28/2023] [Accepted: 07/16/2023] [Indexed: 08/31/2023]
Abstract
STUDY OBJECTIVES Sleep and affect are closely related. Whether modifiable cognitive factors moderate this association is unclear. This study examined whether Dysfunctional Beliefs and Attitudes about Sleep moderate the impact of sleep on next-day affect in young people. METHODS Four hundred and sixty-eight young people (205 adolescents, 54.1% female, M ± SDage=16.92 ± 0.87; 263 emerging adults, 71.9% female, M±SDage=21.29 ± 1.73) self-reported sleep and affect, and wore an actigraph for 7-28 days, providing >5000 daily observations. Linear mixed-effects models tested whether Dysfunctional Beliefs and Attitudes about Sleep moderated daily associations between self-reported and actigraphic sleep duration, sleep efficiency, and next-day affect on between- and within-person levels. Both valence (positive/negative) and arousal (high/low) dimensions of affect were examined. Covariates included age, sex, race/ethnicity, day of week, and previous-day affect. RESULTS Dysfunctional Beliefs and Attitudes about Sleep significantly moderated sleep and high arousal positive affect associations on between- but not within-person levels. Individuals with higher Dysfunctional Beliefs and Attitudes about Sleep (+1 SD) and lower average sleep duration (actigraphic: p = .020; self-reported: p = .047) and efficiency (actigraphic: p = .047) had significantly lower levels of high arousal positive affect. After adjusting for multiple comparisons, Dysfunctional Beliefs and Attitudes about Sleep did not moderate relationships between sleep duration and low arousal positive affect (p ≥ .340). CONCLUSIONS Young people with more unhelpful beliefs about sleep and shorter, or poorer, sleep may experience dampened levels of high arousal positive affect. DBAS may constitute a modifiable factor increasing affective vulnerability on a global but not day-to-day level. Intervention studies are needed to determine if changing Dysfunctional Beliefs and Attitudes about Sleep may reduce sleep-related affect disturbances in young people.
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Affiliation(s)
- Evangelos Chachos
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Lin Shen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Yang Yap
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Svetlana Maskevich
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Julia E Stone
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Joshua F Wiley
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.
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Hawks ZW, Strong R, Jung L, Beck ED, Passell EJ, Grinspoon E, Singh S, Frumkin MR, Sliwinski M, Germine LT. Accurate Prediction of Momentary Cognition From Intensive Longitudinal Data. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:841-851. [PMID: 36922302 PMCID: PMC10264553 DOI: 10.1016/j.bpsc.2022.12.002] [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: 10/14/2022] [Revised: 11/08/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Deficits in cognitive performance are implicated in the development and maintenance of psychopathology. Emerging evidence further suggests that within-person fluctuations in cognitive performance may represent sensitive early markers of neuropsychiatric decline. Incorporating routine cognitive assessments into standard clinical care-to identify between-person differences and monitor within-person fluctuations-has the potential to improve diagnostic screening and treatment planning. In support of these goals, it is critical to understand to what extent cognitive performance varies under routine, remote assessment conditions (i.e., momentary cognition) in relation to a wide range of possible predictors. METHODS Using data-driven, high-dimensional methods, we ranked strong predictors of momentary cognition and evaluated out-of-sample predictive accuracy. Our approach leveraged innovations in digital technology, including ambulatory assessment of cognition and behavior 1) at scale (n = 122 participants, n = 94 females), 2) in naturalistic environments, and 3) within an intensive longitudinal study design (mean = 25.5 assessments/participant). RESULTS Reaction time (R2 > 0.70) and accuracy (0.56 >R2 > 0.35) were strongly predicted by age, between-person differences in mean performance, and time of day. Effects of self-reported, intraindividual fluctuations in environmental (e.g., noise) and internal (e.g., stress) states were also observed. CONCLUSIONS Our results provide robust estimates of effect size to characterize sources of cognitive variability, to support the identification of optimal windows for psychosocial interventions, and to possibly inform clinical evaluation under remote neuropsychological assessment conditions.
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Affiliation(s)
- Zoë W Hawks
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts.
| | - Roger Strong
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts
| | - Laneé Jung
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts
| | - Emorie D Beck
- Department of Psychology, University of California, Davis, Davis, California
| | - Eliza J Passell
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts
| | - Elizabeth Grinspoon
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts
| | - Shifali Singh
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts
| | - Madelyn R Frumkin
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Martin Sliwinski
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania
| | - Laura T Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts
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Du G, Tao T. Vocational Therapy of Physical Training for Children's Learning Motivation and Psychological Cognition. Occup Ther Int 2022; 2022:8625830. [PMID: 35832096 PMCID: PMC9262538 DOI: 10.1155/2022/8625830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/19/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022] Open
Abstract
Childhood is an essential length for the formation and improvement of people's quite a number of psychological abilities; however, due to the damaging consequences of heredity, disease, surroundings, and education, it will carry poor outcomes to the ordinary improvement of kid's psychology. Good body satisfactory and wholesome psychology are vital which ensure to adapt to social competition. Carrying out suitable body exercise can decorate students' horrible psychological conditions, alter kid's negative emotions, promote students' intellectual enchantment, and enhance students' willpower. This paper researches the relationship between kid's gaining knowledge of motivation and psychological cognition and sports activity education occupational therapy, tries to discover out the influence of kid's studying motivation and psychological cognition on kid's sports activity coaching occupational therapy, analyses kid's sports coaching motivation from inside causes, and focuses on how to make college students extra inclined from controlling motivation to self-sustaining motivation, so that college students are inclined to take part in finding out about sports activities and structuring a robust activity in body education.
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Affiliation(s)
- Geng Du
- Sports Training Department, Wuhan Sports University, Wuhan, Hubei 430079, China
| | - Tao Tao
- School of Physical Education and Sports, Beijing Normal University, Beijing 100875, China
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Shen L, Wiley JF, Bei B. Sleep and affect in adolescents: Bidirectional daily associations over 28-day ecological momentary assessment. J Sleep Res 2021; 31:e13491. [PMID: 34585468 DOI: 10.1111/jsr.13491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 07/25/2021] [Accepted: 09/05/2021] [Indexed: 12/01/2022]
Abstract
We examined bidirectional, temporal associations between daily sleep and affect under naturally restricted (school) and unrestricted (vacation) sleep opportunities, while incorporating valence (positive/negative) and arousal (high/low) dimensions of affect. Sleep and affect were measured over 2 weeks of school and 2 weeks of vacation in 205 adolescents (54.1% females, Mage = 16.9 years), providing 5,231 days of data. Total sleep time and sleep efficiency were measured using actigraphy and sleep diary. High- and low-arousal positive and negative affect were self-reported each afternoon. Between- and within-person sleep-affect associations were tested using cross-lagged, multilevel models. Lagged outcome, day of the week, study day and socio-demographics were controlled. Bidirectional associations between self-report sleep and affect were found between-persons: longer self-report total sleep time associated with lower high- and low-arousal negative affect. Higher high-arousal positive affect associated with longer actigraphy total sleep time between-persons, but predicted shorter same-night actigraphy total sleep time within-persons. Results did not differ between school and vacation. Significant within-person random effects demonstrate individual differences in daily sleep-affect associations. Associations differed based on sleep measurement and affect dimensions, highlighting the complex sleep-affect relationship. Strong between-person associations between self-report sleep and affect suggest improving either sleep or mood may benefit the other; alternatively, addressing a common cause may lead to changes in both sleep and affect. Although overall high-arousal positive affect was protective of sleep duration, on a day-to-day basis, higher-than-usual high-arousal positive affect may reduce sleep duration on nights it is experienced. Further research needs to identify causes of individual differences in sleep-affect associations.
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Affiliation(s)
- Lin Shen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Vic., Australia
| | - Joshua F Wiley
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Vic., Australia
| | - Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Vic., Australia.,Department of Psychiatry, Women's Mental Health Service, Royal Women's Hospital, University of Melbourne, Melbourne, Vic., Australia
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Shen L, Wiley JF, Bei B. Perceived daily sleep need and sleep debt in adolescents: associations with daily affect over school and vacation periods. Sleep 2021; 44:6330595. [PMID: 34323993 DOI: 10.1093/sleep/zsab190] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/13/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES To describe trajectories of perceived daily sleep need and sleep debt, and examine if cumulative perceived sleep debt predicts next-day affect. METHODS Daily sleep and affect were measured over 2 school weeks and 2 vacation weeks (N=205, 54.1% females, M±SDage = 16.9±0.87 years). Each day, participants wore actigraphs and self-reported the amount of sleep needed to function well the next day (i.e., perceived sleep need), sleep duration, and high- and low-arousal positive and negative affect (PA, NA). Cumulative perceived sleep debt was calculated as the weighted average of the difference between perceived sleep need and sleep duration over the past 3 days. Cross-lagged, multilevel models were used to test cumulative sleep debt as a predictor of next-day affect. Lagged affect, day of the week, study day, and sociodemographics were controlled. RESULTS Perceived sleep need was lower early in the school week, before increasing in the second half of the week. Adolescents accumulated perceived sleep debt across school days and reduced it during weekends. On weekends and vacations, adolescents self-reported meeting their sleep need, sleeping the amount, or more than the amount of sleep they perceived as needing. Higher cumulative actigraphy sleep debt predicted higher next-day high arousal NA; higher cumulative diary sleep debt predicted higher NA (regardless of arousal), and lower low arousal PA the following day. CONCLUSION Adolescents experienced sustained, cumulative perceived sleep debt across school days. Weekends and vacations appeared to be opportunities for reducing sleep debt. Trajectories of sleep debt during vacation suggested recovery from school-related sleep restriction. Cumulative sleep debt was related to affect on a daily basis, highlighting the value of this measure for future research and interventions.
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Affiliation(s)
- Lin Shen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Joshua F Wiley
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.,Women's Mental Health Service, Royal Women's Hospital, Department of Psychiatry, University of Melbourne, Melbourne, Australia
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7
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Vaziri Z, Nami M, Leite JP, Delbem ACB, Hyppolito MA, Ghodratitoostani I. Conceptual Framework for Insomnia: A Cognitive Model in Practice. Front Neurosci 2021; 15:628836. [PMID: 34366767 PMCID: PMC8339273 DOI: 10.3389/fnins.2021.628836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/03/2021] [Indexed: 02/04/2023] Open
Abstract
Insomnia is a widespread neuropsychological sleep-related disorder known to result in various predicaments including cognitive impairments, emotional distress, negative thoughts, and perceived sleep insufficiency besides affecting the incidence and aggravation of other medical disorders. Despite the available insomnia-related theoretical cognitive models, clinical studies, and related guidelines, an evidence-based conceptual framework for a personalized approach to insomnia seems to be lacking. This study proposes a conceptual cognitive framework (CCF) providing insight into cognitive mechanisms involved in the predisposition, precipitation, and perpetuation of insomnia and consequent cognitive deficits. The current CCF for insomnia relies on evaluative conditional learning and appraisal which generates negative valence (emotional value) and arousal (cognitive value). Even with the limitations of this study, the suggested methodology is well-defined, reproducible, and accessible can help foster future high-quality clinical databases. During clinical insomnia but not the neutral one, negative mood (trait-anxiety) causes cognitive impairments only if mediating with a distorted perception of insomnia (Ind-1 = 0.161, 95% CI 0.040–0.311). Further real-life testing of the CCF is intended to formulate a meticulous, decision-supporting platform for clinical interventions. Furthermore, the suggested methodology is expected to offer a reliable platform for CCF-development in other cognitive impairments and support the causal clinical data models. It may also improve our knowledge of psychological disturbances and complex comorbidities to help design rehabilitation interventions and comprehensive frameworks in line with the “preventive medicine” policies.
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Affiliation(s)
- Zahra Vaziri
- Neurocognitive Engineering Laboratory (NEL), Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil.,Department of Neuroscience and Behavioural Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Mohammad Nami
- Neuroscience Center, Instituto de Investigaciones Científicas Servicios de Alta Tecnología (INDICASAT AIP), Panama City, Panama.,Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran.,Academy of Health, Senses Cultural Foundation, Sacramento, CA, United States.,Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Pardis, Iran
| | - João Pereira Leite
- Department of Neuroscience and Behavioural Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Alexandre Cláudio Botazzo Delbem
- Neurocognitive Engineering Laboratory (NEL), Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil.,Reconfigurable Computing Laboratory, Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil
| | - Miguel Angelo Hyppolito
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Iman Ghodratitoostani
- Neurocognitive Engineering Laboratory (NEL), Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil.,Reconfigurable Computing Laboratory, Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil
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Mei S, Hu Y, Sun M, Fei J, Li C, Liang L, Hu Y. Association between Bullying Victimization and Symptoms of Depression among Adolescents: A Moderated Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3316. [PMID: 33806969 PMCID: PMC8005068 DOI: 10.3390/ijerph18063316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/06/2021] [Accepted: 03/19/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Bullying victimization and its effect on symptoms of depression have received attention from researchers, but few studies have considered the potential mechanism. The aim of this study was to examine a moderated mediation model for the association between bullying victimization and depressive symptoms in terms of it being mediated by social anxiety, and investigated whether sleep duration would show moderating effects in this relationship. METHODS In this study, there were 2956 students, who completed three questionnaires, including a bullying victimization scale, as well as a social anxiety and epidemiologic studies depression scale. RESULTS Bullying victimization's effects on depressive symptoms were mediated by social anxiety. Furthermore, sleep duration moderated the relationship between bullying victimization and depressive symptoms. CONCLUSIONS The research contributes by clarifying the mechanisms underlying the relationship between bullying victimization and depressive symptoms.
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Affiliation(s)
- Songli Mei
- Department of Child and Adolescent Health, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China;
| | - Yueyang Hu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Mengzi Sun
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China;
| | - Junsong Fei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Chuanen Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Leilei Liang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China; (Y.H.); (J.F.); (C.L.); (L.L.)
| | - Yuanchao Hu
- Department of Child and Adolescent Health, School of Public Health, Jilin University, NO. 1163 Xinmin Street, Changchun 130012, China;
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9
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Muzni K, Groeger JA, Dijk DJ, Lazar AS. Self-reported sleep quality is more closely associated with mental and physical health than chronotype and sleep duration in young adults: A multi-instrument analysis. J Sleep Res 2021; 30:e13152. [PMID: 32783404 DOI: 10.1111/jsr.13152] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/07/2020] [Accepted: 06/11/2020] [Indexed: 12/21/2022]
Abstract
Sleep and circadian rhythms are considered to be important determinants of mental and physical health. Epidemiological studies have established the contribution of self-reported sleep duration, sleep quality and chronotype to health outcomes. Mental health and sleep problems are more common in women and men are more likely to be evening types. Few studies have compared the relative strength of these contributions and few studies have assessed these contributions separately in men and women. Furthermore, sleep and circadian characteristics are typically assessed with a limited number of instruments and a narrow range of variables is considered, leaving the understanding of the relative contribution of different predictors somewhat fractionary. We compared sleep quality, sleep duration and chronotype as predictors for self-reported mental and physical health and psychological characteristics in 410 men and 261 women aged 18 to 30. To ascertain that results were not dependent on the use of specific instruments we used a multitude of validated instruments including the Morningness-Eveningness-Questionnaire, Munich-ChronoType-Questionnaire, Pittsburgh-Sleep-Quality-Index, British-Sleep-Survey, Karolinska-Sleep-Diary, Insomnia-Severity-Index, SF-36-Health Survey, General-Health-Questionnaire, Dutch-Eating-Behaviour-Questionnaire, Big-Five-Inventory, Behaviour-Inhibition-System-Behaviour-Activation-System, and the Positive-Affect-Negative-Affect-Schedule. Relative contributions of predictors were quantified as local effect sizes derived from multiple regression models. Across all questionnaires, sleep quality was the strongest independent predictor of health and in particular mental health and more so in women than in men. The effect of sleep duration and social jetlag was inconspicuous. A greater insight into the independent contributions of sleep quality and chronotype may aid the understanding of sleep-health interactions in women and men.
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Affiliation(s)
- Khyla Muzni
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - John A Groeger
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, University of Surrey, Guildford, UK
| | - Alpar S Lazar
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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10
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Bei B, Asarnow LD, Krystal A, Edinger JD, Buysse DJ, Manber R. Treating insomnia in depression: Insomnia related factors predict long-term depression trajectories. J Consult Clin Psychol 2019; 86:282-293. [PMID: 29504795 DOI: 10.1037/ccp0000282] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Insomnia and major depressive disorders (MDD) often co-occur, and such comorbidity has been associated with poorer outcomes for both conditions. However, individual differences in depressive symptom trajectories during and after treatment are poorly understood in comorbid insomnia and depression. This study explored the heterogeneity in long-term depression change trajectories, and examined their correlates, particularly insomnia-related characteristics. METHOD Participants were 148 adults (age M ± SD = 46.6 ± 12.6, 73.0% female) with insomnia and MDD who received antidepressant pharmacotherapy, and were randomized to 7-session Cognitive Behavioral Therapy for Insomnia or control conditions over 16 weeks with 2-year follow-ups. Depression and insomnia severity were assessed at baseline, biweekly during treatment, and every 4 months thereafter. Sleep effort and beliefs about sleep were also assessed. RESULTS Growth mixture modeling revealed three trajectories: (a) Partial-Responders (68.9%) had moderate symptom reduction during early treatment (p value < .001) and maintained mild depression during follow-ups. (b) Initial-Responders (17.6%) had marked symptom reduction during treatment (p values < .001) and low depression severity at posttreatment, but increased severity over follow-up (p value < .001). (c) Optimal-Responders (13.5%) achieved most gains during early treatment (p value < .001), continued to improve (p value < .01) and maintained minimal depression during follow-ups. The classes did not differ significantly on baseline measures or treatment received, but differed on insomnia-related measures after treatment began (p values < .05): Optimal-Responders consistently endorsed the lowest insomnia severity, sleep effort, and unhelpful beliefs about sleep. CONCLUSIONS Three depression symptom trajectories were observed among patients with comorbid insomnia and MDD. These trajectories were associated with insomnia-related constructs after commencing treatment. Early changes in insomnia characteristics may predict long-term depression outcomes. (PsycINFO Database Record
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Affiliation(s)
- Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University
| | - Lauren D Asarnow
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Andrew Krystal
- School of Medicine, University of California, San Francisco
| | | | | | - Rachel Manber
- Department of Psychiatry and Behavioral Sciences, Stanford University
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11
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Farris SG, Matsko SV, Uebelacker LA, Brown RA, Price LH, Abrantes AM. Anxiety sensitivity and daily cigarette smoking in relation to sleep disturbances in treatment-seeking smokers. Cogn Behav Ther 2019; 49:137-148. [PMID: 30947621 DOI: 10.1080/16506073.2019.1583277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although the association between anxiety and sleep disturbance is well-documented, the underlying mechanisms are less clear. Anxiety sensitivity (AS), the fear of physiological arousal and bodily sensations, is a risk factor for anxiety and poor sleep. Smoking also contributes to poor sleep and may compound the effects of AS on sleep quality. This study evaluated the main and interactive effects of AS and cigarettes/day on sleep quality among smokers. Participants (n = 190) were adult treatment-seeking daily smokers who completed a baseline assessment as part of a larger smoking cessation trial. Sleep quality was self-reported. Results indicated that AS was significantly correlated with greater disturbance in sleep duration, subjective sleep quality, sleep onset latency, sleep disturbance, daytime dysfunction, and sleep medication use. There was a significant interaction between AS and cigarettes/day in terms of sleep onset latency, but not other sleep quality indices. AS was associated with significantly longer sleep onset latency minutes among heavier smokers, but not lighter smokers. Specifically, the association between AS and sleep onset latency was significant for those who smoked ≥ 33 cigarettes/day. AS is a psychological factor that may contribute to poor sleep quality, especially in heavy smokers, and thus may be a promising intervention target.
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Affiliation(s)
- Samantha G Farris
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Stephen V Matsko
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Butler Hospital, Providence, RI, USA
| | - Richard A Brown
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Lawrence H Price
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Butler Hospital, Providence, RI, USA
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Butler Hospital, Providence, RI, USA
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12
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Vandendriessche A, Ghekiere A, Van Cauwenberg J, De Clercq B, Dhondt K, DeSmet A, Tynjälä J, Verloigne M, Deforche B. Does Sleep Mediate the Association between School Pressure, Physical Activity, Screen Time, and Psychological Symptoms in Early Adolescents? A 12-Country Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1072. [PMID: 30934658 PMCID: PMC6466024 DOI: 10.3390/ijerph16061072] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/18/2019] [Accepted: 03/22/2019] [Indexed: 01/26/2023]
Abstract
This study examines the mediating role of sleep duration and sleep onset difficulties in the association of school pressure, physical activity, and screen time with psychological symptoms in early adolescents. Data were retrieved from 49,403 children (13.7 ± 1.6 years old, 48.1% boys) from 12 countries participating in the World Health Organization (WHO) "Health Behaviour in School-aged Children" 2013/2014 study. A validated self-report questionnaire assessed psychological symptoms (feeling low, irritability or bad temper, feeling nervous), school pressure, physical activity (number of days/week 60 min moderate-to-vigorous), screen time, sleep duration on week- and weekend days, and perceived difficulties in getting asleep. Multilevel mediation analyses were conducted. School pressure and screen time were positively associated with psychological symptoms, whereas physical activity was negatively associated. With the exception of sleep duration in the association between physical activity and psychological symptoms, all associations were significantly mediated by sleep duration on week- and weekend days and sleep onset difficulties. Percentages mediated ranged from 0.66% to 34.13%. This study partly explains how school pressure, physical activity, and screen time are related to adolescents' psychological symptoms. Future interventions improving adolescents' mental well-being could target schoolwork, physical activity, and screen time, as these behaviours are directly and indirectly (through sleep) related to psychological symptoms.
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Affiliation(s)
- Ann Vandendriessche
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 4K3, B-9000 Ghent, Belgium.
| | - Ariane Ghekiere
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 4K3, B-9000 Ghent, Belgium.
| | - Jelle Van Cauwenberg
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 4K3, B-9000 Ghent, Belgium.
- Fund for Scientific Research Flanders (FWO), Egmontstraat 5, B-1000 Brussels, Belgium.
| | - Bart De Clercq
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 4K3, B-9000 Ghent, Belgium.
| | - Karlien Dhondt
- Department of Psychiatry: Pedicatric Sleep Center, Ghent University Hospital, Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
| | - Ann DeSmet
- Fund for Scientific Research Flanders (FWO), Egmontstraat 5, B-1000 Brussels, Belgium.
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium.
| | - Jorma Tynjälä
- Faculty of Sport and Health Sciences, PO Box 35, FI-40014 University of Jyväskylä, Finland.
| | - Maïté Verloigne
- Fund for Scientific Research Flanders (FWO), Egmontstraat 5, B-1000 Brussels, Belgium.
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium.
| | - Benedicte Deforche
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 4K3, B-9000 Ghent, Belgium.
- Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.
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13
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Agostini A. Objective data contribute to the school start time debate. Sleep 2019; 42:5315540. [DOI: 10.1093/sleep/zsz021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alex Agostini
- Sleep and Chronobiology Laboratory, University of South Australia, Adelaide, South Australia, Australia
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14
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Barreto IS, Teodoro MLM, Ohno PM, Froeseler MVG. Cognitive Vulnerability and Stress for Emotional and Behavioral Problems in Children and Adolescents: A Longitudinal Study. J Cogn Psychother 2018; 32:272-284. [PMID: 32746407 DOI: 10.1891/0889-8391.32.4.272] [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: 11/25/2022]
Abstract
The present study investigated Beck's cognitive diathesis-stress theory (1967, 1987) for the prediction of emotional and behavioral problems in childhood. The study included 218 participants aged 10 to 16 years (M = 12.38, SD = 1.16) who underwent two evaluations with an interval of 8.4 months between them. In the first evaluation, sample was divided according to the participants' cognitive vulnerability (vulnerable, moderate, resilient) and in the second, by their experience of stressful events in recent months (low risk, moderate risk, high risk). The groups were compared by variation in the intensity of the symptoms over time. Results showed that high-risk cognitively vulnerable children had increased externalizing symptoms and children with moderate and high cognitive vulnerability had increased internalizing symptoms at Time 2. These results suggest the importance of considering dysfunctional cognitions and the existence of a certain level of stressful events for the development of psychopathology in childhood.
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15
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Shen L, van Schie J, Ditchburn G, Brook L, Bei B. Positive and Negative Emotions: Differential Associations with Sleep Duration and Quality in Adolescents. J Youth Adolesc 2018; 47:2584-2595. [PMID: 30039509 DOI: 10.1007/s10964-018-0899-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 07/04/2018] [Indexed: 12/25/2022]
Abstract
Despite positive and negative emotions being equally important predictors of adolescent wellbeing, research examining positive emotions is limited. In 4582 adolescents (69.4% females; age M ± SD = 14.55 ± 1.74 years), we used structural equation modelling to examine associations between self-reported sleep duration and quality with positive affect, negative affect, and happiness, controlling for age and sex. Overall, sleep quality displayed stronger associations with all measures of emotions compared to sleep duration. Shorter sleep was more specifically associated with lower positive emotions (happiness, followed by positive affect), whereas poorer sleep showed stronger associations with negative affect. Protecting sleep duration may promote positive emotions and enhancing sleep quality may reduce mood disturbances. Future research could incorporate both positive and negative emotions to better understand adolescents' wellbeing.
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Affiliation(s)
- Lin Shen
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
| | | | - Graeme Ditchburn
- School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, Australia
| | - Libby Brook
- People Diagnostix, Bentley, WA, Australia.,School of Psychology and Exercise Science, Murdoch University, Murdoch, WA, Australia
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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16
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Maric A, Bürgi M, Werth E, Baumann CR, Poryazova R. Exploring the impact of experimental sleep restriction and sleep deprivation on subjectively perceived sleep parameters. J Sleep Res 2018; 28:e12706. [PMID: 29873140 DOI: 10.1111/jsr.12706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 04/04/2018] [Accepted: 04/07/2018] [Indexed: 11/28/2022]
Abstract
We aimed to investigate the effect of increased sleep pressure and shortened sleep duration on subjective sleep perception in relation to electroencephalographic sleep measures. We analyzed the data from a study in which 14 healthy male volunteers had completed a baseline assessment with 8 hr time in bed, a sleep deprivation (40 hr of wakefulness) and a sleep restriction protocol with 5 hr time in bed during 7 nights. In this work, we assessed perception index, derived through dividing the subjectively perceived total sleep time, wake after sleep onset and sleep latency duration by the objectively measured one at each condition. We found that total sleep time was subjectively underestimated at baseline and shifted towards overestimation during sleep restriction and after deprivation. This change in accuracy of subjective estimates was not associated with any changes in sleep architecture or sleep depth. Wake after sleep onset was significantly underestimated only during sleep restriction. Sleep latency was always overestimated subjectively without any significant change in this misperception across conditions. When comparing accuracy of subjective and actimetry estimates, subjective estimates regarding total sleep time and wake after sleep onset deviated less from electroencephalography derived measures during sleep restriction and after deprivation. We conclude that self-assessments and actimetry data of patients with chronic sleep restriction should be interpreted cautiously. The subjectively decreased perception of wake after sleep onset could lead to overestimated sleep efficiency in such individuals, whereas the underestimation of sleep time and overestimation of wake after sleep onset by actimetry could lead to further underestimated sleep duration.
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Affiliation(s)
- Angelina Maric
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Manuel Bürgi
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Esther Werth
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christian R Baumann
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Rositsa Poryazova
- Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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17
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de Zambotti M, Goldstone A, Colrain IM, Baker FC. Insomnia disorder in adolescence: Diagnosis, impact, and treatment. Sleep Med Rev 2018; 39:12-24. [PMID: 28974427 PMCID: PMC5931364 DOI: 10.1016/j.smrv.2017.06.009] [Citation(s) in RCA: 203] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/20/2017] [Accepted: 06/26/2017] [Indexed: 11/26/2022]
Abstract
Insomnia disorder is very common in adolescents; it is particularly manifest in older adolescents and girls, with a prevalence comparable to that of other major psychiatric disorders (e.g., depressive disorders). However, insomnia disorder in adolescence is poorly characterized, under-recognized, under-diagnosed, and under-treated, and the reason for the female preponderance for insomnia that emerges after puberty is largely unknown. Insomnia disorder goes beyond an individual complaint of poor sleep or a sleep state misperception, and there is emerging evidence supporting the association of insomnia symptoms in adolescents with alterations in several bio-systems including functional cortical alterations and systemic inflammation. Insomnia disorder is associated with depression and other psychiatric disorders, and is an independent risk factor for suicidality and substance use in adolescents, raising the possibility that treating insomnia symptoms in early adolescence may reduce risk for these adverse outcomes. Cognitive behavioral treatments have proven efficacy for adolescent insomnia and online methods seem to offer promising cost-effective options. Current evidence indicates that insomnia in adolescence is an independent entity that warrants attention as a public health concern in its own right.
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Affiliation(s)
| | - Aimee Goldstone
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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18
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Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nat Sci Sleep 2018; 10:73-95. [PMID: 29445307 PMCID: PMC5810528 DOI: 10.2147/nss.s125807] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs) and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment approaches and management options, including combination treatments, ranging from cognitive behavioral therapy for insomnia to hormonal and nonhormonal pharmacological options. Emerging studies suggest that the impact of severe insomnia symptoms could extend beyond immediate health care usage and quality of life issues to long-term mental and physical health, if left untreated in midlife women. Appropriate treatment, therefore, has immediate benefit as well as advantages for maintaining optimal health in the postmenopausal years.
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Affiliation(s)
- Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA.,Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA.,Melbourne School of Psychological Sciences, University of Melbourne
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University.,Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Melbourne, VIC, Australia
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19
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Verma S, Allen NB, Trinder J, Bei B. Highs and lows: Naturalistic changes in mood and everyday hassles over school and vacation periods in adolescents. J Adolesc 2017; 61:17-21. [DOI: 10.1016/j.adolescence.2017.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 06/15/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
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20
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Harbard E, Allen NB, Trinder J, Bei B. What's Keeping Teenagers Up? Prebedtime Behaviors and Actigraphy-Assessed Sleep Over School and Vacation. J Adolesc Health 2016; 58:426-432. [PMID: 26874590 DOI: 10.1016/j.jadohealth.2015.12.011] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/17/2015] [Accepted: 12/08/2015] [Indexed: 02/08/2023]
Abstract
PURPOSE Technology-related behaviors (e.g., computer use) before bedtime (BT) have been associated with poorer and shorter sleep in adolescents; however, less is known about other behaviors in relation to sleep. This study characterized a range of behaviors in the hour before bed (i.e., pre-BT behaviors [PBBs]) and examined their relationship with sleep parameters during school and vacation periods (i.e., restricted and extended sleep opportunities, respectively). Mechanistic roles of chronotype and cognitive presleep arousal (PSAcog) were also examined. METHODS During the last week of a school term and throughout a 2-week vacation, 146 adolescents (47.26% male, age M ± standard deviation = 16.2 ± 1.0 years) from the general community completed daily sleep measure using actigraphy, self-report measures on PBBs and PSAcog (Presleep Arousal Scale) for both school and vacation periods, and chronotype (Morningness-Eveningness Questionnaire). RESULTS Adolescents engaged in a variety of behaviors before bed. Notably, playing video games was associated with significantly later school and vacation BT and shorter school sleep duration (controlling for chronotype). During vacation, online social media was associated with significantly longer sleep onset latency, and this relationship was mediated by higher PSAcog. In contrast, on school nights, spending time with family was associated with significantly earlier BT and longer sleep duration. CONCLUSIONS Technology-related PBBs video games and online social media were risk factors for shorter and poorer sleep, whereas time with family was protective of sleep duration. In addressing sleep problems in adolescents, therapeutic procedures that target the potentially addictive nature of technology use and reduce PSAcog were implicated.
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Affiliation(s)
- Emily Harbard
- Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Victoria, Australia
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia; Department of Psychology, University of Oregon, Eugene, Oregon
| | - John Trinder
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia
| | - Bei Bei
- Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Victoria, Australia; Department of Psychiatry, Centre for Women's Mental Health, Royal Women's Hospital, University of Melbourne, Victoria, Australia.
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21
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Bei B, Ong JC, Rajaratnam SMW, Manber R. Chronotype and Improved Sleep Efficiency Independently Predict Depressive Symptom Reduction after Group Cognitive Behavioral Therapy for Insomnia. J Clin Sleep Med 2015; 11:1021-7. [PMID: 25845891 DOI: 10.5664/jcsm.5018] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/16/2015] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Cognitive behavioral therapy for insomnia (CBT-I) has been shown to improve both sleep and depressive symptoms, but predictors of depression outcome following CBT-I have not been well examined. This study investigated how chronotype (i.e., morningness-eveningness trait) and changes in sleep efficiency (SE) were related to changes in depressive symptoms among recipients of CBT-I. METHODS Included were 419 adult insomnia outpatients from a sleep disorders clinic (43.20% males, age mean ± standard deviation = 48.14 ± 14.02). All participants completed the Composite Scale of Morningness and attended at least 4 sessions of a 6-session group CBT-I. SE was extracted from sleep diary; depressive symptoms were assessed using the Beck Depression Inventory (BDI) prior to (Baseline), and at the end (End) of intervention. RESULTS Multilevel structural equation modeling revealed that from Baseline to End, SE increased and BDI decreased significantly. Controlling for age, sex, BDI, and SE at Baseline, stronger evening chronotype and less improvement in SE significantly and uniquely predicted less reduction in BDI from Baseline to End. Chronotype did not predict improvement in SE. CONCLUSIONS In an insomnia outpatient sample, SE and depressive symptoms improved significantly after a CBT-I group intervention. All chronotypes benefited from sleep improvement, but those with greater eveningness and/or less sleep improvement experienced less reduction in depressive symptom severity. This suggests that evening preference and insomnia symptoms may have distinct relationships with mood, raising the possibility that the effect of CBT-I on depressive symptoms could be enhanced by assessing and addressing circadian factors.
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Affiliation(s)
- Bei Bei
- School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Australia.,Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia
| | - Jason C Ong
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Science.,Rush University Medical Center, Department of Behavioral Sciences
| | - Shantha M W Rajaratnam
- School of Psychological Sciences, Faculty of Biomedical and Psychological Sciences, Monash University, Australia
| | - Rachel Manber
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Science
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