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Palatine E, Phillips ML, Soehner AM. The effect of slow wave sleep deprivation on mood in adolescents with depressive symptoms: A pilot study. J Affect Disord 2024; 354:347-355. [PMID: 38479512 DOI: 10.1016/j.jad.2024.03.058] [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: 11/17/2023] [Revised: 02/13/2024] [Accepted: 03/09/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND There is an urgent need for safe, rapid-acting treatment strategies for adolescent depression. In depressed adults, slow wave sleep deprivation (SWSD) improved next-day mood without disrupting sleep duration, but SWSD has not been tested in adolescents. In a pilot study, the aim was to assess the effect of SWSD on sleep physiology and mood outcomes (depression, rumination, anhedonia) among adolescents with depressive symptoms. METHODS Sixteen adolescents (17.44 ± 1.46 yr, 12 female) completed three nights of polysomnographic sleep recording: Baseline, SWSD, and Recovery nights. Acoustic stimulation (tones of random pitch, duration, and volume) suppressed slow wave sleep (SWS) in real-time during SWSD. After each night, depression, rumination, and anhedonia severity were assessed. RESULTS SWSD successfully suppressed SWS, increased N2, and had minimal impact on Rapid Eye Movement (REM), nocturnal awakenings, and total sleep time. While SWSD did not improve depression or anhedonia severity overall, lower baseline non-REM alpha activity and greater SWS rebound during recovery sleep correlated with SWSD-related reduction in clinician-rated depression severity. Next-day rumination severity decreased after SWSD, with sustained improvements following recovery sleep. However, rumination improvement was not associated with SWS suppression, but rather reduction in total sleep time and REM in exploratory correlation models. LIMITATIONS Small sample size and large proportion of females. CONCLUSION SWSD did not improve depression in adolescents overall but a subset with low non-REM alpha activity and intact homeostatic sleep regulation may benefit from this approach. Findings from this pilot study also suggest that partial sleep deprivation may be a beneficial therapeutic strategy for rumination in adolescents.
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Affiliation(s)
- Elise Palatine
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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2
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Dos Santos AB, Prado WL, Tebar WR, Ingles J, Ferrari G, Morelhão PK, Borges LO, Ritti Dias RM, Beretta VS, Christofaro DGD. Screen time is negatively associated with sleep quality and duration only in insufficiently active adolescents: A Brazilian cross-sectional school-based study. Prev Med Rep 2024; 37:102579. [PMID: 38222306 PMCID: PMC10787249 DOI: 10.1016/j.pmedr.2023.102579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/16/2024] Open
Abstract
Background Time spent on screen devices affects sleep quality and duration leading to several health impairments in youth. Although physical activity (PA) benefits sleep patterns and decreases screen time in adolescents, it is unclear whether the relationship between sleep quality/duration and screen time could be influenced by PA levels. Objective To analyze the association between sleep quality and duration with screen time in Brazilian adolescents according PA levels. Methods The sample included 1010 adolescents aged 13.2 ± 2.4 years (n = 556 females - 55 % of the sample). Sleep quality and sleep duration, and PA were assessed by Mini Sleep and Baecke questionnaires, respectively. Participants in the highest quartile were classified as physically active. Screen time was analyzed by the self-reported number of hours spent on different screen devices (i.e., television, computer, videogame, and cellphone/tablet). Participants in the highest tertile were classified as having high screen time. Sex, age, and body mass index were considered covariates in binary logistic regression models. Results Poor sleep quality was observed in 52.3 % of the sample, whereas 46.6 % reported sleeping less than eight hours/day. High screen time was associated with poor sleep quality (OR = 1.45; 95 %CI = 1.01-2.12) and insufficient sleep duration (OR = 1.52; 95 %CI = 1.01-2.03) in adolescents insufficiently active. There were no associations between screen time and sleep parameters in active adolescents. Conclusion High screen time was associated with poor sleep quality and insufficient sleep duration only in insufficiently active adolescents. These results suggest that high PA levels may contribute to improving sleep patterns in pediatric population.
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Affiliation(s)
- Amanda B Dos Santos
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, Brazil
| | - Wagner L Prado
- California State University-San Bernardino, San Bernardino, USA
| | - William R Tebar
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, Brazil
| | - Jared Ingles
- California State University-San Bernardino, San Bernardino, USA
| | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia 7500912, Chile
| | | | - Luan O Borges
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, Brazil
| | | | - Victor S Beretta
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, Brazil
| | - Diego G D Christofaro
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, SP, Brazil
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3
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Kianersi S, Redline S, Mongraw-Chaffin M, Huang T. Associations of Slow-Wave Sleep With Prevalent and Incident Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab 2023; 108:e1044-e1055. [PMID: 37084404 PMCID: PMC10686689 DOI: 10.1210/clinem/dgad229] [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: 01/08/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 04/23/2023]
Abstract
CONTEXT N3 sleep (i.e., slow-wave sleep), a marker of deep restorative sleep, is implicated in hormonal and blood pressure regulation and may impact cardiometabolic health. OBJECTIVE We conducted cross-sectional and prospective analyses to test whether a higher proportion and longer duration of N3 sleep are associated with reduced type 2 diabetes risk. METHODS A subsample of participants from the Multi-Ethnic Study of Atherosclerosis completed 1-night polysomnography at Exam 5 (2010-2013) and were prospectively followed until Exam 6 (2016-2018). We used modified Poisson regression to examine the cross-sectional associations of N3 proportion and duration with prevalent diabetes and Cox proportional hazards models to estimate risk of diabetes according to N3 measures. RESULTS In cross-sectional analyses (n = 2026, mean age: 69 years), diabetes prevalence was 28% (n = 572). Compared with the first quartile (Q1) of the N3 proportion (<2.0%), participants in Q4 (≥15.4%) were 29% (95% CI 0.58, 0.87) less likely to have prevalent diabetes (P trend = .0016). The association attenuated after adjustment for demographics, lifestyles, and sleep-related factors (P trend = .3322). In prospective analyses of 1251 participants and 129 incident cases over 6346 person-years of follow-up, a curvilinear relationship was observed between N3 proportion and incident diabetes risk. In the fully adjusted model, the hazard ratio (95% CI) of developing diabetes vs Q1 was 0.47 (0.26, 0.87) for Q2, 0.34 (0.15, 0.77) for Q3, and 0.32 (0.10, 0.97) for Q4 (P nonlinearity = .0213). The results were similar for N3 duration. CONCLUSION Higher N3 proportion and longer N3 duration were prospectively associated with lower type 2 diabetes risk in a nonlinear fashion among older American adults.
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Affiliation(s)
- Sina Kianersi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Morgana Mongraw-Chaffin
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
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4
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Sivakumaran K, Ritonja JA, Palmer N, Pasumarthi T, Waseem H, Yu T, Denning A, Michaud D, Morgan RL. Effect of sleep disturbance on biomarkers related to the development of adverse health outcomes: A systematic review of the human literature. J Sleep Res 2022; 32:e13775. [PMID: 36330773 DOI: 10.1111/jsr.13775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Literature suggests that unrestricted and undisturbed sleep is vital for basic human function and performance; however, it is unclear as to what amount of sleep disturbance leads to dysregulation in biomarkers, which may underscore the development of adverse health effects. This systematic review aims to identify the amount of sleep disturbance that contributes to biomarker changes as a potential precursor to the development of adverse health effects. English-language comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases from 1 January 1980 to 31 July 2021 were searched. Where possible, random-effects meta-analyses were used to examine the effect of sleep disturbances on adverse health effects. The risk of bias of individual studies was assessed using the Cochrane Risk of Bias Tool and the Risk of Bias of Nonrandomised Studies - of Exposures instruments and the certainty of the body of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. The search identified 92 primary studies reporting on blood pressure, hypertension, heart rate, cardiac arrhythmia, cardiac output, waist circumference, cortisol, adrenaline, noradrenaline, immune system markers, glucose, insulin, cholesterol, and triglyceride levels. Although some meta-analyses suggested there may be an association between sleep disturbances and certain outcomes, the certainty in the evidence was very low due to concerns with risk of bias, inconsistency across exposures, populations, and imprecision in the estimates of effects. Further research is needed to explore the point at which types, levels and duration of sleep disturbances may begin to increase the risk of developing adverse health outcomes to inform and tailor health interventions.
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Affiliation(s)
| | - Jennifer A. Ritonja
- Université de Montréal Hospital Research Centre (CRCHUM) Montreal Quebec Canada
- Department of Social and Preventive Medicine Université de Montréal Montreal Quebec Canada
| | | | - Tejanth Pasumarthi
- Evidence Foundation Cleveland Heights Ohio USA
- School of Interdisciplinary Science McMaster University Hamilton Ontario Canada
| | - Haya Waseem
- Evidence Foundation Cleveland Heights Ohio USA
| | - Tiffany Yu
- Evidence Foundation Cleveland Heights Ohio USA
- Faculty of Health Sciences McMaster University Hamilton Ontario Canada
| | - Allison Denning
- Health Canada, Environmental and Radiation Health Sciences Directorate Consumer & Clinical Radiation Protection Bureau Ottawa Ontario Canada
| | - David Michaud
- Health Canada, Environmental and Radiation Health Sciences Directorate Consumer & Clinical Radiation Protection Bureau Ottawa Ontario Canada
| | - Rebecca L. Morgan
- Evidence Foundation Cleveland Heights Ohio USA
- Department of Health Research Methods, Evidence and Impact McMaster University Hamilton Ontario Canada
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5
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Calvert ME, Molsberry SA, Kangarloo T, Amin MR, Genty V, Faghih RT, Klerman EB, Shaw ND. Acute Sleep Disruption Does Not Diminish Pulsatile Growth Hormone Secretion in Pubertal Children. J Endocr Soc 2022; 6:bvac146. [PMID: 37283961 PMCID: PMC9562791 DOI: 10.1210/jendso/bvac146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Indexed: 11/19/2022] Open
Abstract
Context In children, growth hormone (GH) pulses occur after sleep onset in association with slow-wave sleep (SWS). There have been no studies in children to quantify the effect of disrupted sleep on GH secretion. Objective This study aimed to investigate the effect of acute sleep disruption on GH secretion in pubertal children. Methods Fourteen healthy individuals (aged 11.3-14.1 years) were randomly assigned to 2 overnight polysomnographic studies, 1 with and 1 without SWS disruption via auditory stimuli, with frequent blood sampling to measure GH. Results Auditory stimuli delivered during the disrupted sleep night caused a 40.0 ± 7.8% decrease in SWS. On SWS-disrupted sleep nights, the rate of GH pulses during N2 sleep was significantly lower than during SWS (IRR = 0.56; 95% CI, 0.32-0.97). There were no differences in GH pulse rates during the various sleep stages or wakefulness in disrupted compared with undisrupted sleep nights. SWS disruption had no effect on GH pulse amplitude and frequency or basal GH secretion. Conclusion In pubertal children, GH pulses were temporally associated with episodes of SWS. Acute disruption of sleep via auditory tones during SWS did not alter GH secretion. These results indicate that SWS may not be a direct stimulus of GH secretion.
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Affiliation(s)
- Madison E Calvert
- National Institute of Environmental Health Sciences, Clinical Research Branch, Research Triangle Park, North Carolina 27709, USA
| | - Samantha A Molsberry
- Social & Scientific Systems, A DLH Holdings Company, Durham, North Carolina 27703, USA
| | - Tairmae Kangarloo
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts 02115, USA
| | - Md Rafiul Amin
- Electrical and Computer Engineering Department, Cullen College of Engineering, University of Houston, Houston, Texas 77204, USA
| | - Valentina Genty
- Electrical and Computer Engineering Department, Cullen College of Engineering, University of Houston, Houston, Texas 77204, USA
| | - Rose T Faghih
- Electrical and Computer Engineering Department, Cullen College of Engineering, University of Houston, Houston, Texas 77204, USA
- Biomedical Engineering Department, Tandon School of Engineering, New York University, New York 11201, USA
| | - Elizabeth B Klerman
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Natalie D Shaw
- National Institute of Environmental Health Sciences, Clinical Research Branch, Research Triangle Park, North Carolina 27709, USA
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6
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Monzon AD, Patton SR, Koren D. Childhood diabetes and sleep. Pediatr Pulmonol 2022; 57:1835-1850. [PMID: 34506691 DOI: 10.1002/ppul.25651] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/18/2021] [Accepted: 08/26/2021] [Indexed: 12/18/2022]
Abstract
Sleep modulates glucose metabolism, both in healthy states and in disease. Alterations in sleep duration (insufficient and excessive) and obstructive sleep apnea may have reciprocal ties with obesity, insulin resistance and Type 2 diabetes, as demonstrated by emerging evidence in children and adolescents. Type 1 diabetes is also associated with sleep disturbances due to the influence of wide glycemic fluctuations upon sleep architecture, the need to treat nocturnal hypoglycemia, and the need for glucose monitoring and insulin delivery technologies. In this article, we provide an extensive and critical review on published pediatric literature regarding these topics, reviewing both epidemiologic and qualitative data, and provide an overview of the pathophysiology linking sleep with disorders of glucose homeostasis.
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Affiliation(s)
- Alexandra D Monzon
- Department of Psychology and Applied Behavioral Science, Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
| | - Susana R Patton
- Department of Biomedical Research, Center for Healthcare Delivery Science, Nemours Children's Health System, Jacksonville, Florida, USA
| | - Dorit Koren
- Department of Pediatrics, Pediatric Endocrinology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
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7
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Johnson JM, Durrant SJ, Law GR, Santiago J, Scott EM, Curtis F. The effect of slow-wave sleep and rapid eye-movement sleep interventions on glycaemic control: a systematic review and meta-analysis of randomised controlled trials. Sleep Med 2022; 92:50-58. [DOI: 10.1016/j.sleep.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/04/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
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8
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Huang W, Liu Y, Wang X, Li X, Liu Y, Zou J, Xu H, Zhu H, Yi H, Guan J, Yin S. Effect of Interaction Between Slow Wave Sleep and Obstructive Sleep Apnea on Insulin Resistance: A Large-Scale Study. Nat Sci Sleep 2021; 13:739-749. [PMID: 34113201 PMCID: PMC8187030 DOI: 10.2147/nss.s311130] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/20/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Slow-wave sleep (SWS) and obstructive sleep apnea (OSA) have attracted recent research attention. However, their joint effects on insulin resistance (IR) remain unclear. This study explored whether SWS influences the relationship between OSA and IR. METHODS We enrolled potential participants in our sleep center from 2007 to 2019. We collected demographic and clinical characteristics and determined IR status. SWS was derived from polysomnography data. Logistic regression analysis was used to reveal the associations between SWS and IR. RESULTS In all, 6966 participants (5709 OSA and 1257 primary snoring [PS] subjects) were enrolled. Less SWS increased the risk of IR in OSA patients but not in PS patients. OSA patients with SWS <6.5% were more likely to have IR than were those with SWS >21.3%. OSA was an independent risk factor for IR after adjusting for potential confounding factors. In stratified analyses according to the percentage of SWS, OSA patients with SWS <6.5% had an odds ratio for IR of 2.461 (95% CI, 2.018-3.002) compared to the PS group after adjusting for potential confounders. CONCLUSION Less SWS is associated with higher odds for IR in OSA patients but not in PS patients. OSA is independently associated with IR. In addition, OSA combined with an extreme lack of SWS has a more harmful effect on the status of IR than OSA itself.
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Affiliation(s)
- Weijun Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Yuenan Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Xiaoting Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Xinyi Li
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Yupu Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Jianyin Zou
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Huajun Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Huaming Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Hongliang Yi
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Jian Guan
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Shankai Yin
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
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9
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Carreau AM, Xie D, Garcia-Reyes Y, Rahat H, Bartlette K, Diniz Behn C, Pyle L, Nadeau KJ, Cree-Green M. Good agreement between hyperinsulinemic-euglycemic clamp and 2 hours oral minimal model assessed insulin sensitivity in adolescents. Pediatr Diabetes 2020; 21:1159-1168. [PMID: 32592269 PMCID: PMC7762730 DOI: 10.1111/pedi.13072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/09/2020] [Accepted: 06/23/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND/OBJECTIVE Rates of dysglycemia are increasing in youth, secondary to obesity and decreased insulin sensitivity (IS) in puberty. The oral minimal model (OMM) has been developed in order to measure IS using an easy oral glucose load, such as an oral glucose tolerance test (OGTT), instead of an hyperinsulinemic-euglycemic clamp (HE-clamp), a more invasive and time-consuming procedure. However, this model, following a standard 2 hour- OGTT has never been validated in youth, a population known for a different physiologic response to OGTT than adults. Thus, we compared IS measurements obtained from OMM following a 2-hour OGTT to HE-clamp and isotope tracer-assessed tissue IS in adolescents. We also compared the liver/muscle-specific IS from HE-clamp with other liver/muscle-specific IS surrogates following an OGTT previously validated in adults. METHODS Secondary analysis of a cross-sectional study. Adolescent girls with (n = 26) and without (n = 7) polycystic ovary syndrome (PCOS) (14.6 ± 1.7 years; BMI percentile 23.3%-98.2%) underwent a 2-hour 75 g OGTT and a 4-phase HE-clamp. OMM IS (Si), dynamic Si (Sid ) and other OGTT-derived muscle and liver IS indices were correlated with HE-clamp tissue-specific IS. RESULTS OMM Si and Sid correlated with HE-clamp-measured peripheral IS (r = 0.64, P <.0001 and r = 0.73; P <.0001, respectively) and the correlation coefficient trended higher than the Matsuda index (r = 0.59; P =.003). The other tissue-specific indices were poorly correlated with their HE-clamp measurements. CONCLUSION In adolescent girls, the 2-hour OMM provided the best estimate of peripheral IS. Additional surrogates for hepatic IS are needed for youth.
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Affiliation(s)
- Anne-Marie Carreau
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Danielle Xie
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Yesenia Garcia-Reyes
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Haseeb Rahat
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kai Bartlette
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, Colorado
| | - Cecilia Diniz Behn
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, Colorado
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado
| | - Kristen J. Nadeau
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Center for Women’s Health Research, Aurora, Colorado
| | - Melanie Cree-Green
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado,Center for Women’s Health Research, Aurora, Colorado
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10
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Toyoura M, Miike T, Tajima S, Matsuzawa S, Konishi Y. Inadequate sleep as a contributor to impaired glucose tolerance: A cross-sectional study in children, adolescents, and young adults with circadian rhythm sleep-wake disorder. Pediatr Diabetes 2020; 21:557-564. [PMID: 32134542 DOI: 10.1111/pedi.13003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 01/19/2020] [Accepted: 03/01/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sleep deprivation and circadian disruption are associated with decreased insulin sensitivity and hyperglycemia. It is uncertain whether circadian sleep-wake disorder (CRSWD), which relates to both the homeostatic sleep system and the circadian timing system, affects glycemic regulation and insulin secretion. We aimed to examine the associations among sleep duration, sleep architecture or circadian rhythm of the sleep-wake cycle, and glucose metabolism in children, adolescents, and young adults with CRSWD. METHODS This cross-sectional observational study of 124 patients with CRSWD took place at Hyogo Children's Sleep and Development Medical Research Center in Hyogo, Japan. The patients underwent a 3-hour oral glucose tolerance test, anthropometric measurements, sleep-log analyses, and polysomnography. Analysis of covariance models were used to assess the association between sleep architecture or circadian rhythm of sleep-wake cycle and glucose/insulin homeostasis, adjusted for confounding variables such as age, gender, standardized body mass index, and sleep apnea index. RESULTS Impaired glucose tolerance was detected in 25.8% of all patients with CRSWD. After adjustment for confounding variables, we found a negative association between total sleep time (TST) and the 2-hour plasma glucose level. Stage N1 (%TST) was also a significant predictor of 3-hour glucose level. However, we did not detect an association between circadian rhythm of the sleep-wake cycle and glucose/insulin measures. CONCLUSIONS Decreased sleep duration and increased stage N1 (%TST) were associated with hyperglycemia in patients with CRSWD. Further research should elucidate how circadian misalignment in patients with CRSWD is associated with glucose and insulin homeostasis.
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Affiliation(s)
- Makiko Toyoura
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
| | - Teruhisa Miike
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
| | - Seiki Tajima
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
| | | | - Yukuo Konishi
- Department of Pediatrics, Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
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11
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Obesity and Circadian Cycle of Sleep and Wakefulness: Common Points and Prospects of Therapy. ACTA BIOMEDICA SCIENTIFICA 2020. [DOI: 10.29413/abs.2020-5.1.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The prevalence of obesity in recent years has assumed the character of a non-communicable epidemic. Wherein, the standard approaches for its treatment are not always successful. Meanwhile, obesity remains one of the main causes of the formation of a number of some serious diseases, such as cardiovascular, diabetes, cancer, etc. and death from them. In search of alternative and more adequate methods of obesity treatment and preventing its complications, recent studies are aimed at further identifying new associations and revealing the pathophysiological mechanisms underlying excessive weight gain. It should be noted an increasing amount of chronobiological studies that raised awareness of the key role of the body’s circadian rhythms and its main regulator, melatonin, responsible for the temporary organization of the main physiological (including metabolism) processes throughout the 24-h day, in the development and progression of obesity. This review is devoted to the consideration of mutually directed interactions between the circadian system and metabolism; attempts have been made to explain the role of sleep-wake cycle disruptions in the excess accumulation of adipose tissue and the formation of obesity and its comorbidities, as well as detailed therapeutic principles based on normalizing disruption of body clocks using time-coordinated approaches to food intake, physical activity, the effects of non-drug methods and pharmacological substances (chronobiotics), which represents a novel and promising ways to prevent or treat obesity and associated diseases.
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Mokhlesi B, Temple KA, Tjaden AH, Edelstein SL, Nadeau KJ, Hannon TS, Manchanda S, Sam S, Barengolts E, Utzschneider KM, Ehrmann DA, Van Cauter E. The association of sleep disturbances with glycemia and obesity in youth at risk for or with recently diagnosed type 2 diabetes. Pediatr Diabetes 2019; 20:1056-1063. [PMID: 31486162 PMCID: PMC7199716 DOI: 10.1111/pedi.12917] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/19/2019] [Accepted: 09/03/2019] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Poor sleep may increase obesity and type 2 diabetes (T2D) risk in youth. We explored whether subjective sleep duration, sleep quality, or risk for obstructive sleep apnea (OSA) are associated with glycemia, body mass index (BMI), or blood pressure (BP) in overweight/obese youth. METHODS Two-hundred and fourteen overweight/obese youth of 10 to 19 years of age at risk for or recently diagnosed with T2D who were screened for the Restoring Insulin Secretion (RISE) Study had a 2-hour oral glucose tolerance test (OGTT) and completed a Cleveland Adolescent Sleepiness questionnaire and a Sleep Disturbances Scale questionnaire. Independent associations between sleep variables and measures of glycemia, BMI, and BP were evaluated with regression models. RESULTS The multiethnic cohort was 67% female, 14.1 ± 2.1 years, and BMI 35.9 ± 6.5 kg/m2 . Habitual sleep duration <8 hours was reported in 74%. Daytime sleepiness was reported in 51%, poor sleep quality in 26%, and 30% had high obstructive sleep apnea (OSA) risk. Daytime sleepiness was associated with higher HbA1c (0.2%, P = .02) and 2-hour glucose (13.6 mg/dL, P < .05). Sleep duration, sleep quality, and OSA risk were not associated with the evaluated outcomes. Poor sleep quality and OSA risk were associated with higher BMI (2.9 kg/m2 , P = .004 and 2.83 kg/m2 , P < .003, respectively). CONCLUSIONS In overweight/obese youth with or at risk for T2D, daytime sleepiness was associated with higher HbA1c. In addition, poor sleep quality and OSA risk were associated with higher BMI. These findings support intervention studies aimed at improving sleep quality in obese youth.
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Affiliation(s)
| | | | - Ashley H. Tjaden
- George Washington University Biostatistics Center (RISE Coordinating Center), Rockville, Maryland
| | - Sharon L. Edelstein
- George Washington University Biostatistics Center (RISE Coordinating Center), Rockville, Maryland
| | - Kristen J. Nadeau
- University of Colorado Anschutz Medical Campus/Children’s Hospital Colorado, Denver, Colorado
| | | | | | - Susan Sam
- University of Chicago, Chicago, Illinois
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Arslanian S, Bacha F, Grey M, Marcus MD, White NH, Zeitler P. Evaluation and Management of Youth-Onset Type 2 Diabetes: A Position Statement by the American Diabetes Association. Diabetes Care 2018; 41:2648-2668. [PMID: 30425094 PMCID: PMC7732108 DOI: 10.2337/dci18-0052] [Citation(s) in RCA: 202] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Silva Arslanian
- Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, University of Pittsburgh, Pittsburgh, PA
- Center for Pediatric Research in Obesity and Metabolism, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Fida Bacha
- Children's Nutrition Research Center, Texas Children's Hospital and Baylor College of Medicine, Houston, TX
| | - Margaret Grey
- Yale School of Nursing, New Haven, CT
- Yale School of Medicine, New Haven, CT
| | | | - Neil H White
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Philip Zeitler
- Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO
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Arnal PJ. Slow wave sleep and steroid hormones. Sleep Med 2018; 53:172-173. [PMID: 30389221 DOI: 10.1016/j.sleep.2018.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/20/2018] [Indexed: 11/24/2022]
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15
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Seo YG, Choi MK, Kang JH, Lee HJ, Jang HB, Park SI, Ju YS, Park KH. Cardiovascular disease risk factor clustering in children and adolescents: a prospective cohort study. Arch Dis Child 2018; 103:968-973. [PMID: 29650509 DOI: 10.1136/archdischild-2017-313226] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 03/09/2018] [Accepted: 03/25/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The early identification of predictors related to cardiovascular disease risk factor clustering (CVD-RFC) can help prevent chronic disease. We aimed to identify the risk factors for CVD-RFC in adolescents. METHODS A prospective longitudinal cohort study design was used to obtain data included in these analyses from school-aged children who participated in the Korean Child-Adolescent Study 2008-2014. A total of 1309 children aged 6-15 years were enrolled. We compared the participants based on the presence or absence of CVD-RFC and examined the cumulative incidence of CVD-RFC. RESULTS Of the total 1309 children, 410 (31.32%) had CVD-RFC in adolescence. A higher average household income ≥3 million Korean Republic won (KRW)/month (3-5 million KRW/month: HR 0.75 (95% CI 0.58 to 0.97); ≥5 million KRW/month: HR 0.58 (95% CI 0.44 to 0.77)) was associated with a lower CVD-RFC incidence, while the presence of parental CVD history (HR 1.28 (95% CI 1.04 to 1.57)), overweight or obesity (HR 3.83 (95% CI 3.05 to 4.80)) and shorter sleep duration of 8-9 hour/day (HR 1.80 (95% CI 1.05 to 3.07)) and <8 hour/day (HR 1.93 (95% CI 1.11 to 3.34)) had higher CVD-RFC incidences. CONCLUSIONS Obesity in childhood, short sleep duration and parental factors such as low socioeconomic status and parental history of CVD are significant risk factors for the development of CVD-RFC in adolescents. Efforts to create awareness regarding sufficient sleep duration in children via intervention programmes targeting cardiometabolic health in children and special attention to lifestyle modifications and socioeconomic components of the family should be considered.
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Affiliation(s)
- Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Min-Kyu Choi
- Department of Family Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Jae-Heon Kang
- Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea
| | - Hye-Ja Lee
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Han Byul Jang
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Sang Ick Park
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Young Soo Ju
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
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Fobian AD, Elliott L, Louie T. A Systematic Review of Sleep, Hypertension, and Cardiovascular Risk in Children and Adolescents. Curr Hypertens Rep 2018; 20:42. [PMID: 29717377 DOI: 10.1007/s11906-018-0841-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Many of the risk factors for heart disease have recently been shown to develop during childhood such as left ventricular hypertrophy and fibrous plaque lesions. As risk for cardiovascular disease in children and adolescents has risen, sleep duration has decreased, and inadequate sleep in children and adolescents has been found to be associated with cardiovascular disease risk. The aims of this manuscript are to provide an updated systematic review of the literature assessing sleep, hypertension, and cardiovascular risk and evaluate the strength of the evidence based on the available research. RECENT FINDINGS A systematic review was conducted using six databases from January 1, 2015 through March 9, 2018. We sought studies which looked at the relationship between sleep duration, sleep timing, or sleep quality and outcome variables of hypertension, inflammation, obesity, glucose or insulin, and lipids in children and adolescents. We found 24 studies which met our criteria. Nine studies included hypertension as an outcome variable; fifteen included obesity; thirteen included glucose or insulin; eight included lipids; and three included measures of inflammation. The existing literature on sleep and cardiovascular disease in children and adolescents is limited and relatively weak. Only one RCT was identified, and the overwhelming majority of studies had a high risk of bias. The strongest evidence of an association with sleep is with obesity, hypertension, and insulin sensitivity. Further research using more standardized methods and objective measures is needed to determine if a causal relationship truly exists between sleep and cardiovascular risk.
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Affiliation(s)
- Aaron D Fobian
- Department of Psychiatry, University of Alabama at Birmingham, 1720 2nd Ave. S., SC 1025, Birmingham, AL, 35294, USA.
| | - Lindsey Elliott
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tinnie Louie
- Department of Clinical and Diagnostic Science, University of Alabama at Birmingham, Birmingham, AL, USA
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McHill AW, Hull JT, McMullan CJ, Klerman EB. Chronic Insufficient Sleep Has a Limited Impact on Circadian Rhythmicity of Subjective Hunger and Awakening Fasted Metabolic Hormones. Front Endocrinol (Lausanne) 2018; 9:319. [PMID: 29946297 PMCID: PMC6005823 DOI: 10.3389/fendo.2018.00319] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/28/2018] [Indexed: 01/04/2023] Open
Abstract
UNLABELLED Weight gain and obesity have reached epidemic proportions in modern society. Insufficient sleep-which is also prevalent in modern society-and eating at inappropriate circadian times have been identified as risk factors for weight gain, yet the impact of chronic insufficient sleep on the circadian timing of subjective hunger and physiologic metabolic outcomes are not well understood. We investigated how chronic insufficient sleep impacts the circadian timing of subjective hunger and fasting metabolic hormones in a 32-day in-laboratory randomized single-blind control study, with healthy younger participants (range, 20-34 years) randomized to either Control (1:2 sleep:wake ratio, 6.67 h sleep:13.33 h wake, n = 7, equivalent to 8 h of sleep per 24 h) or chronic sleep restriction (CSR, 1:3.3 sleep:wake ratio, 4.67 h sleep:15.33 h wake, n = 8, equivalent to 5.6 h of sleep per 24 h) conditions. Participants lived on a "20 h day" designed to distribute all behaviors and food intake equally across all phases of the circadian cycle over every six consecutive 20 h protocol days. During each 20 h day, participants were provided a nutritionist-designed, isocaloric diet consisting of 45-50% carbohydrate, 30-35% fat, and 15-20% protein adjusted for sex, weight, and age. Subjective non-numeric ratings of hunger were recorded before and after meals and fasting blood samples were taken within 5 min of awakening. Subjective levels of hunger and fasting concentrations of leptin, ghrelin, insulin, glucose, adiponectin, and cortisol all demonstrated circadian patterns; there were no differences, however, between CSR and Control conditions in subjective hunger ratings or any fasting hormone concentrations. These findings suggest that chronic insufficient sleep may have a limited role in altering the robust circadian profile of subjective hunger and fasted metabolic hormones. CLINICAL TRIAL REGISTRATION The study was registered as clinical trial #NCT01581125.
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Affiliation(s)
- Andrew W. McHill
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, United States
- *Correspondence: Andrew W. McHill,
| | - Joseph T. Hull
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Ciaran J. McMullan
- Renal Division, Brigham and Women’s Hospital, Boston, MA, United States
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Elizabeth B. Klerman
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
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18
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McHill AW, Klerman EB, Slater B, Kangarloo T, Mankowski PW, Shaw ND. The Relationship Between Estrogen and the Decline in Delta Power During Adolescence. Sleep 2017; 40:3002785. [PMID: 28364433 DOI: 10.1093/sleep/zsx008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Study Objectives During adolescence, there is a precipitous decrease in slow-wave sleep (SWS) and its spectral correlate, delta power, which may reflect cortical reorganization. The temporal association between the decrease in delta power and puberty suggests that sex steroids may initiate these changes. This association has not been previously investigated. Methods To determine whether estrogen triggers the adolescent decline in delta power, we compared delta power in 14 girls with central precocious puberty (CPP) and 6 age-matched, prepubertal controls. Five CPP participants were re-studied 7-14 months after pubertal suppression to determine if the changes in delta power are reversible after restoring a prepubertal hormonal milieu. The change in delta power was also compared between CPP participants and five historic controls from a longitudinal polysomnographic study. Results CPP participants (6.7-10.5 years) spent 30% of the night in SWS. Delta power (3.7 × 106 ± 2.7 × 105 µV2) predominated in the first 2 non-rapid eye movement episodes and decayed exponentially (tau 0.006 minutes). Age-matched controls demonstrated similar sleep staging (24% SWS) and delta dynamics (3.3 × 106 ± 5.1 × 105 µV2, tau 0.004 minutes). Four out of 5 CPP participants had a significant decrease (26%) in delta power after hormone suppression (p < .05), similar to historic controls. Conclusion Using an innovative model of girls with CPP studied before and after estrogen suppression, the effects of puberty on the decline in delta power were dissociated from those of chronologic age. The current studies suggest that increased estrogen does not cause the adolescent decline in delta power and indicate that neurodevelopmental changes per se or other factors associated with puberty drive these sleep changes.
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Affiliation(s)
- Andrew W McHill
- Sleep Health Institute and Division of Sleep and Circadian Disorders.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Elizabeth B Klerman
- Sleep Health Institute and Division of Sleep and Circadian Disorders.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | | | - Tairmae Kangarloo
- Reproductive Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Piotr W Mankowski
- Sleep Health Institute and Division of Sleep and Circadian Disorders.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Natalie D Shaw
- Reproductive Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA.,Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC
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Kaar JL, Simon SL, Schmiege SJ, Nadeau KJ, Kelsey MM. Adolescent's Health Behaviors and Risk for Insulin Resistance: A Review of the Literature. Curr Diab Rep 2017; 17:49. [PMID: 28526994 DOI: 10.1007/s11892-017-0881-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW One-third of US adolescents are obese, and related comorbidities exist in this population. Preventing early indicators of these diseases, such as insulin resistance (IR), may impact future morbidity and mortality. Interventions to date have only focused on diet or exercise. Additional targets to prevent disease are needed. This paper reviews the evidence in adolescents examining multiple health behaviors that have been associated with IR. RECENT FINDINGS Health behaviors (i.e., diet, activity, sleep) have been individually examined as possible contributors to disease, but an understanding of the complex interplay between these behaviors is lacking. A better understanding of how multiple health behaviors contribute to IR in adolescents is needed. Future studies using both advanced statistical methodology and robust measures of each health behavior may facilitate better understanding of the impact of lifestyle factors on IR and guide intervention strategies to reduce the risk of disease.
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Affiliation(s)
- Jill L Kaar
- Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 265, Aurora, CO, 80045, USA.
| | - Stacey L Simon
- Department of Pediatrics, Division of Pulmonology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 395, Aurora, CO, 80045, USA
| | - Sarah J Schmiege
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13120 East 19th Avenue, Mail Stop C288-04, Aurora, CO, 80045, USA
| | - Kristen J Nadeau
- Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 265, Aurora, CO, 80045, USA
| | - Megan M Kelsey
- Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 265, Aurora, CO, 80045, USA
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Inadequate sleep as a contributor to type 2 diabetes in children and adolescents. Nutr Diabetes 2017; 7:e266. [PMID: 28481337 PMCID: PMC5518801 DOI: 10.1038/nutd.2017.19] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/04/2017] [Accepted: 03/20/2017] [Indexed: 12/17/2022] Open
Abstract
Lack of sleep is a modifiable risk factor for adverse health in humans. Short sleep duration and poor sleep quality are common in the pediatric population; the largest decline in sleep duration over the past decades has been seen in children and adolescents. The objective of the present narrative review was to provide for the first time an overview of the literature on sleep and its association with type 2 diabetes mellitus (T2D) biomarkers in children and adolescents. For this narrative review, 23 studies were retained (21 observational and 2 experimental studies). Notwithstanding the conflicting results found in these studies and despite being attenuated by adiposity level, maturity, sex and age, there is still some compelling evidence for an association between sleep duration (for both objective or subjective measurements of duration) and architecture with one or more T2D biomarkers in children and adolescents. The majority of the studies reviewed did focus on sleep duration and one or more T2D biomarkers in children and adolescents, but sleep architecture, more precisely the suppression of slow wave sleep and rapid eye movement sleep, has also been shown to be associated with insulin resistance. Only two studies looked at sleep quality, and the association between sleep quality and insulin resistance was not independent of level of adiposity. Future experimental studies will help to better understand the mechanisms linking insufficient sleep with T2D. Work also needs to be carried out on finding novel and effective strategies aimed at improving sleep hygiene and health outcomes of children and adolescents.
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McHill AW, Wright KP. Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease. Obes Rev 2017; 18 Suppl 1:15-24. [PMID: 28164449 DOI: 10.1111/obr.12503] [Citation(s) in RCA: 193] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/02/2016] [Indexed: 12/12/2022]
Abstract
Weight gain, obesity and diabetes have reached alarming levels in the developed world. Traditional risk factors such as over-eating, poor nutritional choices and lack of exercise cannot fully account for the high prevalence of metabolic disease. This review paper examines the scientific evidence on two novel risk factors that contribute to dys-regulated metabolic physiology: sleep disruption and circadian misalignment. Specifically, fundamental relationships between energy metabolism and sleep and circadian rhythms and the impact of sleep and circadian disruption on metabolic physiology are examined. Millions of individuals worldwide do not obtain sufficient sleep for healthy metabolic function, and many participate in shift work and social activities at times when the internal physiological clock is promoting sleep. These behaviours predispose an individual for poor metabolic health by promoting excess caloric intake in response to reduced sleep, food intake at internal biological times when metabolic physiology is not prepared, decreased energy expenditure when wakefulness and sleep are initiated at incorrect internal biological times, and disrupted glucose metabolism during short sleep and circadian misalignment. In addition to the traditional risk factors of poor diet and exercise, disturbed sleep and circadian rhythms represent modifiable risk factors for prevention and treatment of metabolic disease and for promotion of healthy metabolism.
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Affiliation(s)
- A W McHill
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - K P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
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Potter GDM, Skene DJ, Arendt J, Cade JE, Grant PJ, Hardie LJ. Circadian Rhythm and Sleep Disruption: Causes, Metabolic Consequences, and Countermeasures. Endocr Rev 2016; 37:584-608. [PMID: 27763782 PMCID: PMC5142605 DOI: 10.1210/er.2016-1083] [Citation(s) in RCA: 302] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Circadian (∼24-hour) timing systems pervade all kingdoms of life and temporally optimize behavior and physiology in humans. Relatively recent changes to our environments, such as the introduction of artificial lighting, can disorganize the circadian system, from the level of the molecular clocks that regulate the timing of cellular activities to the level of synchronization between our daily cycles of behavior and the solar day. Sleep/wake cycles are intertwined with the circadian system, and global trends indicate that these, too, are increasingly subject to disruption. A large proportion of the world's population is at increased risk of environmentally driven circadian rhythm and sleep disruption, and a minority of individuals are also genetically predisposed to circadian misalignment and sleep disorders. The consequences of disruption to the circadian system and sleep are profound and include myriad metabolic ramifications, some of which may be compounded by adverse effects on dietary choices. If not addressed, the deleterious effects of such disruption will continue to cause widespread health problems; therefore, implementation of the numerous behavioral and pharmaceutical interventions that can help restore circadian system alignment and enhance sleep will be important.
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Affiliation(s)
- Gregory D M Potter
- Division of Epidemiology and Biostatistics (G.D.M.P., L.J.H.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom; Chronobiology Section (D.J.S., J.A.), Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom; Nutritional Epidemiology Group (J.E.C.), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, United Kingdom; and Division of Cardiovascular & Diabetes Research (P.J.G.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Debra J Skene
- Division of Epidemiology and Biostatistics (G.D.M.P., L.J.H.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom; Chronobiology Section (D.J.S., J.A.), Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom; Nutritional Epidemiology Group (J.E.C.), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, United Kingdom; and Division of Cardiovascular & Diabetes Research (P.J.G.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Josephine Arendt
- Division of Epidemiology and Biostatistics (G.D.M.P., L.J.H.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom; Chronobiology Section (D.J.S., J.A.), Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom; Nutritional Epidemiology Group (J.E.C.), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, United Kingdom; and Division of Cardiovascular & Diabetes Research (P.J.G.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Janet E Cade
- Division of Epidemiology and Biostatistics (G.D.M.P., L.J.H.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom; Chronobiology Section (D.J.S., J.A.), Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom; Nutritional Epidemiology Group (J.E.C.), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, United Kingdom; and Division of Cardiovascular & Diabetes Research (P.J.G.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Peter J Grant
- Division of Epidemiology and Biostatistics (G.D.M.P., L.J.H.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom; Chronobiology Section (D.J.S., J.A.), Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom; Nutritional Epidemiology Group (J.E.C.), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, United Kingdom; and Division of Cardiovascular & Diabetes Research (P.J.G.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Laura J Hardie
- Division of Epidemiology and Biostatistics (G.D.M.P., L.J.H.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom; Chronobiology Section (D.J.S., J.A.), Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom; Nutritional Epidemiology Group (J.E.C.), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, United Kingdom; and Division of Cardiovascular & Diabetes Research (P.J.G.), LIGHT Laboratories, University of Leeds, Leeds LS2 9JT, United Kingdom
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