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Burgess HJ, Troost JP, Rizvydeen M, Kikyo F, Kebbeh N, Tan M, Roecklein KA, King AC, Hasler BP. Do sleep and circadian characteristics predict alcohol use in adult drinkers? Alcohol Clin Exp Res (Hoboken) 2024; 48:680-691. [PMID: 38546532 PMCID: PMC11015972 DOI: 10.1111/acer.15280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/16/2024] [Accepted: 02/02/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND While sleep and circadian rhythms are recognized contributors to the risk for alcohol use and related problems, few studies have examined whether objective sleep and circadian measures can predict future alcohol use in humans, and no such studies have been conducted in adults. This study examined whether any baseline sleep and/or circadian characteristics of otherwise healthy adults predicted their alcohol use over the subsequent 12 months. METHODS Participants (21-42 years) included 28 light and 50 heavy drinkers. At baseline, a comprehensive range of self-reported and objective sleep/circadian measures was assessed via questionnaires, wrist actigraphy, and measurement of dim light melatonin onset and circadian photoreceptor responsivity. Following this, the number of alcoholic drinks per week and binge drinking episodes per month were assessed quarterly over the subsequent 12 months. Anticipated effects of alcohol (stimulation, sedation, and rewarding aspects) were also assessed quarterly over the 12 months. Analyses included generalized linear mixed-effects models and causal mediation analysis. RESULTS Across the range of measures, only self-reported insomnia symptoms and a longer total sleep time at baseline predicted more drinks per week and binges per month (ps <0.02). There was a trend for the anticipated alcohol effect of wanting more alcohol at the 6-month timepoint to mediate the relationship between insomnia symptoms at baseline and drinks per week at 12 months (p = 0.069). CONCLUSIONS These results suggest that in otherwise healthy adults, insomnia symptoms, even if subclinical, are a significant predictor of future drinking, and appear to outweigh the influence of circadian factors on future drinking, at least in otherwise healthy adults. Insomnia symptoms may be a modifiable target for reducing the risk of alcohol misuse.
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Affiliation(s)
- Helen J. Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Jonathan P. Troost
- Michigan Institute for Clinical & Health Research, University of Michigan, Ann Arbor, MI USA
| | - Muneer Rizvydeen
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Fumitaka Kikyo
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, IL, USA
| | - Nema Kebbeh
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Michael Tan
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, IL, USA
| | | | - Andrea C. King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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2
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Tapia AL, Wallace ML, Hasler BP, Holmes J, Pedersen SL. Effect of daily discrimination on naturalistic sleep health features in young adults. Health Psychol 2024; 43:298-309. [PMID: 38190204 PMCID: PMC10939866 DOI: 10.1037/hea0001359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Racial inequities in sleep health are well documented and may be partially attributable to discrimination experiences. However, the effects of acute discrimination experiences on same-night sleep health are understudied. We quantified naturalistic discrimination experiences captured using ecological momentary assessment (EMA) and examined whether reporting discrimination on a given day predicted sleep health that night. METHOD Participants completed baseline assessments and a 17-day EMA protocol, with text prompts delivered four times daily to collect discrimination experiences. Seven different daily sleep characteristics were ascertained each morning. Discrimination reasons (e.g., because of my racial identity) were reported by participants and categorized into any, racial, or nonracial discrimination. Outcomes included the seven sleep diary characteristics. We fit generalized linear mixed effects models for each sleep outcome and discrimination category, controlling for key covariates. RESULTS The analytic sample included 116 self-identified Black and White individuals (48% Black, 71% assigned female at birth, average age = 24.5 years). Among Black participants, race-based discrimination was associated with a 0.5-hr reduction in total sleep time (TST). Among White individuals, nonracial discrimination was associated with a 0.6-hr reduction in TST, an earlier sleep offset, and reduced sleep efficiency (partly attributable to more nighttime awakenings). CONCLUSIONS Young adults may sleep worse on nights after experiencing discrimination, and different types of discrimination affect different sleep outcomes for Black and White individuals. Future studies may consider developing treatments that account for different sleep vulnerabilities for people experiencing discrimination on a given day. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh
- Department of Statistics, University of Pittsburgh
- Department of Biostatistics, University of Pittsburgh
| | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh
- Department of Psychology, University of Pittsburgh
- Clinical and Translational Science, University of Pittsburgh
| | | | - Sarah L. Pedersen
- Department of Psychiatry, University of Pittsburgh
- Department of Psychology, University of Pittsburgh
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3
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Tracy EL, Chin BN, Lehrer HM, Hasler BP, Thomas MC, Smagula S, Kimutis S, Hall MH, Buysse DJ. Behavioral-social rhythms and cardiovascular disease risk in retired night shift workers and retired day workers. Psychosom Med 2024:00006842-990000000-00208. [PMID: 38573015 DOI: 10.1097/psy.0000000000001287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE Stability in the timing of key daily routine behaviors such as working/doing housework, sleeping, eating, and engaging in social interactions (i.e., behavioral-social rhythms) contributes to health. This study examined whether behavioral-social rhythms were associated with CVD risk factors in retired night shift workers and retired day workers and explored whether past night shift work exposure moderated this association. METHODS 154 retired older adults participated in this study. Multiple logistic regression models were used to examine associations between behavioral-social rhythms and CVD risk factors. Independent variables included Social Rhythm Metric (SRM)-5 score and actigraphy rest-activity rhythm intra-daily variability (IV) and inter-daily stability (IS). Dependent variables were metabolic syndrome prevalence and its five individual components. RESULTS More regular behavioral-social rhythms were associated with lower odds of prevalent metabolic syndrome (SRM: OR = 0.57, 95% CI [0.35, 0.88]; IV: OR = 4.00, 95% CI [1.86, 8.58]; IS: OR = 0.42, 95% CI [0.24, 0.73]) and two of its individual components: body mass index (SRM: OR = 0.56, 95% CI [0.37, 0.85]; IV: OR = 2.84, 95% CI [1.59, 5.07]; IS: OR = 0.42, 95% CI [0.26, 0.68]) and high-density lipoprotein cholesterol (SRM: OR = 0.49, 95% CI [0.30, 0.80]; IV: OR = 2.49, 95% CI [1.25, 4.96]; IS: OR = 0.35, 95% CI [0.19, 0.66]). Past shift work history did not moderate the association between behavioral-social rhythms and metabolic syndrome. CONCLUSIONS Behavioral-social rhythms were related to CVD risk factors in retired adults regardless of prior night shift work exposure. Older retired workers may benefit from education and interventions aiming to increase behavioral-social rhythm regularity.
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Hasler BP, Schulz CT, Pedersen SL. Sleep-Related Predictors of Risk for Alcohol Use and Related Problems in Adolescents and Young Adults. Alcohol Res 2024; 44:02. [PMID: 38500552 PMCID: PMC10948113 DOI: 10.35946/arcr.v44.1.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
PURPOSE Growing evidence supports sleep and circadian rhythms as influencing alcohol use and the course of alcohol use disorder (AUD). Studying sleep/circadian-alcohol associations during adolescence and young adulthood may be valuable for identifying sleep/circadian-related approaches to preventing and/or treating AUD. This paper reviews current evidence for prospective associations between sleep/circadian factors and alcohol involvement during adolescence and young adulthood with an emphasis on the effects of sleep/circadian factors on alcohol use. SEARCH METHODS The authors conducted a literature search in PsycInfo, PubMed, and Web of Science using the search terms "sleep" and "alcohol" paired with "adolescent" or "adolescence" or "young adult" or "emerging adult," focusing on the title/abstract fields, and restricting to English-language articles. Next, the search was narrowed to articles with a prospective/longitudinal or experimental design, a sleep-related measure as a predictor, an alcohol-related measure as an outcome, and confirming a primarily adolescent and/or young adult sample. This step was completed by a joint review of candidate article abstracts by two of the authors. SEARCH RESULTS The initial search resulted in 720 articles. After review of the abstracts, the list was narrowed to 27 articles reporting on observational longitudinal studies and three articles reporting on intervention trials. Noted for potential inclusion were 35 additional articles that reported on studies with alcohol-related predictors and sleep-related outcomes, and/or reported on candidate moderators or mediators of sleep-alcohol associations. Additional articles were identified via review of relevant article reference lists and prior exposure based on the authors' previous work in this area. DISCUSSION AND CONCLUSIONS Overall, the review supports a range of sleep/circadian characteristics during adolescence and young adulthood predicting the development of alcohol use and/or alcohol-related problems. Although sleep treatment studies in adolescents and young adults engaging in regular and/or heavy drinking show that sleep can be improved in those individuals, as well as potentially reducing alcohol craving and alcohol-related consequences, no studies in any age group have yet demonstrated that improving sleep reduces drinking behavior. Notable limitations include relatively few longitudinal studies and only two experimental studies, insufficient consideration of different assessment timescales (e.g., day-to-day vs. years), insufficient consideration of the multidimensional nature of sleep, a paucity of objective measures of sleep and circadian rhythms, and insufficient consideration of how demographic variables may influence sleep/circadian-alcohol associations. Examining such moderators, particularly those related to minoritized identities, as well as further investigation of putative mechanistic pathways linking sleep/circadian characteristics to alcohol outcomes, are important next steps.
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Affiliation(s)
- Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Christina T Schulz
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sarah L Pedersen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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5
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Wescott DL, Hasler BP, Franzen PL, Taylor ML, Klevens AM, Gamlin P, Siegle GJ, Roecklein KA. Circadian photoentrainment varies by season and depressed state: associations between light sensitivity and sleep and circadian timing. Sleep 2024:zsae066. [PMID: 38530635 DOI: 10.1093/sleep/zsae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/08/2024] [Indexed: 03/28/2024] Open
Abstract
STUDY OBJECTIVES Altered light sensitivity may be an underlying vulnerability for disrupted circadian photoentrainment. The photic information necessary for circadian photoentrainment is sent to the circadian clock from melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs). The current study tested whether the responsivity of ipRGCs measured using the post-illumination pupil response (PIPR) was associated with circadian phase, sleep timing, and circadian alignment, and if these relationships varied by season or depression severity. METHODS Adult participants (N = 323, agem = 40.5, agesd = 13.5) with varying depression severity were recruited during the summer (n = 154) and winter (n = 169) months. Light sensitivity was measured using the PIPR. Circadian phase was assessed using Dim Light Melatonin Onset (DLMO) on Friday evenings. Midsleep was measured using actigraphy. Circadian alignment was calculated as the DLMO-midsleep phase angle. Multilevel regression models covaried for age, gender, and time since wake of PIPR assessment. RESULTS Greater light sensitivity was associated with later circadian phase in summer but not in winter (β = 0.23; p = 0.03). Greater light sensitivity was associated with shorter DLMO-midsleep phase angles (β = 0.20; p = 0.03) in minimal depression but not in moderate depression (SIGHSAD < 6.6; Johnson-Neyman region of significance). CONCLUSIONS Light sensitivity measured by the PIPR was associated with circadian phase during the summer but not in winter, suggesting ipRGC functioning in humans may affect circadian entrainment when external zeitgebers are robust. Light sensitivity was associated with circadian alignment only in participants with minimal depression, suggesting circadian photoentrainment, a possible driver of mood, may be decreased in depression year-round, similar to decreased photoentrainment in winter.
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Affiliation(s)
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Maddison L Taylor
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alison M Klevens
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Paul Gamlin
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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6
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Hasler BP, Wallace ML, Graves JL, Witt R, Guo K, Buysse DJ, Siegle GJ, Clark DB. Pre-pandemic circadian phase predicts pandemic alcohol use among adolescents. J Sleep Res 2024; 33:e13905. [PMID: 37039532 PMCID: PMC10564965 DOI: 10.1111/jsr.13905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/15/2023] [Accepted: 03/29/2023] [Indexed: 04/12/2023]
Abstract
Later circadian timing during adolescence is linked to worse sleep, more severe depression and greater alcohol involvement, perhaps due to circadian misalignment imposed by early school schedules. School schedules shifted later during the COVID-19 pandemic, ostensibly reducing circadian misalignment and potentially mitigating problems with depression and alcohol. We used the pandemic as a natural experiment to test whether adolescent drinkers with later circadian timing showed improvements in sleep, depression and alcohol involvement. Participants were 42 adolescents reporting alcohol use. We assessed circadian phase via dim light melatonin onset prior to the pandemic, then conducted remote assessments of sleep, depressive symptoms and alcohol use during the pandemic. Mixed-effects models were used to test for pandemic effects, covarying for age, sex, time since baseline evaluation, and current school/work status. Adolescents with later circadian timing reported less sleep than other teens on school nights, both before and during the pandemic. Although school night sleep increased during the pandemic (F = 28.36, p < 0.001), those increases were not greater for individuals with later circadian timing. Individuals with later circadian timing reported larger increases in alcohol use than other teens during the pandemic (X2 = 36.03, p < 0.001). Depressive symptoms increased during the pandemic (X2 = 46.51, p < 0.001) but did not differ based on circadian timing. Consistent with prior reports, adolescents with later circadian timing obtained less sleep, and later school schedules facilitated increased sleep duration. Nonetheless, individuals with later circadian timing reported the sharpest increases in alcohol use, suggesting that circadian timing contributes to risk for alcohol use beyond the effects of insufficient sleep.
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Affiliation(s)
- Brant P. Hasler
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | | | - Jessica L. Graves
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Rachel Witt
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Kathryn Guo
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Daniel J. Buysse
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Greg J. Siegle
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Duncan B. Clark
- University of Pittsburgh School of Medicine, Department of
Psychiatry
- School of Pharmacy, Department of Pharmaceutical Sciences,
Pittsburgh, PA, USA
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7
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Lima Santos JP, Hayes R, Franzen PL, Goldstein TR, Hasler BP, Buysse DJ, Siegle GJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Jalbrzikowski M, Soehner AM. The association between cortical gyrification and sleep in adolescents and young adults. Sleep 2024; 47:zsad282. [PMID: 37935899 PMCID: PMC10782503 DOI: 10.1093/sleep/zsad282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
STUDY OBJECTIVES Healthy sleep is important for adolescent neurodevelopment, and relationships between brain structure and sleep can vary in strength over this maturational window. Although cortical gyrification is increasingly considered a useful index for understanding cognitive and emotional outcomes in adolescence, and sleep is also a strong predictor of such outcomes, we know relatively little about associations between cortical gyrification and sleep. We aimed to identify developmentally invariant (stable across age) or developmentally specific (observed only during discrete age intervals) gyrification-sleep relationships in young people. METHODS A total of 252 Neuroimaging and Pediatric Sleep Databank participants (9-26 years; 58.3% female) completed wrist actigraphy and a structural MRI scan. Local gyrification index (lGI) was estimated for 34 bilateral brain regions. Naturalistic sleep characteristics (duration, timing, continuity, and regularity) were estimated from wrist actigraphy. Regularized regression for feature selection was used to examine gyrification-sleep relationships. RESULTS For most brain regions, greater lGI was associated with longer sleep duration, earlier sleep timing, lower variability in sleep regularity, and shorter time awake after sleep onset. lGI in frontoparietal network regions showed associations with sleep patterns that were stable across age. However, in default mode network regions, lGI was only associated with sleep patterns from late childhood through early-to-mid adolescence, a period of vulnerability for mental health disorders. CONCLUSIONS We detected both developmentally invariant and developmentally specific ties between local gyrification and naturalistic sleep patterns. Default mode network regions may be particularly susceptible to interventions promoting more optimal sleep during childhood and adolescence.
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Affiliation(s)
| | - Rebecca Hayes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ronald E Dahl
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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8
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Benedetti D, Frati E, Kiss O, Yuksel D, Faraguna U, Hasler BP, Franzen PL, Clark DB, Baker FC, de Zambotti M. Performance evaluation of the open-source Yet Another Spindle Algorithm sleep staging algorithm against gold standard manual evaluation of polysomnographic records in adolescence. Sleep Health 2023; 9:910-924. [PMID: 37709595 DOI: 10.1016/j.sleh.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 09/16/2023]
Abstract
GOAL AND AIMS To evaluate an automatic sleep scoring algorithm against manual polysomnography sleep scoring. FOCUS METHOD/TECHNOLOGY Yet Another Spindle Algorithm automatic sleep staging algorithm. REFERENCE METHOD/TECHNOLOGY Manual sleep scoring. SAMPLE 327 nights (151 healthy adolescents), from the NCANDA study. DESIGN Participants underwent one-to-three overnight polysomnography recordings, one consisting of an event-related-potential paradigm. CORE ANALYTICS Epoch by Epoch and discrepancy analyses (Bland Altman plots) were conducted on the overall sample. ADDITIONAL ANALYTICS AND EXPLORATORY ANALYSES Epoch by Epoch and discrepancy analysis were repeated separately on standard polysomnography nights and event-related potential nights. Regression models were estimated on age, sex, scorer, and site of recording, separately on standard polysomnography nights and event-related potential nights. CORE OUTCOMES The Yet Another Spindle Algorithm sleep scoring algorithm's average sensitivity of 93.04% for Wake, 87.67% for N2, 84.46% for N3, 86.02% for rapid-eye-movement, and 40.39% for N1. Specificity was 96.75% for Wake, 97.31% for N1, 88.87% for N2, 97.99% for N3, and 97.70% for rapid-eye-movement. The Matthews Correlation Coefficient was highest in rapid-eye-movement sleep (0.85) while lowest in N1 (0.39). Cohen's Kappa mirrored Matthews Correlation Coefficient results. In Bland-Altman plots, the bias between Yet Another Spindle Algorithm and human scoring showed proportionality to the manual scoring measurement size. IMPORTANT ADDITIONAL OUTCOMES Yet Another Spindle Algorithm performance was reduced in event-related-potential/polysomnography nights for N3 and rapid-eye-movement. According to the Matthews Correlation Coefficient, the Yet Another Spindle Algorithm performance was affected by younger age, male sex, recording sites, and scorers. CORE CONCLUSION Results support the use of Yet Another Spindle Algorithm to score adolescents' polysomnography sleep records, possibly with classification outcomes supervised by an expert scorer.
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Affiliation(s)
- Davide Benedetti
- Center for Health Sciences, SRI International, Menlo Park, California, USA; Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.
| | - Emma Frati
- Center for Health Sciences, SRI International, Menlo Park, California, USA; Columbia College, Columbia University, NYC, New York, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, California, USA
| | - Dilara Yuksel
- Center for Health Sciences, SRI International, Menlo Park, California, USA
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy; Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California, USA
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9
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Albinni B, Baker FC, Javitz H, Hasler BP, Franzen PL, Clark DB, de Zambotti M. Morning perception of sleep, stress, and mood, and its relationship with overnight physiological sleep: findings from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. J Sleep Res 2023; 32:e13886. [PMID: 36941027 PMCID: PMC10509318 DOI: 10.1111/jsr.13886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Abstract
This cross-sectional study investigated objective-subjective sleep discrepancies and the physiological basis for morning perceptions of sleep, mood, and readiness, in adolescents. Data collected during a single in-laboratory polysomnographic assessment from 137 healthy adolescents (61 girls; age range: 12-21 years) in the United States National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study were analysed. Upon awakening, participants completed questionnaires assessing sleep quality, mood, and readiness. We evaluated the relationship between overnight polysomnographic, electroencephalographic, sleep autonomic nervous system functioning measures, and next morning self-reported indices. Results showed that older adolescents reported more awakenings, yet they perceived their sleep to be deeper and less restless than younger adolescents. Prediction models including sleep physiology measures (polysomnographic, electroencephalographic, and sleep autonomic nervous system) explained between 3% and 29% of morning sleep perception, mood, and readiness indices. The subjective experience of sleep is a complex phenomenon with multiple components. Distinct physiological sleep processes contribute to the morning perception of sleep and related measures of mood and readiness. More than 70% of the variance (based on a single observation per person) in the perception of sleep, mood, and morning readiness is not explained by overnight sleep-related physiological measures, suggesting that other factors are important for the subjective sleep experience.
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Affiliation(s)
- Benedetta Albinni
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- Department of Psychology, University of Campania “Luigi Vanvitelli”
| | - 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
| | - Harold Javitz
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Brant P. Hasler
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Peter L. Franzen
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Duncan B. Clark
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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10
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Santos JPL, Hayes R, Franzen PL, Goldstein TR, Hasler BP, Buysse DJ, Siegle GJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Jalbrzikowski M, Soehner AM. The association between cortical gyrification and sleep in adolescents and young adults. bioRxiv 2023:2023.09.15.557966. [PMID: 37745609 PMCID: PMC10516006 DOI: 10.1101/2023.09.15.557966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Study objectives Healthy sleep is important for adolescent neurodevelopment, and relationships between brain structure and sleep can vary in strength over this maturational window. Although cortical gyrification is increasingly considered a useful index for understanding cognitive and emotional outcomes in adolescence, and sleep is also a strong predictor of such outcomes, we know relatively little about associations between cortical gyrification and sleep. Methods Using Local gyrification index (lGI) of 34 bilateral brain regions and regularized regression for feature selection, we examined gyrification-sleep relationships in the Neuroimaging and Pediatric Sleep databank (252 participants; 9-26 years; 58.3% female) and identified developmentally invariant (stable across age) or developmentally specific (observed only during discrete age intervals) brain-sleep associations. Naturalistic sleep characteristics (duration, timing, continuity, and regularity) were estimated from wrist actigraphy. Results For most brain regions, greater lGI was associated with longer sleep duration, earlier sleep timing, lower variability in sleep regularity, and shorter time awake after sleep onset. lGI in frontoparietal network regions showed associations with sleep patterns that were stable across age. However, in default mode network regions, lGI was only associated with sleep patterns from late childhood through early-to-mid adolescence, a period of vulnerability for mental health disorders. Conclusions We detected both developmentally invariant and developmentally specific ties between local gyrification and naturalistic sleep patterns. Default mode network regions may be particularly susceptible to interventions promoting more optimal sleep during childhood and adolescence.
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Affiliation(s)
| | - Rebecca Hayes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ronald E Dahl
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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11
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Kiss O, Goldstone A, de Zambotti M, Yüksel D, Hasler BP, Franzen PL, Brown SA, De Bellis MD, Nagel BJ, Nooner KB, Tapert SF, Colrain IM, Clark DB, Baker FC. Effects of emerging alcohol use on developmental trajectories of functional sleep measures in adolescents. Sleep 2023; 46:zsad113. [PMID: 37058610 PMCID: PMC10848227 DOI: 10.1093/sleep/zsad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/17/2023] [Indexed: 04/16/2023] Open
Abstract
STUDY OBJECTIVES Adolescence is characterized by significant brain development, accompanied by changes in sleep timing and architecture. It also is a period of profound psychosocial changes, including the initiation of alcohol use; however, it is unknown how alcohol use affects sleep architecture in the context of adolescent development. We tracked developmental changes in polysomnographic (PSG) and electroencephalographic (EEG) sleep measures and their relationship with emergent alcohol use in adolescents considering confounding effects (e.g. cannabis use). METHODS Adolescents (n = 94, 43% female, age: 12-21 years) in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study had annual laboratory PSG recordings across 4-years. Participants were no/low drinkers at baseline. RESULTS Linear mixed effect models showed developmental changes in sleep macrostructure and EEG, including a decrease in slow wave sleep and slow wave (delta) EEG activity with advancing age. Emergent moderate/heavy alcohol use across three follow-up years was associated with a decline in percentage rapid eye movement (REM) sleep over time, a longer sleep onset latency (SOL) and shorter total sleep time (TST) in older adolescents, and lower non-REM delta and theta power in males. CONCLUSIONS These longitudinal data show substantial developmental changes in sleep architecture. Emergent alcohol use during this period was associated with altered sleep continuity, architecture, and EEG measures, with some effects dependent on age and sex. These effects, in part, could be attributed to the effects of alcohol on underlying brain maturation processes involved in sleep-wake regulation.
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Affiliation(s)
- Orsolya Kiss
- Center for Health Sciences, Bioscience Division, SRI International, Menlo Park, CA, USA
| | - Aimée Goldstone
- Center for Health Sciences, Bioscience Division, SRI International, Menlo Park, CA, USA
| | | | - Dilara Yüksel
- Center for Health Sciences, Bioscience Division, SRI International, Menlo Park, CA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sandra A Brown
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Michael D De Bellis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Bonnie J Nagel
- School of Medicine, Division of Clinical Psychology, Oregon Health and Sciences University, Portland, OR, USA
| | - Kate B Nooner
- Psychology Department, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Ian M Colrain
- Center for Health Sciences, Bioscience Division, SRI International, Menlo Park, CA, USA
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Fiona C Baker
- Center for Health Sciences, Bioscience Division, SRI International, Menlo Park, CA, USA
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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12
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Smagula SF, Hasler BP, Schulz R, Graves JL, Reynolds CF, Aizenstein HJ, Buysse DJ, Krafty RT, Hall MH. Activity patterns related to depression symptoms in stressed dementia caregivers. Int Psychogeriatr 2023; 35:373-380. [PMID: 31658928 PMCID: PMC7188574 DOI: 10.1017/s1041610219001601] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Self-reported activity restriction is an established correlate of depression in dementia caregivers (dCGs). It is plausible that the daily distribution of objectively measured activity is also altered in dCGs with depression symptoms; if so, such activity characteristics could provide a passively measurable marker of depression or specific times to target preventive interventions. We therefore investigated how levels of activity throughout the day differed in dCGs with and without depression symptoms, then tested whether any such differences predicted changes in symptoms 6 months later. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS We examined 56 dCGs (mean age = 71, standard deviation (SD) = 6.7; 68% female) and used clustering to identify subgroups which had distinct depression symptom levels, leveraging baseline Center for Epidemiologic Studies of Depression Scale-Revised Edition and Patient Health Questionnaire-9 (PHQ-9) measures, as well as a PHQ-9 score from 6 months later. Using wrist activity (mean recording length = 12.9 days, minimum = 6 days), we calculated average hourly activity levels and then assessed when activity levels relate to depression symptoms and changes in symptoms 6 months later. RESULTS Clustering identified subgroups characterized by: (1) no/minimal symptoms (36%) and (2) depression symptoms (64%). After multiple comparison correction, the group of dCGs with depression symptoms was less active from 8 to 10 AM (Cohen's d ≤ -0.9). These morning activity levels predicted the degree of symptom change on the PHQ-9 6 months later (per SD unit β = -0.8, 95% confidence interval: -1.6, -0.1, p = 0.03) independent of self-reported activity restriction and other key factors. CONCLUSIONS These novel findings suggest that morning activity may protect dCGs from depression symptoms. Future studies should test whether helping dCGs get active in the morning influences the other features of depression in this population (i.e. insomnia, intrusive thoughts, and perceived activity restriction).
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Affiliation(s)
- Stephen F Smagula
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Richard Schulz
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jessica L Graves
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Charles F Reynolds
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Howard J Aizenstein
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert T Krafty
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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13
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Hasler BP. Chronotype and mental health: timing seems to matter, but how, why, and for whom? World Psychiatry 2023; 22:329-330. [PMID: 37159371 PMCID: PMC10168154 DOI: 10.1002/wps.21092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 05/11/2023] Open
Affiliation(s)
- Brant P Hasler
- Center for Sleep and Circadian Science, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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14
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Hisler GC, Dickinson DL, Bruce SA, Hasler BP. Preliminary evidence that misalignment between sleep and circadian timing alters risk-taking preferences. J Sleep Res 2023; 32:e13728. [PMID: 36122900 PMCID: PMC10023298 DOI: 10.1111/jsr.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/19/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022]
Abstract
Decision-making has been shown to suffer when circadian preference is misaligned with time of assessment; however, little is known about how misalignment between sleep timing and the central circadian clock impacts decision-making. This study captured naturally occurring variation in circadian alignment (i.e., alignment of sleep-wake timing with the central circadian clock) to examine if greater misalignment predicts worse decision-making. Over the course of 2 weeks, 32 late adolescent drinkers (aged 18-22 years; 61% female; 69% White) continuously wore actigraphs and completed two overnight in-laboratory visits (Thursday and Sunday) in which both dim-light melatonin onset (DLMO) and behavioural decision-making (risk taking, framing, and strategic reasoning tasks) were assessed. Sleep-wake timing was assessed by actigraphic midsleep from the 2 nights prior to each in-laboratory visit. Alignment was operationalised as the phase angle (interval) between average DLMO and average midsleep. Multilevel modelling was used to predict performance on decision-making tasks from circadian alignment during each in-laboratory visit; non-linear associations were also examined. Shorter DLMO-midsleep phase angle predicted greater risk-taking under conditions of potential loss (B = -0.11, p = 0.06), but less risk-taking under conditions of potential reward (B = 0.14, p = 0.03) in a curvilinear fashion. Misalignment did not predict outcomes in the framing and strategic reasoning tasks. Findings suggest that shorter alignment in timing of sleep with the central circadian clock (e.g., phase-delayed misalignment) may impact risky decision-making, further extending accumulating evidence that sleep/circadian factors are tied to risk-taking. Future studies will need to replicate findings and experimentally probe whether manipulating alignment influences decision-making.
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Affiliation(s)
| | - David L. Dickinson
- Appalachian State University, Department of Economics and CERPA; ESI; IZA
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15
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Wescott DL, Franzen PL, Hasler BP, Miller MA, Soehner AM, Smagula SF, Wallace ML, Hall MH, Roecklein KA. Elusive hypersomnolence in seasonal affective disorder: actigraphic and self-reported sleep in and out of depressive episodes. Psychol Med 2023; 53:1313-1322. [PMID: 37010222 PMCID: PMC10071357 DOI: 10.1017/s003329172100283x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Hypersomnolence has been considered a prominent feature of seasonal affective disorder (SAD) despite mixed research findings. In the largest multi-season study conducted to date, we aimed to clarify the nature and extent of hypersomnolence in SAD using multiple measurements during winter depressive episodes and summer remission. METHODS Sleep measurements assessed in individuals with SAD and nonseasonal, never-depressed controls included actigraphy, daily sleep diaries, retrospective self-report questionnaires, and self-reported hypersomnia assessed via clinical interviews. To characterize hypersomnolence in SAD we (1) compared sleep between diagnostic groups and seasons, (2) examined correlates of self-reported hypersomnia in SAD, and (3) assessed agreement between commonly used measurement modalities. RESULTS In winter compared to summer, individuals with SAD (n = 64) reported sleeping 72 min longer based on clinical interviews (p < 0.001) and 23 min longer based on actigraphy (p = 0.011). Controls (n = 80) did not differ across seasons. There were no seasonal or group differences on total sleep time when assessed by sleep diaries or retrospective self-reports (p's > 0.05). Endorsement of winter hypersomnia in SAD participants was predicted by greater fatigue, total sleep time, time in bed, naps, and later sleep midpoints (p's < 0.05). CONCLUSION Despite a winter increase in total sleep time and year-round elevated daytime sleepiness, the average total sleep time (7 h) suggest hypersomnolence is a poor characterization of SAD. Importantly, self-reported hypersomnia captures multiple sleep disruptions, not solely lengthened sleep duration. We recommend using a multimodal assessment of hypersomnolence in mood disorders prior to sleep intervention.
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Affiliation(s)
| | - Peter L. Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Megan A. Miller
- Rehabilitation Care Services, VA Puget Sound Healthcare System, Seattle, WA
| | - Adriane M. Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Stephen F. Smagula
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Statistics, University of Pittsburgh, Pittsburgh PA
| | - Martica H. Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Kathryn A. Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Center for the Neural Basis of Behavior, University of Pittsburgh, Pittsburgh, PA
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16
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Soehner AM, Hayes RA, Franzen PL, Goldstein TR, Hasler BP, Buysse DJ, Siegle GJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Jalbrzikowski M. Naturalistic Sleep Patterns are Linked to Global Structural Brain Aging in Adolescence. J Adolesc Health 2023; 72:96-104. [PMID: 36270890 PMCID: PMC9881228 DOI: 10.1016/j.jadohealth.2022.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE We examined whether interindividual differences in naturalistic sleep patterns correlate with any deviations from typical brain aging. METHODS Our sample consisted of 251 participants without current psychiatric diagnoses (9-25 years; mean [standard deviation] = 17.4 ± 4.52 yr; 58% female) drawn from the Neuroimaging and Pediatric Sleep Databank. Participants completed a T1-weighted structural magnetic resonance imaging scan and 5-7 days of wrist actigraphy to assess naturalistic sleep patterns (duration, timing, continuity, and regularity). We estimated brain age from extracted structural magnetic resonance imaging indices and calculated brain age gap (estimated brain age-chronological age). Robust regressions tested cross-sectional associations between brain age gap and sleep patterns. Exploratory models investigated moderating effects of age and biological gender and, in a subset of the sample, links between sleep, brain age gap, and depression severity (Patient-Reported Outcomes Measurement Information System Depression). RESULTS Later sleep timing (midsleep) was associated with more advanced brain aging (larger brain age gap), β = 0.1575, puncorr = .0042, pfdr = .0167. Exploratory models suggested that this effect may be driven by males, although the interaction of gender and brain age gap did not survive multiple comparison correction (β = 0.2459, puncorr = .0336, pfdr = .1061). Sleep duration, continuity, and regularity were not significantly associated with brain age gap. Age did not moderate any brain age gap-sleep relationships. In this psychiatrically healthy sample, depression severity was also not associated with brain age gap or sleep. DISCUSSION Later midsleep may be one behavioral cause or correlate of more advanced brain aging, particularly among males. Future studies should examine whether advanced brain aging and individual differences in sleep precede the onset of suboptimal cognitive-emotional outcomes in adolescents.
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Affiliation(s)
- Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rebecca A Hayes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ronald E Dahl
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, Florida
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
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17
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Wescott DL, Wallace ML, Hasler BP, Klevens AM, Franzen PL, Hall MH, Roecklein KA. Sleep and circadian rhythm profiles in seasonal depression. J Psychiatr Res 2022; 156:114-121. [PMID: 36244199 DOI: 10.1016/j.jpsychires.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/09/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022]
Abstract
Sleep and circadian rhythm disruptions are symptoms of, and hypothesized underlying mechanisms in, seasonal depression. Discrepant observational findings and mixed responses to sleep/circadian-based treatments suggest heterogenous sleep and circadian disruptions in seasonal depression, despite these disruptions historically conceptualized as delayed circadian phase and hypersomnia. This study used a data-driven cluster analysis to characterize sleep/circadian profiles in seasonal depression to identify treatment targets for future interventions. Biobehavioral measures of sleep and circadian rhythms were assessed during the winter in individuals with Seasonal Affective Disorder (SAD), subsyndromal-SAD (S-SAD), or nonseasonal, never depressed controls (total sample N = 103). The following variables were used in the cluster analysis: circadian phase (from dim light melatonin onset), midsleep timing, total sleep time, sleep efficiency, regularity of midsleep timing, and nap duration (all from wrist actigraphy). Sleep and circadian variables were compared across clusters and controls. Despite limited sleep/circadian differences between diagnostic groups, there were two reliable (Jaccard Coefficients >0.75) sleep/circadian profiles in SAD/S-SAD individuals: a 'Disrupted sleep' cluster, characterized by irregular and fragmented sleep and an 'Advanced' cluster, characterized by early sleep and circadian timing and longer total sleep times (>7.5 h). Clusters did not differ by depression severity. Midsleep correlated with DLMO (r = 0.56), irregularity (r = 0.3), and total sleep time (r = -0.27). Sleep and circadian disruptions in seasonal depression are not uniformly characterized by hypersomnia and circadian phase delay. Presence of distinct sleep and circadian subgroups in seasonal depression may predict successful treatment response. Prospective assessment and tailoring of individual sleep and circadian disruptions may reduce treatment failures.
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Affiliation(s)
- Delainey L Wescott
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alison M Klevens
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA; Center for the Neural Basis of Behavior, University of Pittsburgh, Pittsburgh, PA, USA
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18
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Tracy EL, Zhang J, Wilckens K, Krafty RT, Hasler BP, Hall MH, Buysse DJ. Homeostatic response to sleep deprivation and circadian rhythmicity are intact in older adults with insomnia. Sleep 2022; 45:zsac162. [PMID: 35878753 PMCID: PMC9453614 DOI: 10.1093/sleep/zsac162] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/20/2022] [Indexed: 07/27/2023] Open
Abstract
STUDY OBJECTIVES We examined whether homeostatic sleep drive and circadian rhythmicity differ in older adults with insomnia (OAI) compared to older good sleepers (GS). METHODS OAI (n = 37) and GS (n = 30) participated in a 60-h in-lab study with sleep deprivation and constant routine paradigms. Homeostatic sleep drive was assessed by examining the effect of sleep deprivation on delta EEG power and theta EEG power, and repeated sleep latency tests. Circadian rhythm was assessed with salivary melatonin (phase and amplitude), core body temperature (phase, amplitude, and mesor), and sleep latency during a constant routine paradigm. Mixed models were used to assess interactions of group (OAS vs GS) with homeostatic sleep and circadian effects. RESULTS Compared to GS, OAI showed a greater linear increase in waking theta power during sleep deprivation, but the two groups did not show differential responses to sleep deprivation in delta EEG, or in repeated sleep latency tests. The two groups did not differ in circadian phase or amplitude of melatonin or core body temperature rhythms. OAI had a significantly elevated core body temperature mesor compared to GS. CONCLUSIONS Homeostatic response to sleep deprivation was intact in OAI compared to GS; theta EEG power suggested a greater homeostatic response in OAI. Circadian rhythm amplitude and phase were similar in OAI compared to GS. Elevated body temperature mesor in OAI may indicate elevated physiological arousal. These findings suggest that effective treatments for insomnia in older adults may leverage intact sleep and circadian regulatory mechanisms, rather than repair defective sleep and circadian regulation.
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Affiliation(s)
| | | | - Kristine Wilckens
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert T Krafty
- Department of Biostatics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Daniel J Buysse
- Corresponding author. Daniel J. Buysse, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara St. Pittsburgh, PA, 15213, USA.
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19
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Boness CL, Hasler BP, Sheehan H, Pedersen SL. Associations between specific sleep and circadian characteristics and alcohol use disorder criteria and problems. Addict Behav 2022; 132:107348. [PMID: 35598530 PMCID: PMC10039735 DOI: 10.1016/j.addbeh.2022.107348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/05/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022]
Abstract
Given the significant heterogeneity of alcohol use disorder (AUD) and the increasing priority to understand individual profiles of AUD, pursuing symptom-level examinations of AUD is important. Disturbances in sleep and circadian rhythms have demonstrated robust associations with alcohol consumption and AUD, yet little research has examined these associations at the symptom- or problem-levels and research to date has focused on one or two sleep/circadian characteristics. We sought to investigate the associations between (a) specific AUD symptoms and (b) domains of alcohol-related problems, and multiple sleep characteristics, collected at a daily level in the naturalistic environment. Young adult drinkers were recruited from the community (N = 159, Mage = 23.9, 58.5% female, 6.3% Asian, 35.9% Black or African American, 51.6% White, 5.0% multiracial) and completed a baseline visit as well as up to 18 days of naturalistic assessment. Several sleep/circadian characteristics, including eveningness, later midsleep timing, and shorter total sleep time, were consistently associated with the hazardous use symptom, above and beyond alcohol consumption. Eveningness (beta[SE] = 0.21[0.00], p <.01) was a significant predictor of the alcohol-related problem domain of role interference. Exploratory analyses did not find significant associations between sleep/circadian characteristics and cannabis-related problems. The relationship between sleep/circadian characteristics and AUD and related problems may be driven by a narrower set of symptoms, such as hazardous use and role interference. This may be due to shared mechanistic dysfunction in domains such as reward processing or cognitive control. Thus, these alcohol-related symptoms and problems may be addressed through transdiagnostic treatment approaches that target these underlying mechanisms.
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Affiliation(s)
- Cassandra L Boness
- University of Pittsburgh, Department of Psychiatry, USA; University of New Mexico, Center on Alcohol, Substance use, And Addictions, USA
| | | | - Haley Sheehan
- University of Pittsburgh, Department of Psychiatry, USA
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20
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Burgess HJ, Rizvydeen M, Kikyo F, Kebbeh N, Tan M, Roecklein KA, Hasler BP, King AC, Cao D. Sleep and circadian differences between light and heavy adult alcohol drinkers. Alcohol Clin Exp Res 2022; 46:1181-1191. [PMID: 35908247 PMCID: PMC9357170 DOI: 10.1111/acer.14872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 12/01/2022]
Abstract
Background Numerous studies have reported that eveningness is associated with increased alcohol consumption. However, biological markers of circadian timing, such as dim light melatonin onset (DLMO) and circadian photoreceptor responsivity (post‐illumination pupil response, PIPR), have rarely been assessed in the context of habitual alcohol consumption. This study aimed to examine sleep, circadian timing, and photoreceptor responsivity in adult alcohol drinkers. Methods Participants (21 to 45 years) included 28 light and 50 heavy drinkers. The 8‐day study consisted of a week of adlib sleep monitored with wrist actigraphy, followed by a 9‐h laboratory session with a photoreceptor responsivity and circadian phase assessment. Results The heavy drinkers obtained on average 28 more minutes of sleep (p = 0.002) and reported more eveningness than the light drinkers (p = 0.029). There was a trend for a shorter DLMO‐midsleep interval (p = 0.059) in the heavy drinkers, reflecting a tendency for them to sleep at an earlier circadian phase. The PIPR in the heavy drinkers was significantly smaller than in the light drinkers (p = 0.032), suggesting reduced circadian photoreceptor responsivity in the heavy drinkers. A larger PIPR was significantly associated with a later DLMO in the light drinkers (r = 0.44, p = 0.019), but this relationship was absent in the heavy drinkers (r = −0.01, p = 0.94). Conclusions These results are consistent with earlier reports of more eveningness and a shorter DLMO‐midsleep interval being associated with heavier alcohol drinking. The novel finding of reduced circadian photoreceptor responsivity in heavy drinkers is consistent with prior rodent studies. Future studies should explore the impact of habitual alcohol consumption on other measures of circadian photoreceptor responsivity.
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Affiliation(s)
- Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Muneer Rizvydeen
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Fumitaka Kikyo
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Nema Kebbeh
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael Tan
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea C King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Dingcai Cao
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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21
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Hisler GC, Pedersen SL, Hasler BP. The 24-hour rhythm in alcohol craving and individual differences in sleep characteristics and alcohol use frequency. Alcohol Res 2022; 46:1084-1093. [PMID: 35383960 DOI: 10.1111/acer.14826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/15/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Evidence implicates sleep/circadian factors in alcohol use, suggesting the existence of a 24-h rhythm in alcohol craving, which may vary by individual differences in sleep factors and alcohol use frequency. This study sought to (1) replicate prior findings of a 24-h rhythm in alcohol craving, and (2) examine whether individual differences in sleep timing, sleep duration, or alcohol use frequency are related to differences in the timing of the peak of the craving rhythm (i.e., the acrophase) or magnitude of fluctuation of the rhythm (i.e., amplitude). Finally, whether such associations varied by sex or racial identity was explored. METHODS Two-hundred fifteen adult drinkers (21 to 35 years of age, 72% male, 66% self-identified as White) completed a baseline assessment of alcohol use frequency and then smartphone reports of alcohol craving intensity six times a day across 10 days. Sleep timing was also recorded each morning of the 10-day period. Multilevel cosinor analysis was used to test the presence of a 24-h rhythm and to estimate acrophase and amplitude. RESULTS Multilevel cosinor analysis revealed a 24-h rhythm in alcohol craving. Individual differences in sleep timing or sleep duration did not predict rhythm acrophase or amplitude. However, alcohol use frequency moderated this rhythm wherein individuals who used alcohol more frequently in the 30 days prior to beginning the study had higher mean levels of craving and greater rhythm amplitudes (i.e., greater rhythmic fluctuations). Associations did not vary by sex or racial identity. CONCLUSIONS Results show that alcohol craving exhibits a systematic rhythm over the course of the 24 h and that the frequency of alcohol use may be relevant to the shape of this rhythm. Consideration of daily rhythms in alcohol craving may further our understanding of the mechanisms that drive alcohol use.
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Affiliation(s)
- Garrett C Hisler
- University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Sarah L Pedersen
- University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brant P Hasler
- University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
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22
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Hasler BP, Graves JL, Wallace ML, Claudatos S, Franzen PL, Nooner KB, Brown SA, Tapert SF, Baker FC, Clark DB. Self-reported sleep and circadian characteristics predict alcohol and cannabis use: A longitudinal analysis of the National Consortium on Alcohol and Neurodevelopment in Adolescence Study. Alcohol Clin Exp Res 2022; 46:848-860. [PMID: 35579668 DOI: 10.1111/acer.14808] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/15/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Growing evidence indicates that sleep characteristics predict future substance use and related problems. However, most prior studies assessed a limited range of sleep characteristics, studied a narrow age span, and included few follow-up assessments. Here, we used six annual assessments from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study, which spans adolescence and young adulthood with an accelerated longitudinal design, to examine whether multiple sleep characteristics in any year predict alcohol and cannabis use the following year. METHODS The sample included 831 NCANDA participants (423 females; baseline age 12-21 years). Sleep variables included circadian preference, sleep quality, daytime sleepiness, the timing of midsleep (weekday/weekend), and sleep duration (weekday/weekend). Using generalized linear mixed models (logistic for cannabis; ordinal for binge severity), we tested whether each repeatedly measured sleep characteristic (years 0-4) predicted substance use (alcohol binge severity or cannabis use) the following year (years 1-5), covarying for age, sex, race, visit, parental education, and previous year's substance use. RESULTS Greater eveningness, more daytime sleepiness, later weekend sleep timing, and shorter sleep duration (weekday/weekend) all predicted more severe alcohol binge drinking the following year. Only greater eveningness predicted a greater likelihood of any cannabis use the following year. Post-hoc stratified exploratory analyses indicated that some associations (e.g., greater eveningness and shorter weekend sleep duration) predicted binge severity only in female participants, and that middle/high school versus post-high school adolescents were more vulnerable to sleep-related risk for cannabis use. CONCLUSIONS Our findings support the relevance of multiple sleep/circadian characteristics in the risk for future alcohol binge severity and cannabis use. Preliminary findings suggest that these risk factors vary based on developmental stage and sex. Results underscore a need for greater attention to sleep/circadian characteristics as potential risk factors for substance use in youth and may inform new avenues to prevention and intervention.
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Affiliation(s)
- Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jessica L Graves
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kate B Nooner
- University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Sandra A Brown
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California, USA
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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23
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Wallace ML, Kissel N, Hall MH, Germain A, Matthews KA, Troxel WM, Franzen PL, Buysse DJ, Reynolds C, Monk T, Roecklein KA, Gunn HE, Hasler BP, Goldstein TR, McMakin DL, Szigethy E, Soehner AM. Age Trends in Actigraphy and Self-Report Sleep Across the Life Span: Findings From the Pittsburgh Lifespan Sleep Databank. Psychosom Med 2022; 84:410-420. [PMID: 35100181 PMCID: PMC9064898 DOI: 10.1097/psy.0000000000001060] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Sleep changes over the human life span, and it does so across multiple dimensions. We used individual-level cross-sectional data to characterize age trends and sex differences in actigraphy and self-report sleep dimensions across the healthy human life span. METHODS The Pittsburgh Lifespan Sleep Databank consists of harmonized participant-level data from sleep-related studies conducted at the University of Pittsburgh (2003-2019). We included data from 1065 (n = 577 female; 21 studies) Pittsburgh Lifespan Sleep Databank participants aged 10 to 87 years without a major psychiatric, sleep, or medical condition. All participants completed wrist actigraphy and the self-rated Pittsburgh Sleep Quality Index. Main outcomes included actigraphy and self-report sleep duration, efficiency, and onset/offset timing, and actigraphy variability in midsleep timing. RESULTS We used generalized additive models to examine potentially nonlinear relationships between age and sleep characteristics and to examine sex differences. Actigraphy and self-report sleep onset time shifted later between ages 10 and 18 years (23:03-24:10 [actigraphy]; 21:58-23:53 [self-report]) and then earlier during the 20s (00:08-23:40 [actigraphy]; 23:50-23:34 [self-report]). Actigraphy and self-report wake-up time also shifted earlier during the mid-20s through late 30s (07:48-06:52 [actigraphy]; 07:40-06:41 [self-report]). Self-report, but not actigraphy, sleep duration declined between ages 10 and 20 years (09:09-07:35). Self-report sleep efficiency decreased over the entire life span (96.12-93.28), as did actigraphy variability (01:54-01:31). CONCLUSIONS Awareness of age trends in multiple sleep dimensions in healthy individuals-and explicating the timing and nature of sex differences in age-related change-can suggest periods of sleep-related risk or resilience and guide intervention efforts.
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Affiliation(s)
- Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Departments of Statistics and Biostatistics, University of Pittsburgh
| | | | - Martica H. Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Departments of Psychology, University of Pittsburgh
| | - Anne Germain
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Karen A. Matthews
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Departments of Psychology, University of Pittsburgh
| | | | - Peter L. Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Department Clinical & Translational Science, University of Pittsburgh
| | - Charles Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Timothy Monk
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | | | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Departments of Psychology, University of Pittsburgh
- Department Clinical & Translational Science, University of Pittsburgh
| | - Tina R. Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | - Eva Szigethy
- Department of Medicine, University of Pittsburgh
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24
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Hasler BP, Graves JL, Soehner AM, Wallace ML, Clark DB. Preliminary Evidence That Circadian Alignment Predicts Neural Response to Monetary Reward in Late Adolescent Drinkers. Front Neurosci 2022; 16:803349. [PMID: 35250449 PMCID: PMC8888521 DOI: 10.3389/fnins.2022.803349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundRobust evidence links sleep and circadian rhythm disturbances to alcohol use and alcohol-related problems, with a growing literature implicating reward-related mechanisms. However, the extant literature has been limited by cross-sectional designs, self-report or behavioral proxies for circadian timing, and samples without substantive alcohol use. Here, we employed objective measures of sleep and circadian rhythms, and an intensive prospective design, to assess whether circadian alignment predicts the neural response to reward in a sample of late adolescents reporting regular alcohol use.MethodsParticipants included 31 late adolescents (18–22 y/o; 19 female participants) reporting weekly alcohol use. Participants completed a 14-day protocol including pre- and post-weekend (Thursday and Sunday) circadian phase assessments via the dim light melatonin onset (DLMO), in counterbalanced order. Sleep-wake timing was assessed via actigraphy. Circadian alignment was operationalized as the DLMO-midsleep interval; secondary analyses considered social jet lag based on weekday-weekend differences in midsleep or DLMO. Neural response to reward (anticipation and outcome) was assessed via a monetary reward fMRI task (Friday and Monday scans). Alcohol use was assessed at baseline and via ecological momentary assessment. Mean BOLD signal was extracted from two regions-of-interest (striatum and medial prefrontal cortex, mPFC) for analyses in regression models, accounting for age, sex, racial identity, and scan order.ResultsIn primary analyses, shorter DLMO-midsleep intervals (i.e., greater misalignment) on Thursday predicted lower striatal and mPFC responses to anticipated reward, but not reward outcome, on Friday. Lower neural (striatum and mPFC) responses to anticipated reward on Friday correlated with more binge-drinking episodes at baseline, but were not associated with alcohol use in the post-scan weekend. In secondary analyses, greater social jet lag (particularly larger weekend delays in midsleep or DLMO) was associated with lower neural responses to reward anticipation on Monday.ConclusionFindings provide preliminary evidence of proximal associations between objectively determined circadian alignment and the neural response to anticipated monetary reward, which is linked in turn to patterns of problematic drinking. Replication in a larger sample and experimental designs will be important next steps to determining the extent to which circadian misalignment influences risk for alcohol involvement via alterations in reward function.
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25
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Hasler BP, Wallace ML, Graves JL, Molina BSG, Pedersen SL. Circadian preference is associated with multiple domains of trait and state level impulsivity. Chronobiol Int 2022; 39:792-804. [PMID: 35144510 DOI: 10.1080/07420528.2022.2035392] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Impulsivity is a multidimensional construct with well-documented risk for substance use problems at both the trait- and state levels. A circadian preference towards eveningness has been linked to trait-level, global impulsivity, but whether this association holds true across multiple dimensions of impulsivity and whether actual sleep timing shows parallel associations with impulsivity remain unclear. Here, we extend existing literature by investigating whether eveningness is associated with multiple facets of both trait- and state-level impulsivity. We also examined these associations utilizing daily measures of sleep timing and duration and explored whether they differed by sex and/or race. All participants were moderate-to-heavy social drinkers aged 21-35. Primary analyses included 78 participants (100% White male participants: Sample 1) with circadian preference data (Composite Scale of Morningness: CSM) and sleep timing (midsleep) and duration assessed via daily self-report over 10 days. Five facets of impulsivity were assessed via the UPPS-P, both at baseline (full scale; trait-level) and up to 6 times per day over 10 days (reduced scale; state-level). Linear regression and mixed-effects models were used to examine between- and within-person associations of impulsivity with measures of circadian preference, timing, and duration, accounting for covariates. Exploratory analyses combined Sample 1 with an additional more diverse sample (Sample 2), resulting in a total of 182 participants (29.1% self-identified as Black, 29.7% as female) with daily self-report sleep timing and duration only (no circadian preference). Primary between-person models found that eveningness was associated with multiple facets of impulsivity, at trait (lack of perseverance) and state levels (negative and positive urgency, lack of perseverance, and lack of premeditation), while average midsleep and duration were generally unrelated to impulsivity. Primary within-person models largely paralleled the between-person findings. Exploratory analyses in the larger combined Samples 1 and 2 (without circadian preference) found that later midsleep timing was associated with greater mean state-level impulsivity across multiple facets, associations that may differ by race and sex. In a sample of White male participants, circadian preference for eveningness was strongly associated with multiple facets of impulsivity, at both trait- and state-levels, which may contribute to risk for substance use. Preliminary findings suggest sex and race differences in sleep-impulsivity associations, but future research with objective sleep/circadian measures in larger, more diverse samples will be important to clarify implications for sleep-focused prevention and/or treatment of substance use.
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Affiliation(s)
- Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jessica L Graves
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brooke S G Molina
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Sarah L Pedersen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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26
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Abstract
Disrupted sleep and circadian rhythms are linked with substance abuse risk. Human studies that investigate relationships between sleep, circadian rhythm, and substance use reward generally rely on indirect means to infer dopaminergic function, such as functional magnetic resonance imaging. In this issue of the JCI, Zhang and colleagues used positron emission tomography (PET) to image striatal dopamine D1 (D1R) and D2/3 receptor (D/3R) availability in healthy adults. The authors assessed rest-activity rhythms, then conducted PET scans using radioligand antagonists selective for D1 receptors or D2/D3 receptors to measure D1R and D2/3R availability. They also measured the subjective drug effects of oral methylphenidate. Higher D1R availability in caudate and a greater methylphenidate reward sensitivity were associated with delayed rest-activity rhythms. Unexpectedly, lower overall activity was associated with higher D2/3R availability in the nucleus accumbens, which coincided with greater methylphenidate reward score. These findings may inform personalized prevention and/or treatment interventions.
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27
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Roecklein KA, Franzen PL, Wescott DL, Hasler BP, Miller MA, Donofry SD, DuPont CM, Gratzmiller SM, Drexler SP, Wood-Vasey WM, Gamlin PD. Melanopsin-driven pupil response in summer and winter in unipolar seasonal affective disorder. J Affect Disord 2021; 291:93-101. [PMID: 34029883 PMCID: PMC8693789 DOI: 10.1016/j.jad.2021.04.084] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/19/2021] [Accepted: 04/25/2021] [Indexed: 11/30/2022]
Abstract
A retinal subsensitivity to environmental light may trigger Seasonal Affective Disorder (SAD) under low wintertime light conditions. The main aim of this study was to assess the responses of melanopsin-containing retinal ganglion cells in participants (N= 65) diagnosed with unipolar SAD compared to controls with no history of depression. Participants attended a summer visit, a winter visit, or both. Retinal responses to light were measured using the post-illumination pupil response (PIPR) to assess melanopsin-driven responses in the non-visual light input pathway. Linear mixed-effects modeling was used to test a group*season interaction on the Net PIPR (red minus blue light response, percent baseline). We observed a significant group*season interaction such that the PIPR decreased from summer to winter significantly in the SAD group while not in the control group. The SAD group PIPR was significantly lower in winter compared to controls but did not differ between groups in summer. Only 60% of the participants underwent an eye health exam, although all participants reported no history of retinal pathology, and eye exam status was neither associated with outcome nor different between groups. This seasonal variation in melanopsin driven non-visual responses to light may be a risk factor for SAD, and further highlights individual differences in responses to light for direct or indirect effects of light on mood.
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Affiliation(s)
- Kathryn A. Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,The Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania, USA.,Corresponding Author:Kathryn A. Roecklein, Ph.D. Associate Professor Department of Psychology, University of Pittsburgh 210 S. Bouquet Street Pittsburgh, PA 15206 (412) 624-4553
| | - Peter L. Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Delainey L. Wescott
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Megan A. Miller
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shannon D. Donofry
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Caitlin M. DuPont
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah M. Gratzmiller
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Scott P. Drexler
- Department of Ophthalmology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - W. Michael Wood-Vasey
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Paul D. Gamlin
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
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28
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Duffy JF, Abbott SM, Burgess HJ, Crowley SJ, Emens JS, Epstein LJ, Gamble KL, Hasler BP, Kristo DA, Malkani RG, Rahman SA, Thomas SJ, Wyatt JK, Zee PC, Klerman EB. Workshop report. Circadian rhythm sleep-wake disorders: gaps and opportunities. Sleep 2021; 44:zsaa281. [PMID: 33582815 PMCID: PMC8120340 DOI: 10.1093/sleep/zsaa281] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/02/2020] [Indexed: 01/09/2023] Open
Abstract
This White Paper presents the results from a workshop cosponsored by the Sleep Research Society (SRS) and the Society for Research on Biological Rhythms (SRBR) whose goals were to bring together sleep clinicians and sleep and circadian rhythm researchers to identify existing gaps in diagnosis and treatment and areas of high-priority research in circadian rhythm sleep-wake disorders (CRSWD). CRSWD are a distinct class of sleep disorders caused by alterations of the circadian time-keeping system, its entrainment mechanisms, or a misalignment of the endogenous circadian rhythm and the external environment. In these disorders, the timing of the primary sleep episode is either earlier or later than desired, irregular from day-to-day, and/or sleep occurs at the wrong circadian time. While there are incomplete and insufficient prevalence data, CRSWD likely affect at least 800,000 and perhaps as many as 3 million individuals in the United States, and if Shift Work Disorder and Jet Lag are included, then many millions more are impacted. The SRS Advocacy Taskforce has identified CRSWD as a class of sleep disorders for which additional high-quality research could have a significant impact to improve patient care. Participants were selected for their expertise and were assigned to one of three working groups: Phase Disorders, Entrainment Disorders, and Other. Each working group presented a summary of the current state of the science for their specific CRSWD area, followed by discussion from all participants. The outcome of those presentations and discussions are presented here.
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Affiliation(s)
- Jeanne F Duffy
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Sabra M Abbott
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Stephanie J Crowley
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Jonathan S Emens
- Department of Psychiatry, Oregon Health & Science University, Portland, OR
| | - Lawrence J Epstein
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Karen L Gamble
- Department of Psychiatry University of Alabama at Birmingham, Birmingham, AL
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - David A Kristo
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Roneil G Malkani
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Shadab A Rahman
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - S Justin Thomas
- Department of Psychiatry University of Alabama at Birmingham, Birmingham, AL
| | - James K Wyatt
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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29
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Jalbrzikowski M, Hayes RA, Scully KE, Franzen PL, Hasler BP, Siegle GJ, Buysse DJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Goldstein TR, Soehner AM. Associations between brain structure and sleep patterns across adolescent development. Sleep 2021; 44:6273224. [PMID: 33971013 PMCID: PMC8503824 DOI: 10.1093/sleep/zsab120] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/21/2021] [Indexed: 01/05/2023] Open
Abstract
STUDY OBJECTIVES Structural brain maturation and sleep are complex processes that exhibit significant changes over adolescence and are linked to many physical and mental health outcomes. We investigated whether sleep-gray matter relationships are developmentally invariant (i.e. stable across age) or developmentally specific (i.e. only present during discrete time windows) from late childhood through young adulthood. METHODS We constructed the Neuroimaging and Pediatric Sleep Databank from eight research studies conducted at the University of Pittsburgh (2009-2020). Participants completed a T1-weighted structural MRI scan (sMRI) and 5-7 days of wrist actigraphy to assess naturalistic sleep. The final analytic sample consisted of 225 participants without current psychiatric diagnoses (9-25 years). We extracted cortical thickness and subcortical volumes from sMRI. Sleep patterns (duration, timing, continuity, regularity) were estimated from wrist actigraphy. Using regularized regression, we examined cross-sectional associations between sMRI measures and sleep patterns, as well as the effects of age, sex, and their interaction with sMRI measures on sleep. RESULTS Shorter sleep duration, later sleep timing, and poorer sleep continuity were associated with thinner cortex and altered subcortical volumes in diverse brain regions across adolescence. In a discrete subset of regions (e.g. posterior cingulate), thinner cortex was associated with these sleep patterns from late childhood through early-to-mid adolescence but not in late adolescence and young adulthood. CONCLUSIONS In childhood and adolescence, developmentally invariant and developmentally specific associations exist between sleep patterns and gray matter structure, across brain regions linked to sensory, cognitive, and emotional processes. Sleep intervention during specific developmental periods could potentially promote healthier neurodevelopmental outcomes.
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Affiliation(s)
- Maria Jalbrzikowski
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Rebecca A Hayes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Kathleen E Scully
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA,Department of Clinical and Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA,Department of Clinical and Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Clinical and Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Ronald E Dahl
- Department of Public Health, University of California, Berkeley, CA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Psychology, University of Pittsburgh, Pittsburgh, PA,Department of Clinical and Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, FL
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Corresponding author. Adriane Soehner, Department of Psychiatry, University of Pittsburgh, Loeffler Building, Room 304, 121 Meyran Ave, Pittsburgh, PA 15213, USA.
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30
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Aguinaldo LD, Goldstone A, Hasler BP, Brent DA, Coronado C, Jacobus J. Preliminary analysis of low-level alcohol use and suicidality with children in the adolescent brain and cognitive development (ABCD) baseline cohort. Psychiatry Res 2021; 299:113825. [PMID: 33713937 PMCID: PMC8224175 DOI: 10.1016/j.psychres.2021.113825] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 02/21/2021] [Indexed: 12/21/2022]
Abstract
Cross-sectional analyses were conducted in the baseline cohort of the Adolescent Brain and Cognitive Development (ABCD) Study to determine if lifetime low-level alcohol use was associated with an increased likelihood of lifetime suicidality (N=10,773, ages 9-10). Among the lifetime suicide ideation and attempt groups, 37.7% and 36.2% reported lifetime low-level alcohol use, respectively; versus 22.2% in the non-suicidality group. Children reporting lifetime alcohol use (i.e., ≥ a sip) showed a nearly two-fold increase in their odds of lifetime suicidality compared to those with no previous alcohol use. Future prospective research with this cohort will continue to probe alcohol-suicidality associations.
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Affiliation(s)
- Laika D. Aguinaldo
- University of California San Diego, Department of Psychiatry, La Jolla, California, USA
| | - Aimee Goldstone
- SRI International, Human Sleep Research Program, Menlo Park, California, USA
| | - Brant P. Hasler
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, USA
| | - David A. Brent
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, USA
| | - Clarisa Coronado
- University of California San Diego, Department of Psychiatry, La Jolla, California, USA
| | - Joanna Jacobus
- University of California San Diego, Department of Psychiatry, La Jolla, California, USA.
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31
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Hasler BP, Soehner AM, Wallace ML, Logan RW, Ngari W, Forbes EE, Buysse DJ, Clark DB. Experimentally imposed circadian misalignment alters the neural response to monetary rewards and response inhibition in healthy adolescents. Psychol Med 2021; 52:1-9. [PMID: 33729109 PMCID: PMC8935965 DOI: 10.1017/s0033291721000787] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sleep and circadian timing shifts later during adolescence, conflicting with early school start times, and resulting in circadian misalignment. Although circadian misalignment has been linked to depression, substance use, and altered reward function, a paucity of experimental studies precludes the determination of causality. Here we tested, for the first time, whether experimentally-imposed circadian misalignment alters the neural response to monetary reward and/or response inhibition. METHODS Healthy adolescents (n = 25, ages 13-17) completed two in-lab sleep schedules in counterbalanced order: An 'aligned' condition based on typical summer sleep-wake times (0000-0930) and a 'misaligned' condition mimicking earlier school year sleep-wake times (2000-0530). Participants completed morning and afternoon functional magnetic resonance imaging scans during each condition, including monetary reward (morning only) and response inhibition (morning and afternoon) tasks. Total sleep time and circadian phase were assessed via actigraphy and salivary melatonin, respectively. RESULTS Bilateral ventral striatal (VS) activation during reward outcome was lower during the Misaligned condition after accounting for the prior night's total sleep time. Bilateral VS activation during reward anticipation was lower during the Misaligned condition, including after accounting for covariates, but did not survive correction for multiple comparisons. Right inferior frontal gyrus activation during response inhibition was lower during the Misaligned condition, before and after accounting for total sleep time and vigilant attention, but only during the morning scan. CONCLUSIONS Our findings provide novel experimental evidence that circadian misalignment analogous to that resulting from school schedules may have measurable impacts on healthy adolescents' reward processing and inhibition of prepotent responses.
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Affiliation(s)
- Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School
of Medicine, Pittsburgh, PA
| | - Adriane M. Soehner
- Department of Psychiatry, University of Pittsburgh School
of Medicine, Pittsburgh, PA
| | - Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh School
of Medicine, Pittsburgh, PA
| | - Ryan W. Logan
- Department of Pharmacology and Experimental Therapeutics,
Boston University School of Medicine, Boston, MA
| | - Wambui Ngari
- Department of Psychiatry, University of Pittsburgh School
of Medicine, Pittsburgh, PA
| | - Erika E. Forbes
- Department of Psychiatry, University of Pittsburgh School
of Medicine, Pittsburgh, PA
| | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh School
of Medicine, Pittsburgh, PA
| | - Duncan B. Clark
- Department of Psychiatry, University of Pittsburgh School
of Medicine, Pittsburgh, PA
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32
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Wong PM, Hasler BP, Kamarck TW, Wright AGC, Hall M, Carskadon MA, Gao L, Manuck SB. Day-to-day associations between sleep characteristics and affect in community dwelling adults. J Sleep Res 2021; 30:e13297. [PMID: 33588521 PMCID: PMC8637582 DOI: 10.1111/jsr.13297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 11/30/2022]
Abstract
Despite the high co-occurrence of sleep and mood disturbances, day-to-day associations between sleep characteristics (sleep duration, continuity, and timing) and dimensions of mood (positive affect and negative affect) remain unclear. The present study aimed to test whether there is a daily, bidirectional association between these sleep characteristics and affective states, while addressing methodological limitations in the extant literature by using actiography and ecological momentary assessment methods. Participants were community dwelling, midlife adults (aged 30-54 years, N = 462, 47% male) drawn from the Adult Health and Behavior Project-Phase 2 study. Participants' sleep patterns were assessed with actiography over a 7-day monitoring period, and on 4 of those days, participants completed an ecological momentary assessment protocol that included hourly assessments of positive affect and negative affect during their wake intervals. Using hierarchical linear modelling, we tested whether participants' sleep characteristics on a given night predicted next-day affect and vice versa. We also explored whether nocturnal sleep characteristics would differentially associate with affect at different times of day (morning, afternoon, and evening) while controlling for multiple health behaviours. We found that when participants reported higher positive affect on a given day, they slept later that night (B = 0.22, p = .010). Although we found no other statistically significant associations in our primary analyses (all p > .05), we found several sleep-affect associations specific to time of day (B ranges: 0.01-0.18, all p ≤ .02), which warrants further study. Overall, our findings suggest that healthy adults may be resilient to daily fluctuations in their sleep and mood.
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Affiliation(s)
- Patricia M Wong
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA.,Sleep Research Laboratory, Brown University, Providence, RI, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Thomas W Kamarck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Martica Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mary A Carskadon
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA.,Sleep Research Laboratory, Brown University, Providence, RI, USA
| | - Lei Gao
- Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.,Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Stephen B Manuck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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33
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Abstract
Increasing evidence implicates sleep/circadian factors in alcohol use; however, the role of such factors in alcohol craving has received scant attention. Prior research suggests a 24-hour rhythm in related processes (e.g., reward motivation), but more research directly investigating a rhythm in craving is needed. Moreover, prior evidence is ambiguous whether such a rhythm in alcohol craving may vary by sleep/circadian timing. To examine these possibilities, 36 late adolescents (18-22 years of age; 61% female) with regular alcohol use but without a current alcohol use disorder were recruited to complete smartphone reports of alcohol craving intensity six times a day for two weeks. During these two weeks, participants wore wrist actigraphs and completed two in-lab assessments (on Thursday and Sunday) of dim light melatonin onset (DLMO). Average actigraphically derived midpoint of sleep on weekends and average DLMO were used as indicators of sleep and circadian timing, respectively. Multilevel cosinor analysis revealed a 24-hour rhythm in alcohol craving. Findings across the sleep and circadian timing variables converged to suggest that sleep/circadian timing moderated the 24-hour rhythm in alcohol craving. Specifically, people with later sleep/circadian timing had later timing of peak alcohol craving. These findings add to the growing evidence of potential circadian influences on reward-related phenomena and suggest that greater consideration of sleep and circadian influences on alcohol craving may be useful for understanding alcohol use patterns and advancing related interventions.
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Affiliation(s)
- Garrett C Hisler
- Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
| | - Scott D Rothenberger
- Division of General Internal Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
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34
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Taylor BJ, Bowman MA, Brindle A, Hasler BP, Roecklein KA, Krafty RT, Matthews KA, Hall MH. Evening chronotype, alcohol use disorder severity, and emotion regulation in college students. Chronobiol Int 2020; 37:1725-1735. [PMID: 32791860 PMCID: PMC10080672 DOI: 10.1080/07420528.2020.1800028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The evening chronotype is strongly associated with greater alcohol use, though mechanisms underlying this association are not well understood. The current study evaluated emotion regulation as a potential mechanism linking evening chronotype and alcohol use. Participants were 81 undergraduate students. Chronotype was assessed using the Composite Scale of Morningness (CSM). Alcohol use disorder severity was assessed using the Alcohol Use Disorder Identification Test (AUDIT). Participants recorded daily sleep patterns using an online diary for seven days. Participants then completed a standardized laboratory emotion regulation task. Self-reported affect, high-frequency heart rate variability (HF-HRV), and pre-ejection period (PEP) were measured throughout the task. Sleep duration on non-free days (defined as days when sleep was restricted by morning obligations such as work or school) was evaluated as a moderator. Thirty-one evening chronotypes (CSM scores ≤ 26) were compared to 50 non-evening chronotypes (CSM scores >26). Evening chronotypes reported significantly greater symptoms of alcohol use disorder (F = 4.399, p = .039). In the full sample, emotion regulation was successful for altering affective but not autonomic reactivity to emotional stimuli. There were no chronotype differences in self-reported affect, HF-HRV, or PEP during the emotion regulation task. Longer sleep duration on non-free days was associated with increased HF-HRV during negative emotion regulation among non-evening chronotypes. Moderated mediation revealed that emotion regulation did not mediate the association between evening chronotype and alcohol use, irrespective of sleep duration on non-free days. This study is consistent with the literature on chronotype and substance use, demonstrating that undergraduate evening chronotypes endorse greater severity of alcohol use disorder. Given that emotion regulation did not successfully alter autonomic reactivity to emotional stimuli, emotion regulation as a potential mechanism linking chronotype and alcohol use remains inconclusive. Longer sleep duration appears to be protective for non-evening chronotypes in terms of parasympathetic control during the regulation of negative emotions.
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Affiliation(s)
- Briana J Taylor
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA.,Center for Psychiatric Research, Maine Medical Center , Portland, Maine, USA
| | - Marissa A Bowman
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Alicia Brindle
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Robert T Krafty
- Department of Biostatistics, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Karen A Matthews
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA.,Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
| | - Martica H Hall
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA.,Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
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35
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Hasler BP, Soehner AM, Ngari W, Clark DB. 0068 Circadian Alignment Predicts Neural Response to Monetary Reward in Late Adolescent Drinkers. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Abundant evidence from animal models implicates the circadian system in modulating the brain’s reward circuitry, but evidence in humans has been more limited. In particular, published evidence has relied on self-report and/or behavioral proxies of circadian misalignment and cross-sectional designs. Here, we employed objective measures and a prospective design to assess whether circadian alignment predicts the neural response to reward in a sample of late adolescent drinkers.
Methods
Participants included 23 late adolescents (18–22 y/o; 14 females) reporting weekly alcohol use. Participants completed pre-weekend (Thursday) circadian phase assessments via the dim light melatonin onset (DLMO). Sleep-wake timing was assessed via wrist actigraphy (midpoint of sleep on Tuesday and Wednesday prior to DLMO assessment). Circadian alignment was operationalized as the DLMO-midsleep interval. Neural response to reward was assessed via a card-guessing monetary reward fMRI task; analyzed on reward anticipation and reward win relative to neutral conditions. Mean BOLD signal was extracted from two regions-of-interest (striatum and medial prefrontal cortex, mPFC) for analyses in regression models, accounting for sex and scan order (participants also completed scans on Monday in counterbalanced order, not reported here).
Results
Shorter DLMO-midsleep intervals (i.e., greater misalignment) predicted lower striatal response to anticipated reward (beta=0.48,p=0.02) and showed a trend towards predicting lower mPFC response to anticipated reward (beta=0.39,p=0.06). No statistically-significant effects were found for reward win. Notably, a lower striatal response to anticipated reward correlated with more binge-drinking episodes in the past 30 days, but was not associated with alcohol use in the weekend immediately following the scan.
Conclusion
Our findings provide preliminary evidence of proximal associations between objectively-determined circadian alignment and the neural response to anticipated monetary reward. Ongoing work in a larger sample of adolescents aims to replicate this finding and more definitively determine its relevance to adolescent drinking.
Support
This work was supported by the National Institute on Alcohol Abuse and Alcoholism (R21 AA023209; R01 AA025626).
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Affiliation(s)
- B P Hasler
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - A M Soehner
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - W Ngari
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - D B Clark
- University of Pittsburgh School of Medicine, Pittsburgh, PA
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36
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Roecklein KA, Wescott DL, Smagula SF, Soehner AM, Franzen PL, Hasler BP. 0037 Melanopsin Driven Pupil Responses and Physical Activity: Stability of Activity from Day-to-Day in Winter in Seasonal Affective Disorder. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The post-illumination pupil response (PIPR) is a measure of the responsivity of intrinsically photosensitive retinal ganglion cells (ipRGCs), and reflects the cell biology of the photoentrainment pathway projecting from the retina to the circadian clock. Adequate signaling from the ipRGCs in the retina to the circadian clock is necessary to result in robust circadian output which we hypothesize would increase inter-daily stability (IS), a non-parametric modeling technique that examines stability of rest activity rhythms across successive days.
Methods
Participants were aged 18–66 years and recruited from the greater Pittsburgh area during the Winter with Seasonal Affective Disorder who completed both actigraphy and pupillometry (n = 16). PIPR measures were collected after a 1 second red or blue light pulse, and are calculated as the Net difference between red and blue at multiple time frames: at 6 seconds post stimulus (PIPR 6), from 10–30 seconds post-stimulus (PIPR 20), or from 10–40 seconds post-stimulus (PIPR 30). Using actigraphy, inter-daily stability (IS) was calculated as the amount of overall variability in the recording that is accounted for by the typical 24-hour profile, and reflects stability of the mean 24-h profile day-to-day.
Results
Inter-daily stability (IS) was associated with Net PIPR 20 (Β = 0.561; p = .031) and Net PIPR 30 (Β = 0.551; p = .034; all Β’s are standardized), but not Net PIPR 6 (Β = 0.298; p = .304). Retinal irradiance was calculated for each participant based on age and pupil diameter, to account for age-related differences in transmission of the stimulus to the retina. All raw Net PIPR values were adjusted for calculated retinal irradiance, and gender and time since wake were included as covariates.
Conclusion
Inter-daily stability (IS) values indicate greater stability of 24-hour activity profiles across days. If reduced responsivity to entraining pulses of light is associated with day-to-day instability in activity rhythms, as shown here, we might expect that amplifying entraining light through environmental changes or bright light therapy would normalize inter-daily stability in SAD, or the reverse, stabilizing activity profiles across days could improve depression and/or normalize retinal ipRGC responsivity.
Support
NIMH K.A.R. MH103303
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Affiliation(s)
- K A Roecklein
- University of Pittsburgh Department of Psychology, Pittsburgh, PA
| | - D L Wescott
- University of Pittsburgh Department of Psychology, Pittsburgh, PA
| | - S F Smagula
- University of Pittsburgh Department of Psychiatry, Pittsburgh, PA
| | - A M Soehner
- University of Pittsburgh Department of Psychiatry, Pittsburgh, PA
| | - P L Franzen
- University of Pittsburgh Department of Psychiatry, Pittsburgh, PA
| | - B P Hasler
- University of Pittsburgh Department of Psychiatry, Pittsburgh, PA
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37
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Wescott DL, Dickman KD, Franzen PL, Hasler BP, Roecklein KA. 1091 The Effects Of Sleep Duration, Timing, And Depressed Mood On Daily Eating Patterns. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Insufficient sleep, circadian misalignment, and altered eating patterns are linked to depression. Despite the temporal association between the sleep/wake and feed/fast cycles, it is unclear how depression severity influences this relationship.
Methods
Sixty-eight participants ages 18-65 years across the depression continuum wore an Actiwatch for 5-17 nights and reported daily meal times (730 nights total). Multilevel models tested previous night’s sleep timing and duration as predictors of the length of the next day’s eating window. Within-person sleep duration and timing were entered as Level 1 predictors to account for nightly variation in sleep. Between-person sleep duration and timing were entered as Level 2 predictors. A three-way interaction between depression severity and Level 2 sleep duration/timing was entered. Covariates included age, gender, and day (weeknight/weekend).
Results
Across participants, average later sleep timing predicted a longer eating window (Β= -.222; p =.005). Earlier sleep timing (Β= -.186; p < .001) and shorter sleep duration(Β= -.103; p < .001) relative to a person’s average each predicted a longer next-day eating window. A three-way interaction was found between sleep duration, timing, and depression (Β= -.159; p = .002). At shorter sleep durations, individuals with higher depression severity had a positive relationship between sleep timing and eating window length, and individuals with low depression had a negative relationship between sleep timing and eating window length.
Conclusion
At shorter sleep durations (< 6.5 hr), individuals with high depression and later sleep timing or low depression and early sleep timing had the longest eating windows, which have been linked to adverse metabolic health. Future experiments should test short sleep duration, sleep timing, and depression as potential causes of lengthened eating windows to determine if targeting sleep duration and timing could improve adverse metabolic markers in depression.
Support
NIMH K.A.R. MH103303
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Affiliation(s)
| | | | - P L Franzen
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - B P Hasler
- University of Pittsburgh Medical Center, Pittsburgh, PA
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38
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Kim KN, Wescott DL, Franzen PL, Hasler BP, Roecklein KA. 1092 Attention-deficit/hyperactivity Disorder Symptoms And Sleep Characteristics Within A Seasonal Affective Disorder Spectrum. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Seasonal affective disorder (SAD) increases risk for attention-deficit/hyperactivity disorder (ADHD), although the mechanism linking SAD and ADHD is unknown. Prior research has identified insomnia and delayed sleep phase in both ADHD and SAD. We hypothesized that sleep duration and timing in SAD would be associated with the severity of ADHD symptoms.
Methods
Adults with SAD (n = 45) and subsyndromal SAD (S-SAD; n = 18) aged 19-66 years from Pittsburgh, PA., were assessed for ADHD symptoms, self-report sleep quality, depression severity, and daytime sleepiness in the Winter. Participants wore an Actiwatch for 4-14 days, from which we calculated sleep-onset latency, total sleep time, sleep midpoint, and sleep efficiency. We conducted a hierarchical multivariate linear regression to determine if sleep characteristics predict ADHD symptom severity in our sample while controlling for depressive symptoms. Age and gender were added in Step 1, seasonal depression severity in Step 2, actigraphy-based total sleep time, sleep onset latency, midpoint, and efficiency in Step 3, and self-reported sleep quality and daytime sleepiness in Step 4.
Results
Participants mostly scored in the “likely” or “highly likely” ADHD range (87.30%, n=55), higher than the national prevalence rate (4.4%). When controlling for age, gender, and depression severity, only shorter actigraphy-based total sleep time was associated with higher ADHD symptom severity (β=-0.30, p<0.05). However, when self-reported sleep quality and daytime sleepiness were added as predictors, total sleep time was no longer a statistically-significant predictor of ADHD symptom severity and only daytime sleepiness predicted ADHD symptom severity (β=0.31, p<0.05).
Conclusion
Our results suggest that individuals with SAD who experience daytime sleepiness and/or possibly shorter actigraphy-based sleep duration experience higher ADHD symptom severity. Treatments like Trans-C or CBT-I to improve daytime sleepiness and sleep duration may be indicated for SAD patients who present with comorbid ADHD symptoms.
Support
NIMH K.A.R. MH103303
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Affiliation(s)
- K N Kim
- Carnegie Mellon University Department of Psychology, Pittsburgh, PA
| | - D L Wescott
- University of Pittsburgh Department of Psychology, Pittsburgh, PA
| | - P L Franzen
- University of Pittsburgh Department of Psychiatry, Pittsburgh, PA
| | - B P Hasler
- University of Pittsburgh Department of Psychiatry, Pittsburgh, PA
| | - K A Roecklein
- University of Pittsburgh Department of Psychology, Pittsburgh, PA
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39
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Wescott DL, Hasler BP, Franzen PL, Roecklein KA. 0771 Explaining Self-reported Hypersomnolence In Seasonal Depression. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Hypersomnolence is commonly reported in Major Depressive Disorder with Seasonal Pattern (Seasonal Affective Disorder; SAD). However, self-reported hypersomnolence may conflate long sleep duration, daytime sleepiness, fatigue, increased time in bed, or maladaptive sleep cognitions, undermining treatment efforts.
Methods
Eighty-eight participants ages 18-65 years old were recruited during the winter (SAD = 43, Control = 45). Depression severity was assessed by a clinician rated interview, and self-reported hypersomnolence was determined by assessing self-reported sleep duration. Participants wore an Actiwatch for 4-14 days and completed self-report measures of daytime sleepiness and fatigue. We performed a hierarchical linear regression to determine which factors best explain self-reported winter hypersomnolence: actigraphic total sleep time (TST), time in bed (TIB), depression severity, sleepiness, or fatigue. Due to collinearity of TST and TIB, we separated those variables into two models predicting hypersomnolence.
Results
SAD participants endorsed greater hypersomnolence than controls during the winter (B = .714; p < .001). In model 1, TST (OR(1,14) = .024, p <.001) and daytime sleepiness (OR(1,14) = .208, p = .03) significantly predicted the presence of self-reported winter hypersomnolence above and beyond age, gender, depression, and fatigue. In model 2, only TIB (OR(1, 14) = .021, p = .001) was a significant predictor. Post-hoc analyses indicated that fatigue and depression severity significantly predicted self-reported hypersomnolence when entered separately into the model. Sleepiness accounted for the largest change in pseudo-R2 in bth models.
Conclusion
We found evidence for the multifaceted etiology of self-reported hypersomnolence. Daytime sleepiness, sleep duration, time in bed, and the shared variance between fatigue and depression severity all explained self-reported hypersomnolence. Treatment of hypersomnolence should include actigraphy, and should be individually tailored based on presentation.
Support
NIMH K.A.R. MH103303
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Affiliation(s)
| | - B P Hasler
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - P L Franzen
- University of Pittsburgh Medical Center, Pittsburgh, PA
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40
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Wong PM, Hasler BP, Kamarck T, Wright A, Hall M, Carskadon MA, Manuck SB. 0250 The Day-to-Day Associations Between Sleep Characteristics, Affect, and Affect Reactivity. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Despite the high co-occurrence of sleep and mood disturbances, day-to-day associations between sleep characteristics (sleep duration, continuity, timing) and dimensions of mood (positive affect, PA, and negative affect, NA) remain unclear. Few field studies have tested whether sleep changes may affect mood by altering people’s emotional response to daily experiences outside the laboratory. The current study aimed to examine how sleep characteristics influence affective states and a measure of emotional response to daily experiences—affect reactivity.
Methods
Participants were healthy, midlife adults (30–54 yrs old, N =462, 47% male) drawn from the Adult Health and Behavior Project- Phase 2 study. Sleep was measured with actigraphy across a 4-day monitoring period; hourly self-report measures of affect, work demand, and social interactions were collected via ecological momentary assessment. Affect reactivity was quantified as hour-to-hour changes in affect following these daily experiences. We used hierarchical linear modeling to examine whether sleep characteristics on a given night predicted average daily affect and moderated affect reactivity the following day.
Results
When participants slept later than their average sleep time on a given night, they reported greater NA the following morning (before 12pm) and afternoon (12-6pm; B’s =.03, p’s<.05). When participants slept longer than their average sleep duration, they subsequently reported greater NA throughout the following day (B’s =.02, p’s<.05). Sleep efficiency was unrelated to affect report (p’s >.05). While episodes of greater work demand and social conflict predicted lower PA and higher NA (p’s<.05), participants’ sleep characteristics did not moderate these associations (p’s>.05).
Conclusion
Overall, our findings suggest proximal associations between sleep characteristics and next-day mood. While previous studies have shown effects of sleep disruptions on affect reactivity, we did not observe such associations in the context of small, day-to-day fluctuations in sleep characteristics among healthy individuals.
Support
National Institutes of Health Grant PO1 HL040962 (to S.B.M.).
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Affiliation(s)
- P M Wong
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - B P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - T Kamarck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - A Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - M Hall
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - M A Carskadon
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | - S B Manuck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
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41
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Goldstone A, Javitz HS, Claudatos SA, Buysse DJ, Hasler BP, de Zambotti M, Clark DB, Franzen PL, Prouty DE, Colrain IM, Baker FC. Sleep Disturbance Predicts Depression Symptoms in Early Adolescence: Initial Findings From the Adolescent Brain Cognitive Development Study. J Adolesc Health 2020; 66:567-574. [PMID: 32046896 PMCID: PMC7183901 DOI: 10.1016/j.jadohealth.2019.12.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/05/2019] [Accepted: 12/04/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of the study was to investigate associations between sleep disturbances and mental health in adolescents. METHODS Data are from a national sample of 11,670 U.S. participants (5,594 females, aged 9-10 years, 63.5% white) in the Adolescent Brain Cognitive Development study. Initial longitudinal analyses were conducted for a subset of the sample (n = 4,951). Measures of youth sleep disturbance (disorders of initiating and maintaining sleep, sleep-wake transition disorders, and disorders of excessive somnolence) and "typical" total sleep time (number of hours slept on most nights in the past 6 months) were obtained from the parent-report Sleep Disturbance Scale (Data Release 2.0). Parent-report measures of youth mental health (depression, internalizing, and externalizing behaviors) from the Child Behavior Checklist and typical screen time were included. RESULTS At baseline, greater sleep disturbance and shorter total sleep time were associated with greater internalizing, externalizing, and depression scores. After controlling for baseline mental health symptoms, baseline sleep disturbance significantly predicted depression and internalizing and externalizing scores at 1-year follow-up. A significant interaction with sex indicated that the association between disorders of excessive somnolence and depression 1 year later was steeper for girls, compared with boys (p < .001; 95% confidence interval 1.04-3.45). CONCLUSIONS Sleep disturbances predicted future mental health, particularly depression in this young sample, highlighting the potential to harness sleep as a tool to mitigate the persistence of depression across early adolescence and potentially prevent an adolescent onset of major depressive disorder.
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Affiliation(s)
- Aimée Goldstone
- Center for Health Sciences, SRI International, Menlo Park, California.
| | - Harold S. Javitz
- Center for Health Sciences, SRI International, Menlo Park, California
| | | | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Duncan B. Clark
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Peter L. Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Devin E. Prouty
- Center for Health Sciences, SRI International, Menlo Park, California
| | - Ian M. Colrain
- Center for Health Sciences, SRI International, Menlo Park, California,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, California,Brain Function Research Group, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
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42
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Baker FC, Carskadon MA, Hasler BP. Sleep and Women's Health: Sex- and Age-Specific Contributors to Alcohol Use Disorders. J Womens Health (Larchmt) 2020; 29:443-445. [PMID: 32119636 DOI: 10.1089/jwh.2020.8328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Prior research on alcohol use disorder (AUD) has focused primarily on men, but psycho-social-cultural changes have led to more women drinking or binge drinking, thus highlighting sex differences observed in alcohol use. In parallel, recent evidence indicates bidirectional links between alcohol use and sleep disruption, offering a burgeoning field of research for the study of sex differences in sleep-alcohol interactions. As part of the 2018 Research Conference on Sleep and the Health of Women at the National Institutes of Health, three presentations focused on the intersection between alcohol and sleep in women, including links between disrupted sleep and the risk of AUD. The literature to date hints at sex differences in the relationships between sleep and alcohol use that may be relevant to prevention and/or intervention. For example, insomnia is more prevalent among women, yet men may be more likely to self-medicate insomnia with alcohol and may benefit more from alcohol's sedating effects. Sex differences in sleep timing and duration that begin during adolescence may also be relevant, as later and/or shorter sleep appear to be risk factors for binge drinking. Preliminary data also implicate circadian timing as a sex difference potentially relevant to alcohol use. Limited extant data suggest complex relationships between sex, sleep, and alcohol problems, but defy easy summary. Relevant studies sufficiently powered to test sex differences are needed.
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Affiliation(s)
- Fiona C Baker
- Human Sleep Research Program, SRI International, Menlo Park, California
| | - Mary A Carskadon
- Alpert Medical School of Brown University, Providence, Rhode Island
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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43
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Abstract
Sleep disturbance is common among individuals with alcohol use disorder (AUD). Insomnia not only is a pathway toward alcohol consumption but also is related to increased risk of relapse, psychosocial impairment, decreased quality of life, and suicidal ideation in individuals with AUD. Few studies examining sleep disturbance and alcohol use have explored how this relationship differs between men and women. Historically, studies of AUD have included few, if any, women in their samples. However, women are increasingly consuming alcohol at an earlier age and at higher rates, and the effect of alcohol on women's mental and physical health is expected to rise. This narrative review consolidates findings from studies that have reported the effects of acute and chronic alcohol use on sleep among women. Additional research is needed to investigate sex differences in this area. Such research should consider the modifying effects of age, lifetime alcohol use, and psychiatric co-occurrence, as well as the effectiveness of combined interventions for AUD and sleep disturbance.
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Affiliation(s)
- Sarah M Inkelis
- Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California San Diego, San Diego, California
| | - Brant P Hasler
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California; School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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44
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Hasler BP, Pedersen SL. Sleep and circadian risk factors for alcohol problems: a brief overview and proposed mechanisms. Curr Opin Psychol 2019; 34:57-62. [PMID: 31629218 DOI: 10.1016/j.copsyc.2019.09.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/22/2019] [Accepted: 09/05/2019] [Indexed: 12/12/2022]
Abstract
Disturbances in sleep and circadian rhythms may be important, albeit underappreciated, risk factors for the initiation of alcohol use and the escalation of alcohol problems. In this review, we first describe sleep and circadian changes during adolescence and young adulthood. Second, we explain how these sleep/circadian changes intersect with onset and escalation of alcohol use. Third, we briefly note how alcohol use (whether acute or chronic) affects sleep and circadian rhythms. Finally, we articulate a conceptual model containing two mechanistic pathways-broadly positive and negative reinforcement-linking sleep/circadian factors to alcohol involvement before listing key areas we believe are ripe for further inquiry.
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Affiliation(s)
- Brant P Hasler
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Sarah L Pedersen
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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45
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Claudatos S, Baker FC, Hasler BP. Relevance of Sleep and Circadian Rhythms to Adolescent Substance Use. Curr Addict Rep 2019. [DOI: 10.1007/s40429-019-00277-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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46
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Hasler BP, Wallace ML, White SJ, Molina BSG, Pedersen SL. Preliminary Evidence That Real World Sleep Timing and Duration are Associated With Laboratory-Assessed Alcohol Response. Alcohol Clin Exp Res 2019; 43:1575-1584. [PMID: 31070238 DOI: 10.1111/acer.14076] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/29/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sleep timing and evening chronotype have been implicated in alcohol use problems but research has yet to study them in relation to theory-driven laboratory-based measures of alcohol use disorder risk. The current study examined (i) whether chronotype, sleep timing, and/or sleep duration are associated with alcohol response (subjective stimulation, sedation, and behavioral disinhibition) and (ii) if sex and race moderate these associations. METHODS Adult drinkers (N = 144; 46 female participants) completed 2 counterbalanced beverage administration sessions (alcohol and nonalcohol) during which they rated stimulation/sedation and completed a cued go/no-go task. They reported bed and waketimes over 10 days. RESULTS Later sleep timing was associated with greater increases in alcohol stimulation, but among male and White participants only. Later sleep timing (among male participants) and greater eveningness (examined among White male participants only) were associated with greater overall stimulation on average in the alcohol session relative to the nonalcohol session, irrespective of alcohol consumption. More variable sleep duration was associated with greater increases in sedation. CONCLUSIONS These findings offer preliminary, but novel evidence that sleep characteristics may relate to the relative stimulating and sedating effects of alcohol, thereby influencing the risk for alcohol problems.
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Affiliation(s)
- Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Meredith L Wallace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sarah J White
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Brooke S G Molina
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sarah L Pedersen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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47
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Goldstone A, Claudatos SA, Lim YQ, Smith E, Gil M, Alschuler VR, Rosas LD, Prouty DE, Clark DB, Hasler BP, Franzen PL, Zambotti MD, Colrain IM, Baker FC. 0262 Associations Between Sleep And Mental Health In Children Aged 9 And 10 Years. Sleep 2019. [DOI: 10.1093/sleep/zsz067.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - Duncan B Clark
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brant P Hasler
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peter L Franzen
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Ian M Colrain
- SRI International, Menlo Park, CA, USA
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Melbourne, Australia
| | - Fiona C Baker
- SRI International, Menlo Park, CA, USA
- Brain Function Research Group, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
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48
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Wescott DL, Hasler BP, Roecklein KA, Franzen PL. 0894 Self-reported Sleep Quality Mediates The Relationship Between Dysfunctional Beliefs About Sleep And Severity Of Depression Symptoms. Sleep 2019. [DOI: 10.1093/sleep/zsz067.892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Brant P Hasler
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Peter L Franzen
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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49
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Wescott DL, Hasler BP, Roecklein KA, Franzen PL. 0623 Objective Sleep Parameters And Night-to-night Variability In Sleep Duration In Seasonal And Non-seasonal Depression. Sleep 2019. [DOI: 10.1093/sleep/zsz067.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Brant P Hasler
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Peter L Franzen
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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50
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Hasler BP, Bruce S, Scharf D, Ngari W, Clark DB. Circadian misalignment and weekend alcohol use in late adolescent drinkers: preliminary evidence. Chronobiol Int 2019; 36:796-810. [PMID: 30950299 DOI: 10.1080/07420528.2019.1586720] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Alcohol use accelerates during late adolescence, predicting the development of alcohol use disorders (AUDs) and other negative outcomes. Identifying modifiable risk factors for alcohol use during this time could lead to novel prevention approaches. Burgeoning evidence suggests that sleep and circadian factors are cross-sectionally and longitudinally linked to alcohol use and problems, but more proximal relationships have been understudied. Circadian misalignment, in particular, is hypothesized to increase the risk for AUDs, but almost no published studies have included a biological measure of misalignment. In the present study, we aimed to extend existing research by assessing the relationship between adolescent circadian misalignment and alcohol use on a proximal timeframe (over two weeks) and by including three complementary measures of circadian alignment. We studied 36 healthy late (18-22 years old, 22 females) alcohol drinkers (reporting ≥1, standard drink per week over the past 30 days) over 14 days. Throughout the study, participants reported prior day's alcohol use and prior night's sleep each morning via smartphone and a secure, browser-based interface. Circadian phase was assessed via the dim light melatonin onset (DLMO) in the laboratory on two occasions (Thursday and Sunday nights) in counterbalanced order. The three measures of circadian alignment included DLMO-midsleep interval, "classic" social jet lag (weekday-weekend difference in midsleep), and "objective" social jet lag (weekday-weekend difference in DLMO). Multivariate imputation by chained equations was used to impute missing data, and Poisson regression models were used to assess associations between circadian alignment variables and weekend alcohol use. Covariates included sex, age, Thursday alcohol use, and Thursday sleep characteristics. As predicted, greater misalignment was associated with greater weekend alcohol use for two of the three alignment measures (shorter DLMO-midsleep intervals and larger weekday-weekend differences in midsleep), while larger weekday-weekend differences in DLMO were associated with less alcohol use. Notably, in contrast to expectations, the distribution of weekday-weekend differences in DLMO was nearly equally distributed between individuals advancing over the weekend and those delaying over the weekend. This unexpected finding plausibly reflects the fact that college students are not subject to the same systematically earlier weekday schedules observed in high school students and working adults. These preliminary findings support the need for larger, more definitive studies investigating the proximal relationships between circadian alignment and alcohol use among late adolescents.
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Affiliation(s)
- Brant P Hasler
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Scott Bruce
- b Department of Statistics , George Mason University , Fairfax , VA , USA
| | - Deborah Scharf
- c Department of Psychology , Lakehead University , Thunder Bay , Canada
| | - Wambui Ngari
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Duncan B Clark
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
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