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Gagnadoux F, Bequignon E, Prigent A, Micoulaud-Franchi JA, Chambe J, Texereau J, Alami S, Roche F. The PAP-RES algorithm: Defining who, why and how to use positive airway pressure therapy for OSA. Sleep Med Rev 2024; 75:101932. [PMID: 38608395 DOI: 10.1016/j.smrv.2024.101932] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024]
Abstract
Obstructive sleep apnea (OSA) is a common condition that is increasing in prevalence worldwide. Untreated OSA has a negative impact on health-related quality of life and is an independent risk factor for cardiovascular diseases. Despite available data suggesting that cardiovascular risk might differ according to clinical phenotypes and comorbidities, current approaches to OSA treatment usually take a "one size fits all" approach. Identification of cardiovascular vulnerability biomarkers and clinical phenotypes associated with response to positive airway pressure (PAP) therapy could help to redefine the standard treatment paradigm. The new PAP-RES (PAP-RESponsive) algorithm is based on the identification of OSA phenotypes that are likely to impact therapeutic goals and modalities. The paradigm shift is to propose a simplified approach that defines therapeutic goals based on OSA phenotype: from a predominantly "symptomatic phenotype" (individuals with high symptom burden that negatively impacts on daily life and/or accident risk or clinically significant insomnia) to a "vulnerable cardiovascular phenotype" (individuals with comorbidities [serious cardiovascular or respiratory disease or obesity] that have a negative impact on cardiovascular prognosis or a biomarker of hypoxic burden and/or autonomic nervous system dysfunction). Each phenotype requires a different PAP therapy care pathway based on differing health issues and treatment objectives.
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Affiliation(s)
- Frédéric Gagnadoux
- Service de Pneumologie et Allergologie, CHU Angers, Angers, France; MITOVASC UMR Inserm 1083 - UMR CNRS 6015, Angers, France
| | - Emilie Bequignon
- Service d'ORL et chirurgie cervico-faciale, Centre Hospitalier Intercommunal de Créteil, Créteil, France; CNRS EMR 7000, Créteil, France; INSERM, IMRB, and Faculté de Santé, Université Paris Est Créteil, Créteil, France
| | - Arnaud Prigent
- Pulmonology Medical Group, Polyclinique Saint-Laurent, Rennes, France
| | - Jean-Arthur Micoulaud-Franchi
- Université de Bordeaux, CNRS, SANPSY, UMR, 6033, Bordeaux, France; University Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France
| | - Juliette Chambe
- Département de Médecine Générale, Faculté de Médecine, Strasbourg, France; CNRS UPR 3212, Équipe Sommeil, Horloge, Lumière & NeuroPsychiatrie, Strasbourg, France
| | - Joëlle Texereau
- Lung Function & Respiratory Physiology Units, Cochin University Hospital, AP-HP, Paris, France; Air Liquide Healthcare, Bagneux, France
| | | | - Frédéric Roche
- Physical Exercise and Clinical Physiology Department, CHU Nord, Saint-Étienne, France; INSERM U1059 Santé Ingénierie Biologie, Université Jean Monnet, Saint-Étienne, France.
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Martin VP, Gauld C, Taillard J, Peter-Derex L, Lopez R, Micoulaud-Franchi JA. Sleepiness should be reinvestigated through the lens of clinical neurophysiology: A mixed expertal and big-data Natural Language Processing approach. Neurophysiol Clin 2024; 54:102937. [PMID: 38401240 DOI: 10.1016/j.neucli.2023.102937] [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: 10/21/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 02/26/2024] Open
Abstract
Historically, the field of sleep medicine has revolved around electrophysiological tools. However, the use of these tools as a neurophysiological method of investigation seems to be underrepresented today, from both international recommendations and sleep centers, in contrast to behavioral and psychometric tools. The aim of this article is to combine a data-driven approach and neurophysiological and sleep medicine expertise to confirm or refute the hypothesis that neurophysiology has declined in favor of behavioral or self-reported dimensions in sleep medicine for the investigation of sleepiness, despite the use of electrophysiological tools. Using Natural Language Processing methods, we analyzed the abstracts of the 18,370 articles indexed by PubMed containing the terms 'sleepiness' or 'sleepy' in the title, abstract, or keywords. For this purpose, we examined these abstracts using two methods: a lexical network, enabling the identification of concepts (neurophysiological or clinical) related to sleepiness in these articles and their interconnections; furthermore, we analyzed the temporal evolution of these concepts to extract historical trends. These results confirm the hypothesis that neurophysiology has declined in favor of behavioral or self-reported dimensions in sleep medicine for the investigation of sleepiness. In order to bring sleepiness measurements closer to brain functioning and to reintroduce neurophysiology into sleep medicine, we discuss two strategies: the first is reanalyzing electrophysiological signals collected during the standard sleep electrophysiological test; the second takes advantage of the current trend towards dimensional models of sleepiness to situate clinical neurophysiology at the heart of the redefinition of sleepiness.
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Affiliation(s)
- Vincent P Martin
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg; Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400 Talence, France; Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France
| | - Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, France
| | - Jacques Taillard
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France
| | - Laure Peter-Derex
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR 5292, Lyon, France; Centre for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France
| | - Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy-Rare hypersomnias, Sleep Unit, Department of Neurology, CHU de Montpellier, University of Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France.
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Micoulaud-Franchi JA, Lopez R, McGonigal A, Nobili L. Toward an electroclinical approach for neurophysiological hypersomnolence in sleep medicine. Neurophysiol Clin 2024; 54:102958. [PMID: 38489950 DOI: 10.1016/j.neucli.2024.102958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Sleep Medicine Unit, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France; UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, 33 076 Bordeaux, France.
| | - Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy - Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Aileen McGonigal
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4067, Australia; Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4067, Australia; Mater Epilepsy Unit, Department of Neurosciences, Mater Hospital, Brisbane, QLD 4101, Australia
| | - Lino Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy; Istituto G. Gaslini, Genoa, Italy
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Hernandez Poblete N, Gay F, Salvo F, Micoulaud-Franchi JA, Bienvenu T, Coelho J, Aupy J. Resective epilepsy surgery and its impact on depression in adults: a systematic review, meta-analysis, and implications for future research. J Neurol Neurosurg Psychiatry 2024:jnnp-2023-333073. [PMID: 38443157 DOI: 10.1136/jnnp-2023-333073] [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: 11/27/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND How epilepsy surgery influences the bidirectional relationship of epilepsy and depression remains poorly defined. METHOD For a better understanding of this question, we conducted a systematic review and meta-analysis of risk ratio on depression prevalence before and after epilepsy surgery, using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Three databases were comprehensively screened for all studies assessing depression before and after resective surgery in adult epileptic patients until 8 October 2022. Studies were included if depression was assessed before and after epilepsy surgery regardless of the time of follow-up. A total of 1917 studies were screened for eligibility and 91 full-texts up for inclusion; 35 studies were finally included, 25 studies and 2563 patients were included in main meta-analysis and 10 for exploratory analysis. Risk of bias was assessed using Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) from Cochrane. To derive the pooled depression rates before and after surgery, a meta-analysis with inversed-variance was performed using random-effects logistic models with Peto's correction and a 95% CI. Heterogeneity was assessed with Cochran's Q-test along with its derived measure of inconsistency I2. RESULTS Overall, the depression rates before and after resective epilepsy surgery were 0.70 (0.53 to 0.91) 95% CI, suggesting that the rate of depression at last follow-up evaluation tends to decrease after Resective Epilepsy Surgery (RES). Subgroup analysis suggest a positive long-term effect appears with a significant lower rates of depression already 6 months (0.61 (0.38 to 0.98)), after surgery which is maintained over time after 1 year (0.53 (0.31 to 0.90)), and after 2 years (0.62 (0.42 to 0.92)). CONCLUSION This important finding should be taken in consideration before resective surgery for drug-resistant epilepsies. However, prospective studies should be conducted to characterise which patient, at the individual level, might be at risk of de novo or worsening of depression. PROSPERO REGISTRATION NUMBER CRD42022355386.
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Affiliation(s)
| | - Florian Gay
- CERPAD, CH Charles Perrens, Bordeaux, Aquitaine, France
| | - Francesco Salvo
- INSERM, Pharmaco-epidemiology Team, Université de Bordeaux, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Clinical Neurosciences, CHU de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
- CNRS, SANPSY, Université de Bordeaux, Bordeaux, France
| | - Thomas Bienvenu
- CERPAD, CH Charles Perrens, Bordeaux, Aquitaine, France
- INSERM, Neurocentre Magendie, Université de Bordeaux, Bordeaux, France
| | - Julien Coelho
- Clinical Neurosciences, CHU de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
| | - Jerome Aupy
- Clinical Neurosciences, CHU de Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
- CNRS, IMN, Université de Bordeaux, Bordeaux, France
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Micoulaud-Franchi JA, Coelho J, Boileau L, Quiles C, Geoffroy PA. [Pathophysiological hypothesis and diagnosis of insomnia disorder]. Rev Prat 2024; 74:275-280. [PMID: 38551867] [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] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
PATHOPHYSIOLOGICAL HYPOTHESES AND DIAGNOSIS OF INSOMNIA DISORDER. All pathophysiological models place hyperarousal as a central process in the mechanisms of insomnia. These models differ, however, in terms of the importance and role of the variables explaining this hyperarousal. Behavioral and cognitive models describe self-maintenance behaviors and dysfunctional thoughts, such as worries and concerns about sleep and the consequences of insomnia. Alterations in cognitive functions related to hyperarousal in perceptual and memory processes can explain these behaviors and thoughts. Neurobiological models show instability in the sleepwake balance, with orexin possibly involved, but this remains to be confirmed. The diagnosis of insomnia must consider the semiology related to the mechanisms of insomnia, as well as co-morbidities.
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Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Service universitaire de médecine du sommeil (SUMS), CHU de Bordeaux, Bordeaux, France. CNRS UMR 6033 Sanpsy, CHU de Bordeaux, Bordeaux, France
| | - Julien Coelho
- Service universitaire de médecine du sommeil (SUMS), CHU de Bordeaux, Bordeaux, France. CNRS UMR 6033 Sanpsy, CHU de Bordeaux, Bordeaux, France
| | - Léa Boileau
- Service universitaire de médecine du sommeil (SUMS), CHU de Bordeaux, Bordeaux, France
| | - Clélia Quiles
- Centre hospitalier Charles-Perrens, Bordeaux, France. Université de Bordeaux, Inserm, Bordeaux. Population Health Research Center, team
| | - Pierre-Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU neurosciences, hôpital Bichat-Claude-Bernard, Paris, France. GHU Paris psychiatrie et neurosciences, université de Paris, NeuroDiderot, Inserm, Paris, France. Université Paris-Cité, Inserm, NeuroDiderot, Paris, France
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Micoulaud-Franchi JA, Coelho J, Geoffroy PA, Vecchierini MF, Poirot I, Royant-Parola S, Hartley S, Cugy D, Gronfier C, Gauld C, Rey M. Eco-anxiety: An adaptive behavior or a mental disorder? Results of a psychometric study. Encephale 2024:S0013-7006(23)00173-2. [PMID: 38429155 DOI: 10.1016/j.encep.2023.08.009] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/06/2023] [Accepted: 08/05/2023] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Eco-anxiety is a complex construct that has been created to grasp the psychological impact of the consequences of global warming. The concept needs a reliably valid questionnaire to better evaluate its impact on the risk of anxiety and depressive disorders. The Eco-Anxiety Questionnaire (EAQ-22) evaluates two dimensions: 'habitual ecological anxiety' and 'distress related to eco-anxiety'. However, a version in French, one of the world's widely spoken languages, was until now lacking. We aimed to translate and validate the French EAQ-22 and to evaluate the prevalence of the level of the two dimensions of eco-anxiety and the relationship with anxiety and depressive symptoms in a representative adult sample of the French general population. METHODS This study was performed under the auspices of the Institut national du sommeil et de la vigilance (INSV). Participants (18-65 years) were recruited by an institute specialized in conducting online surveys of representative population samples (quota sampling). Two native French speakers and two native English speakers performed a forward-backward translation of the questionnaire. The Hospital Anxiety and Depression scale (HAD) was administered to assess anxiety (HAD-A) and depressive (HAD-D) symptoms and for external validity. Internal structural validity and external validity were analysed. RESULTS Evaluation was performed on 1004 participants: mean age 43.47 years (SD=13.41, range: [19-66]); 54.1% (n=543) women. Using the HAD, 312 (31.1%) patients had current clinically significant anxiety symptoms (HAD-A>10) and 150 (14.9%) had current clinically significant depressive symptoms (HAD-D>10). Cronbach's alpha coefficient was 0.934, indicating very good internal consistency. Correlation between EAQ-22 and HAD scores was low (r[1004]=0.209, P<0.001), 'habitual ecological anxiety' was correlated less with HAD-A and HAD-D than 'distress related to eco-anxiety', indicating good external validity. CONCLUSION This study validates the French EAQ-22 and paves the way for using the EAQ-22 as a global tool for assessing eco-anxiety. Further prospective studies are now required to better evaluate the impact of eco-anxiety on the occurrence of anxiety and depressive disorder.
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Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- University Sleep Medicine Department, University Hospital of Bordeaux, place Amélie-Raba-Leon, 33076 Bordeaux, France; UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, 33076 Bordeaux, France; Institut national du sommeil et de la vigilance, Paris, France.
| | - Julien Coelho
- University Sleep Medicine Department, University Hospital of Bordeaux, place Amélie-Raba-Leon, 33076 Bordeaux, France; UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, 33076 Bordeaux, France
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU Neurosciences, hôpital Bichat - Claude-Bernard, AP-HP, 75018 Paris, France; GHU Paris - Psychiatry & Neurosciences, 1, rue Cabanis, 75014 Paris, France; Université Paris Cité, NeuroDiderot, Inserm, 75019 Paris, France
| | - Marie-Françoise Vecchierini
- Centre du sommeil et de la vigilance, hôpital Hôtel Dieu, AP-HP, Paris, France; Sorbonne Paris Cité, université Paris Descartes, Paris, France; Institut national du sommeil et de la vigilance, Paris, France
| | - Isabelle Poirot
- Service de psychiatrie adulte, hôpital Fontan, CHU de Lille, Lille, France; Institut national du sommeil et de la vigilance, Paris, France
| | | | - Sarah Hartley
- Réseau Morphée, Garches, France; EA 4047, Sleep Center, Hôpital Raymond Poincaré, AP-HP, université de Versailles Saint-Quentin en Yvelines, Garches, France
| | - Didier Cugy
- University Sleep Medicine Department, University Hospital of Bordeaux, place Amélie-Raba-Leon, 33076 Bordeaux, France; Institut national du sommeil et de la vigilance, Paris, France
| | - Claude Gronfier
- Lyon Neuroscience Research Center (CRNL), Neurocampus, Waking Team, Inserm UMRS 1028, CNRS UMR 5292, Lyon, France; Université Claude-Bernard Lyon 1, université de Lyon, 69000 Lyon, France; Institut national du sommeil et de la vigilance, Paris, France
| | - Christophe Gauld
- Department of Psychiatry, University of Grenoble, avenue du Maquis du Grésivaudan, 38000 Grenoble, France; Institut des sciences cognitives Marc-Jeannerod, UMR 5229 CNRS & université Claude-Bernard Lyon 1, Lyon, France
| | - Marc Rey
- Institut national du sommeil et de la vigilance, Paris, France
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Gauld C, Baillieul S, Martin VP, Richaud A, Lopez R, Pelou M, Abi-Saab P, Coelho J, Philip P, Pépin JL, Micoulaud-Franchi JA. Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms? J Clin Sleep Med 2024. [PMID: 38420966 DOI: 10.5664/jcsm.11086] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is a heterogeneous condition covering many clinical phenotypes in terms of the diversity of symptoms. Patient-based OSA screening questionnaires used in routine practice contain significantly varying contents that can impact the reliability and validity of the screening. We investigated to what extent common patient-based OSA screening questionnaires differ or overlap in their item content by conducting a rigorous, methodical, and quantified content overlap analysis. METHODS We conducted an item content analysis of 11 OSA screening questionnaires validated in adult populations and characterized their overlap using a four-step approach: i) selection of OSA screening questionnaires; ii) item extraction and selection; iii) extraction of symptoms from items; iv) assessment of content overlap with the Jaccard Index (from 0: no overlap to 1: full overlap). RESULTS We extracted 72 items that provided 25 distinct symptoms from 11 selected OSA questionnaires. The overlap between them was weak (mean Jaccard Index 0.224, ranging from 0.138 to 0.329). All questionnaires contained symptoms of the "OSA symptom" dimension (e.g., snoring or witnessed apneas). The STOP-BANG (0.329) and the Berlin (0.280) questionnaires exhibited the highest overlap content. Ten symptoms (40%) were investigated in only one questionnaire. CONCLUSIONS The heterogeneity of content and the low overlap across these questionnaires reflect the challenges of screening OSA. The different OSA questionnaires potentially capture varying aspects of the disorder, with the risk of biased results in studies. Suggestions are made for better OSA screening and refinement of clinical OSA phenotypes.
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Affiliation(s)
- Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, France
| | - Sébastien Baillieul
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Vincent P Martin
- University Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence, France
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | | | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, Montpellier, France
- Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, Montpellier, France
| | - Marie Pelou
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Poeiti Abi-Saab
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Julien Coelho
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Pierre Philip
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Jean Louis Pépin
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
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François C, Bonafé I, Carra MC, Bertrand C, Micoulaud-Franchi JA, d'Incau E. Dental sleep medicine education among undergraduate dental students in France. Eur J Dent Educ 2024; 28:148-153. [PMID: 37353975 DOI: 10.1111/eje.12931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/29/2023] [Accepted: 06/10/2023] [Indexed: 06/25/2023]
Abstract
INTRODUCTION Dental sleep medicine (DSM) is an emerging discipline that studies the oral and maxillofacial causes and consequences of sleep-related problems. DSM is of upmost importance given the major medical challenge it represents. Therefore, to verify whether the future generation of dentists would be ready to face this challenge, the main objective of this study was to assess the degree of involvement of the French dental schools in teaching DSM at the undergraduate level. MATERIALS AND METHODS All 16 dental schools in France were asked to participate in the study by answering to an online survey concerning the DSM curriculum during the 2018-2019 academic year. The survey was addressed to the head of the dental school and/or to relevant course coordinators and contained 10 questions related to the type, content and amount of DSM teaching to undergraduate dental students. RESULTS Nine of the 16 (56.2%) French dental schools responded to the questionnaire. All these nine reported the inclusion of DSM in their undergraduate curriculum. The total average hours dedicated to teaching DSM was 5.6 h (SD 4.2; range 1-15 h). Seven of the 9 dental schools spent most of their DSM curriculum teaching time in the fifth year. All of them reviewed obstructive sleep apnoea and sleep-related bruxism and covered some topics related to therapies for sleep-related breathing disorders, such as the use of oral appliance. CONCLUSION The results of this survey showed that, although the average hourly volume is relatively high, the DSM teaching in French dental schools appeared to be non-standardised, heterogeneous and often lacunar. It is therefore essential to develop a common curriculum and implement it in all dental schools to provide undergraduate students a comprehensive and updated teaching in DSM.
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Affiliation(s)
- Cindy François
- PhyMedExp, INSERM U1046, CNRS UMR9214, Université de Montpellier, Montpellier, France
- UFR of Odontology, Université de Montpellier, Montpellier, France
- Centre de Soins, d'Enseignement et de Recherche Dentaires, CHU de Montpellier, Montpellier, France
| | - Isabelle Bonafé
- UFR of Odontology, Université de Montpellier, Montpellier, France
- Centre de Soins, d'Enseignement et de Recherche Dentaires, CHU de Montpellier, Montpellier, France
- Unité de recherche «Aide à la décision médicale personnalisée» EA 2415, Université de Montpellier, Montpellier, France
| | - Maria Clotilde Carra
- INSERM - Sorbonne Paris Cité Epidemiology and Statistics Research Centre, Paris, France
- UFR of Odontology, Université Paris Cité, Paris, France
- Department of Periodontology, Service of Odontology, Rothschild Hospital (AP-HP), Paris, France
| | - Caroline Bertrand
- Univ. Bordeaux, CNRS, ICMCB, UMR 5026, Talence, France
- UFR of Odontological Sciences, Univ. Bordeaux, Bordeaux, France
- Service of Oral Medicine, University Hospital of Bordeaux, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- UFR of Medical Sciences, Univ. Bordeaux, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France
| | - Emmanuel d'Incau
- UFR of Odontological Sciences, Univ. Bordeaux, Bordeaux, France
- Service of Oral Medicine, University Hospital of Bordeaux, Bordeaux, France
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France
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Coelho J, Rey M, Labonne A, Adan A, Taillard J, Geoffroy PA, Cugy D, Dakar A, Philip P, Poirot I, Royant-Parola S, Hartley S, Vecchierini MF, Micoulaud-Franchi JA. Better characterizing sleep beliefs for personalized sleep health promotion: the French sleep beliefs scale validation study. Front Public Health 2024; 11:1293045. [PMID: 38274535 PMCID: PMC10808670 DOI: 10.3389/fpubh.2023.1293045] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024] Open
Abstract
Background The Sleep Beliefs Scale (SBS) is a well-known tool to design and monitor personalized sleep health promotion at an individual and population level. The lack of an established French version limits the development of effective interventions targeting these populations. Thus, the aim of this study was to validate the French version of the SBS in a representative sample of the general population. Methods Quota sampling was used to recruit 1,004 participants (18-65 years, mean age: 43 years, 54% of female) who underwent an online survey to complete the SBS, and to assess sleep schedules, sleep quality and disorders, and mental health. Cronbach's α coefficient, confirmatory factor analysis, item-internal consistency (IIC), and item discriminant validity (IDV) of the SBS were computed to assess internal validity while bivariate associations with sleep schedules, sleep quality and disorders, and mental health were used to assess external convergent and discriminant validity. Results The mean score on the SBS was 12.3 ± 4.9. Item 19 ("Quiet & Dark") showed the highest rate of correct answers (n = 801, 79.8%), while item 20 ("Recovering sleep") showed the lowest rate of correct answers (n = 246, 24.5%). Overall, the SBS showed satisfactory internal consistency (α = 0.87) and confirmed the three-factor structure proposed by the original study. All items were found consistent (IIC > 0.4) and discriminant (IIC > IDV) except for item 20 ("recovering lost sleep by sleeping for a long time"). Females, older participants, and subjects with short time-in-bed, poor sleep quality, insomnia, and circadian rhythm disorder had higher SBS scores while participants with depressive symptoms had lower SBS scores. Conclusion We successfully translated and validated the French version of the SBS in a representative sample, making it a reliable instrument for researchers and clinicians to assess and target sleep beliefs. Correct answers vary from 25 to 80% which underlines the importance of continuing sleep health promotion campaigns by targeting poorly understood behaviors. Our findings also shed light on the fickleness of beliefs that are prone to vary within individuals across time, in step with societal changes. Several associated factors were identified, thus contributing to our understanding of sleep beliefs and offering insights for personalized approaches to enhance sleep health and overall well-being.
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Affiliation(s)
- Julien Coelho
- University Sleep Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- University Hospital of Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Marc Rey
- Institut National du Sommeil et de la Vigilance, Paris, France
| | | | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Jacques Taillard
- University Hospital of Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Pierre-Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
- GHU Paris-Psychiatry & Neurosciences, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, Paris, France
| | - Didier Cugy
- University Sleep Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- Institut National du Sommeil et de la Vigilance, Paris, France
| | - Alexandre Dakar
- Institut National du Sommeil et de la Vigilance, Paris, France
- Clinique Médicale et Cardiologique d’Aressy, Aressy, France
| | - Pierre Philip
- University Sleep Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- University Hospital of Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Isabelle Poirot
- Institut National du Sommeil et de la Vigilance, Paris, France
- Service de médecine physique et réadaptation pédiatrique, hospices civils de Lyon, Bron, France
| | - Sylvie Royant-Parola
- Institut National du Sommeil et de la Vigilance, Paris, France
- Réseau Morphée, Garches, France
| | - Sarah Hartley
- Institut National du Sommeil et de la Vigilance, Paris, France
- APHP, Hôpital Raymond Poincaré, Sleep Center, Université de Versailles Saint-Quentin en Yvelines, Garches, France
| | - Marie-Françoise Vecchierini
- Institut National du Sommeil et de la Vigilance, Paris, France
- AP-HP, Hôpital Hôtel Dieu, Centre du Sommeil et de la Vigilance, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- University Hospital of Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- Institut National du Sommeil et de la Vigilance, Paris, France
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Coelho J, Sanchez-Ortuño MM, Martin VP, Gauld C, Richaud A, Lopez R, Pelou M, Abi-Saab P, Philip P, Geoffroy PA, Palagini L, Micoulaud-Franchi JA. Content analysis of insomnia questionnaires: A step to better evaluate the complex and multifaceted construct of insomnia disorder. Psychiatry Res 2023; 330:115584. [PMID: 37944205 DOI: 10.1016/j.psychres.2023.115584] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
Insomnia disorder is a mental disorder that includes various types of symptoms (e.g., insomnia initiating, worries, mood disturbances) and impairments (e.g., distress related to sleep alterations). Self-report questionnaires are the most common method for assessing insomnia but no systematic quantified analysis of their content and overlap has been carried out. We used content analysis and a visualization method to better identify the different types of clinical manifestations that are investigated by nine commonly used insomnia questionnaires for adults and the Jaccard index to quantify the degree to which they overlap. Content analysis found and visualized 16 different clinical manifestations classified into five dimensions ("Insomnia symptoms", "Insomnia-related symptoms", "Daytime symptoms", "Insomnia-related impairments", "Sleep behaviors"). The average Jaccard Index was 0.409 (moderate overlap in content). There is a lack of distinction between symptoms and impairments, and the assessment of sleep duration and hyperarousal symptoms remains overlooked. This preliminary analysis makes it possible to visualize the content of each of the nine questionnaires and to select the most appropriate questionnaire based on the issue to be addressed. Suggestions are made regarding the development of future questionnaires to better distinguish symptoms and impairments, and the different phenotypes of insomnia disorder.
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Affiliation(s)
- Julien Coelho
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France.
| | - Maria Montserrat Sanchez-Ortuño
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; Department of Nursing, School of Nursing, University of Murcia, Murcia, Spain
| | - Vincent P Martin
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence F-33400, France
| | - Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon, France
| | - Alexandre Richaud
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, Montpellier 34000, France; Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, Montpellier 34000, France
| | - Marie Pelou
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France
| | - Poeiti Abi-Saab
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France
| | - Pierre Philip
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
| | - Pierre-Alexis Geoffroy
- Département de Psychiatrie et D'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, Paris 75018, France; GHU Paris-Psychiatry & Neurosciences, 1 Rue Cabanis, Université de Paris, NeuroDiderot, Inserm, Paris 75019, France
| | - Laura Palagini
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa 56126, Italy; Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara 44121, Italy
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
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Allavena C, Bastides F, Moroy A, Occhipinti S, Durand F, Barriere G, Micoulaud-Franchi JA, Ghosn J. The screening and management of sleep disturbances in people living with HIV: Delphi consensus. J Sleep Res 2023:e14070. [PMID: 37941027 DOI: 10.1111/jsr.14070] [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: 07/19/2023] [Accepted: 09/27/2023] [Indexed: 11/10/2023]
Abstract
Sleep disturbances in people living with HIV (PLHIV) are frequent but their management remains insufficient. In the absence of specific recommendations, a DELPHI consensus research project was conducted in France to establish best practice. A multidisciplinary Steering Committee (STC) undertook a literature review and used it with clinical expertise to create statements that were voted on. Two profiles of healthcare professionals with significant experience in monitoring PLHIV were selected for the voting: physicians and nurses/psychologists. Votes were collected electronically, independently, and anonymously. The STC created 27 statements covering six areas: Screening of sleep disturbances, Investigation, First-line management, Referral to a specialist, Antiretroviral treatment (ARV), and Prevention. Two rounds of votes included 42 physicians and 32 nurses/psychologists. Consensus was reached for 24 out of 27 statements (89%) including: to assess quantity and quality of sleep among PLHIV at least annually, ideally using a common methodology within the medical department; to consider the temporary addition of a hypnotic treatment in cases of acute insomnia not improved by the rules of sleep hygiene, with full awareness of potential drug-drug interactions and risk of dependence; to correct ferritinaemia if <100 ng/mL before referral to a specialist when restless legs syndrome is suspected; to consider changing the time of ARV administration or an ARV switch within the same class when sleep disturbances are caused by an ARV. This DELPHI Consensus provides best practice for screening and managing sleep disturbances in PLHIV and optimising their quality of life.
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Affiliation(s)
- Clotilde Allavena
- Infectious Diseases Department, INSERM EA1413, CHU Nantes, Nantes, France
| | | | - Anne Moroy
- Centre du Sommeil et de la Vigilance, Hôtel Dieu Hospital, AP-HP, Paris, France
- Sleep Unit, Department of Psychiatry, CHU Lille, Lille, France
| | | | | | | | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, University Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France
| | - Jade Ghosn
- APHP.Nord, Department of Infectious Diseases, Bichat University Hospital, Paris, France
- Université Paris Cité, INSERM, UMR 1137 IAME, Paris, France
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Coelho J, Lucas G, Micoulaud-Franchi JA, Tran B, Yon DK, Taillard J, D'Incau E, Philip P, Boyer L, Fond G. Sleep timing, workplace well-being and mental health in healthcare workers. Sleep Med 2023; 111:123-132. [PMID: 37769583 DOI: 10.1016/j.sleep.2023.09.013] [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: 07/12/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION Healthcare workers face an elevated risk of burnout, sleep disorders, and mental health issues, potentially stemming from the misalignment of their circadian rhythm due to nonstandard work schedules. This cross-sectional survey aims to examine the connections between sleep timing, workplace well-being (including burnout and absenteeism), and mental health outcomes (specifically depression and poor sleep) in healthcare workers. Additionally, the survey takes into account individual and professional factors, as well as the interaction with work schedules. METHODS The study encompasses 4,971 healthcare workers from both public and private healthcare facilities in France, including nurses, nursing assistants, and physicians recruited during the third wave of the COVID-19 pandemic. The Maslach Burnout Inventory assesses burnout, the Center for Epidemiologic Studies Depression Scale measures depression, and the Pittsburgh Sleep Quality Index evaluates poor sleep. Sleep timing is categorized into morning, neutral, and evening timing, referred to as midsleep. Multivariate logistic regression analysis is conducted to explore the relationships between sleep timing and burnout, depression, and poor sleep, while adjusting for various factors. RESULTS The findings reveal that 56.5% of participants experience burnout, 29.8% report depression, and 64.5% report poor sleep. Nurses and nursing assistants exhibit a higher prevalence of poor sleep. Morning sleep timing is associated with burnout among those with fixed schedules and with depression among those with shift schedules. Among physicians, both morning and evening sleep timing are associated with depression, while morning sleep timing is linked to poor sleep across all subgroups. INTERPRETATION This study suggests that the misalignment between healthcare workers' internal circadian rhythm and their work schedules may contribute to an increased risk of burnout, depression, and poor sleep. Occupational health services and policymakers should recognize the potential for enhancing workplace well-being and mental health outcomes by enabling healthcare workers to maintain sleep schedules that accommodate their needs.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Guillaume Lucas
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Bach Tran
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Jacques Taillard
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France
| | - Emmanuel D'Incau
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Pierre Philip
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Laurent Boyer
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Guillaume Fond
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France.
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Coelho J, Lucas G, Micoulaud-Franchi JA, Philip P, Boyer L, Fond G. Poor sleep is associated with work environment among 10,087 French healthcare workers: Results from a nationwide survey. Psychiatry Res 2023; 328:115448. [PMID: 37713924 DOI: 10.1016/j.psychres.2023.115448] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/17/2023]
Abstract
Poor sleep is a prevalent issue among healthcare workers and can have detrimental effects on their health. Various individual and professional factors, including the work environment, may contribute to poor sleep. However, only a limited number of studies have examined the simultaneous influence of these factors. Hence, we conducted a nationwide survey among graduated healthcare workers in both public and private healthcare facilities in France. The aim was to analyze the association between poor sleep, assessed using the Pittsburgh Sleep Quality Index (>5), and the work environment, evaluated using the Job Content Questionnaire. The study encompassed 10,087 healthcare workers, among whom 6,540 (64.8%) reported experiencing poor sleep. Nurses, health executives, nursing assistants, and other allied healthcare professionals were more likely to experience poor sleep compared to physicians. Through multivariate regression analysis, we identified several aspects of the work environment associated with an increased likelihood of poor sleep. These factors included high speed and quantity of work, high complexity and intensity, high fragmentation and unpredictability, limited decision-making latitude, underutilization of skills, lack of emotional support from colleagues, and sustained workplace bullying. These findings highlight the significance of considering the work environment in addressing sleep issues among healthcare professionals.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux France
| | - Guillaume Lucas
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux France
| | - Pierre Philip
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux France
| | - Laurent Boyer
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Guillaume Fond
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France.
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Vion-Dury J, Micoulaud-Franchi JA, Grousset B, Kanny G, Dubois O. Psychosomatic states and their correlation with letting-go: two newly evaluated core factors for investigating the therapeutic effect of spa treatment. Int J Biometeorol 2023; 67:1643-1650. [PMID: 37481483 DOI: 10.1007/s00484-023-02526-z] [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] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023]
Abstract
Spa therapy (aka crenobalneotherapy) has been the object of criticism due to insufficient evidence of its effectiveness. While further effectiveness studies are needed, others are also required to better evaluate the curative factors involved during spa therapy that may contribute to the effectiveness. The current study used specific scales to investigate two possible curative factors: the psychosomatic state and the letting-go of patients with mental disorders after 3 weeks of spa therapy. The Saujon Psychosomatic Questionnaire (SPQ) and the Quantified Assessment of Fluidity of Consciousness Questionnaire (QACF) evaluate psychosomatic state and letting-go, respectively. The Hospital Anxiety and Depression Scale (HAD) and the Insomnia Severity Index (ISI) evaluate depression and anxiety symptoms and insomnia symptoms, respectively. Sixty-five subjects (57 women (87.69%); 8 men), with a mean age of 56.9 (± 9.7) years, were included. SPQ and QAFC scores improved significantly before and after the 3 weeks of spa therapy. Improvement in HAD and ISI scores was significantly correlated with SPQ and QACF scores. These preliminary results suggest that the induced psychosomatic state and the letting-go induced by spa treatment with bubbling baths, jet showers, pool bathing and massage could help patients to become more available and more able to change their psychophysiological state.
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Affiliation(s)
- Jean Vion-Dury
- PRISM, CNRS, Aix-Marseille University, Marseille, France.
| | - Jean-Arthur Micoulaud-Franchi
- UMR 6033, SANPSY, CNRS, University of Bordeaux, 33000, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33076, Bordeaux, France
| | - Blandine Grousset
- Faculté de Médecine, Département de Médecine Générale, Aix Marseille Université, Marseille, France
| | - Gisèle Kanny
- Laboratoire INTERPSY EA 4432, axe GRC, Campus Lettres et Sciences Humaines et Sociales, Université de Lorraine, Nancy, France
- Faculté de Médecine, Laboratoire d'Hydrologie et Climatologie Médicales, CHRU de Nancy, Vandœuvre-lès-Nancy, France
| | - Olivier Dubois
- Groupe Thermes de Saujon, Cliniques de Saujon, Hippocrate et Villa du Parc., 17600, Saujon, France
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Salvo F, Micoulaud-Franchi JA, Palagini L, Geoffroy PA. Dual Orexin Receptor Antagonists and Suicide Risk: Findings From the WHO Spontaneous Reporting Database. J Clin Psychiatry 2023; 84:23br14923. [PMID: 37756127 DOI: 10.4088/jcp.23br14923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Affiliation(s)
- Francesco Salvo
- Department of Medical Pharmacology, Regional Pharmacovigilance Center of Bordeaux, University Hospital of Bordeaux, Inserm U1219, Université de Bordeaux, F-33000, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic Service, University Hospital of Bordeaux, F-33076, Bordeaux, France; UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, F-33076, Bordeaux, France
| | - Laura Palagini
- Psychiatric Clinic Department of Experimental Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Pierre A Geoffroy
- Département de Psychiatrie et d'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, F-75018, Paris, France; Centre ChronoS, GHU Paris-Psychiatry & Neurosciences, Paris, France; Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, F-75019, Paris, France
- Corresponding Author: Prof Pierre Alexis Geoffroy, MD, PhD, University Hospital Bichat-Claude Bernard, Department of Psychiatry and Addictive Medicine, 46 rue Henri Huchard, 75018, Paris, France
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Coelho J, Pecune F, Levavasseur Y, De Sevin E, D'incau E, Sagaspe P, Sanchez-Ortuño MM, Micoulaud-Franchi JA, Philip P. From improved sleep regularity to reduced sleep complaints and mental health conditions: a population-based interventional study using a smartphone-based virtual agent. Sleep 2023; 46:zsad165. [PMID: 37282717 DOI: 10.1093/sleep/zsad165] [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: 12/20/2022] [Revised: 04/28/2023] [Indexed: 06/08/2023] Open
Abstract
STUDY OBJECTIVES To explore the effect of sleep regularity on sleep complaints and mental health conditions (i.e. insomnia, fatigue, anxiety, and depressive symptoms) in a population-based interventional study using a smartphone-based virtual agent. METHODS A populational cohort based on the Kanopée application, which provided interactions with a virtual companion to collect data on sleep and make personalized recommendations to improve sleep over 17 days. A pre-intervention sleep diary and interview were used for cross-sectional analysis (n = 2142), and a post-intervention sleep diary and interview were used for longitudinal analysis (n = 732). The intra-individual mean (IIM) and standard deviation (ISD) of total sleep time (TST) were calculated to measure sleep quantity and sleep regularity. RESULTS The mean age at baseline was 49 years, 65% were female, 72% reported insomnia, 58% fatigue, 36% anxiety, and 17% depressive symptoms. Before the intervention, irregular and short sleep was associated with a higher likelihood of insomnia (Relative risk [RR] = 1.26 [1.21-1.30] for irregular TST and RR = 1.19 [1.15-1.23] for short TST), fatigue, anxiety, and depressive symptoms. After the intervention, the IIM of the TST increased while the ISD of the TST and sleep complaints and mental health conditions decreased. More regular TST was associated with reduced insomnia and depressive symptoms (RR = 1.33 [1.10-1.52] and RR = 1.55 [1.13-1.98], respectively). CONCLUSIONS Our results reveal a longitudinal association between sleep regularity and sleep complaints and mental health conditions. Policymakers, health professionals, and the general population should be aware that, beyond its positive effect on sleep health, regular sleep could promote mental health.
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Affiliation(s)
- Julien Coelho
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Florian Pecune
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Yannick Levavasseur
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Etienne De Sevin
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Emmanuel D'incau
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Patricia Sagaspe
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Maria-Montserrat Sanchez-Ortuño
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- School of Nursing, University of Murcia, Murcia, Spain
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
| | - Pierre Philip
- University Bordeaux, SANPSY, UMR 6033, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, BordeauxFrance
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Gentina T, Gentina E, Douay B, Micoulaud-Franchi JA, Pépin JL, Bailly S. Investigating associations between social determinants, self-efficacy measurement of sleep apnea and CPAP adherence: the SEMSA study. Front Neurol 2023; 14:1148700. [PMID: 37528857 PMCID: PMC10390224 DOI: 10.3389/fneur.2023.1148700] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/29/2023] [Indexed: 08/03/2023] Open
Abstract
Study objectives The prospective Self-Efficacy Measure for Sleep Apnea study (SEMSAS) is investigating thresholds for health literacy, self-efficacy and precariousness at obstructive sleep apnea (OSA) diagnosis to predict CPAP adherence. This paper describes the study protocol and presents baseline data from the ongoing study. Methods Eligible individuals had confirmed OSA and were referred to a homecare provider for continuous positive airway pressure (CPAP) therapy initiation. Data on patient characteristics and comorbidities were collected, along with baseline evaluations of self-efficacy [15-item Self-Efficacy Measure for Sleep Apnea tool (SEMSA-15)], precariousness [Deprivation in Primary Care Questionnaire (DipCareQ)], and health literacy (Health Literacy Questionnaire). CPAP adherence over 12 months of follow-up will be determined using remote monitoring of CPAP device data. The primary objective is to define an optimal SEMSA-15 score threshold to predict CPAP adherence at 3- and 12-month follow-up. Results Enrollment of 302 participants (71% male, median age 55 years, median body mass index 31.6 kg/m2) is complete. Low self-efficacy (SEMSA-15 score ≤ 2.78) was found in 93/302 participants (31%), and 38 (12.6%) reported precariousness (DipCareQ score > 1); precariousness did not differ significantly between individuals with a SEMSA-15 score ≤ 2.78 versus >2.78. Health literacy was generally good, but was significantly lower in individuals with versus without precariousness, and with low versus high self-efficacy. Conclusion SEMSAS is the first study using multidimensional baseline assessment of self-efficacy, health literacy and precariousness, plus other characteristics, to determine future adherence to CPAP, including CPAP adherence trajectories. Collection of follow-up data is underway.
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Affiliation(s)
- Thibaut Gentina
- Ramsey General Healthcare La Louviere Hospital, Lille, France
| | - Elodie Gentina
- IESEG School of Management, CNRS, UMR 9221 – LEM – Lille Economie Management, Univ. Lille, Lille, France
| | - Bernard Douay
- Ramsey General Healthcare La Louviere Hospital, Lille, France
| | - Jean-Arthur Micoulaud-Franchi
- SANPSY, UMR 6033, University of Bordeaux, Bordeaux, France
- Sleep Medicine Service, University Hospital, Bordeaux, France
| | - Jean-Louis Pépin
- HP2 Laboratory, INSERM U1300, Univ. Grenoble Alpes, Grenoble, France
- EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
| | - Sébastien Bailly
- HP2 Laboratory, INSERM U1300, Univ. Grenoble Alpes, Grenoble, France
- EFCR Laboratory, Grenoble Alpes University Hospital, Grenoble, France
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18
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Philip P, Micoulaud-Franchi JA, Taillard J, Coelho J, Tisserand C, Dauvilliers Y, Sagaspe P. The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk. J Clin Sleep Med 2023; 19:957-965. [PMID: 36727504 PMCID: PMC10152350 DOI: 10.5664/jcsm.10470] [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: 08/29/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES Sleepiness is a well-known risk factor for traffic accidents. Our study presents a new questionnaire, the Bordeaux Sleepiness Scale (BOSS), specifically designed to evaluate sleep-related driving risk in patients with sleep disorders. METHODS The BOSS was designed by gathering data on sociodemographics, sleepiness, driving items, and traffic accident exposure (kilometers driven) in the past year of 293 patients followed for sleep disorders at a French sleep clinic. It was then validated on data from a large population-based cohort of 7,296 highway drivers. Its performance was compared to the Epworth sleepiness scale and to self-reported episodes of severe sleepiness at the wheel. Receiver operating characteristic curves were computed. RESULTS The sensitivity and specificity of the BOSS (cutoff = 3) to predict sleep-related near-misses or accidents was, respectively, 82% and 74%, with an area under the receiver operating characteristic curve of 0.83. In a cohort of patients and a large population-based cohort, the area under the curve of the BOSS was significantly larger than that of the Epworth sleepiness scale (P < .001). Although the areas under the curve were equivalent between the BOSS and sleepiness at the wheel, the specificity of the BOSS was higher. CONCLUSIONS The BOSS scale combining exposure (kilometers driven) and self-perception of situational sleepiness provides a simple and reliable evaluation of sleep-related driving risk. This short, specific questionnaire should be promoted as a first-line tool to evaluate the risk of traffic accidents in sleepy patients. CITATION Philip P, Micoulaud-Franchi J-A, Taillard J, et al. The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk. J Clin Sleep Med. 2023;19(5):957-965.
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Affiliation(s)
- Pierre Philip
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
- INSERM CIC1401, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jacques Taillard
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Julien Coelho
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | | | - Yves Dauvilliers
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France
- PSNREC, University of Montpellier, INSERM, Montpellier, France
| | - Patricia Sagaspe
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
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Coelho J, Montagni I, Micoulaud-Franchi JA, Plancoulaine S, Tzourio C. Study of the association between cannabis use and sleep disturbances in a large sample of University students. Psychiatry Res 2023; 322:115096. [PMID: 36842936 DOI: 10.1016/j.psychres.2023.115096] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
Sleep complaints and cannabis use are common among University students and are related to detrimental effects on health. The aim of this study was to explore their association. This cross-sectional study based on the i-Share e-cohort included French students between 18 and 30 years old (n = 14,787). Frequency of cannabis use was categorized into daily, weekly, monthly, and never/rarely use. Sleep complaints were defined using four items (i.e., insomnia, sleepiness, poor sleep quality, and sleep deprivation). In the whole sample (mean age: 20.4 years, 75.5% of females), 22.7% had insomnia, 18.3% had sleepiness, 22.4% had poor sleep quality, 52.5% had sleep deprivation, and 5.8% used cannabis weekly or daily. After adjustment, the likelihood of insomnia was significantly higher by 45% in cannabis users compared to non-users. The estimates steadily increased with frequency of use, reaching a 2.0-fold higher likelihood of insomnia in daily users compared to never/rarely users. Results were similar for the other sleep complaints. These findings provide support for an association between cannabis use and sleep complaints, particularly insomnia, among University students. Though direction and causality cannot be established in this setting, these results suggest warning students and health professionals about the association between cannabis use and sleep complaints.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, F-33000 Bordeaux, Nouvelle-Aquitaine, France.
| | - Ilaria Montagni
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, F-33000 Bordeaux, Nouvelle-Aquitaine, France
| | - Jean-Arthur Micoulaud-Franchi
- CHU Bordeaux, Service Universitaire de Médecine du sommeil, Place Amélie Raba Léon, 33000, Bordeaux, Nouvelle-Aquitaine, France
| | - Sabine Plancoulaine
- Université Paris Cité, Inserm, INRAE, Centre de Recherche en Epidémiologie et StatistiquesS (CRESS), F-75004 Paris, France
| | - Christophe Tzourio
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, F-33000 Bordeaux, Nouvelle-Aquitaine, France
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20
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Gauld C, Baillet E, Micoulaud-Franchi JA, Kervran C, Serre F, Auriacombe M. The centrality of craving in network analysis of five substance use disorders. Drug Alcohol Depend 2023; 245:109828. [PMID: 36868091 DOI: 10.1016/j.drugalcdep.2023.109828] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/26/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND AND AIMS Among the 11 current diagnostic criteria, craving is a potential central marker for understanding and for treatment of Substance Use Disorders (SUD). Our objective was to explore craving centrality across SUD based on the study of symptom interactions in cross-sectional network analyses of DSM-5 SUD diagnostic criteria. We hypothesized the centrality of "Craving" in SUD across substance types. DESIGN Participants from the ADDICTAQUI clinical cohort with regular use (2 times per week threshold for a substance) and at least one DSM-5 SUD. SETTING Outpatient substance use treatment services in Bordeaux, France. PARTICIPANTS The sample of 1359 participants, had a mean age of 39 years old and 67% were males. The prevalence of SUD over the time course of the study was: 93% for alcohol, 98% for opioids, 94% for cocaine, 94% for cannabis and 91% tobacco. MEASUREMENTS Construction of a Symptom Network Model conducted on the DSM-5 SUD criteria evaluated over the past 12 months for Alcohol-, Cocaine-, Tobacco-, Opioid- and Cannabis Use disorder. FINDINGS The only symptom that consistently remained in terms of centrality was "Craving" [3.96 - 6.17] (z-scores), indicating that it exhibits a high degree of connections in the entire symptom network regardless of the substance. CONCLUSION Identifying craving as central in SUD symptoms network confirms the role of craving as a marker of addiction. This constitutes a major avenue in the understanding of the mechanisms of addiction, with implications to ameliorate diagnostic validity and clarify treatment targets.
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Affiliation(s)
- Christophe Gauld
- Department of Child Psychiatry, CHU de Lyon, F-69000 Lyon, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, F-69000 Lyon, France
| | - Emmanuelle Baillet
- University of Bordeaux, F-33076 Bordeaux, France; SANPSY, CNRS, UMR 6033, F-33076 Bordeaux, France; Pôle Interétablissement d'Addictologie, CH Ch. Perrens and CHU de Bordeaux, F-33076 Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- University of Bordeaux, F-33076 Bordeaux, France; SANPSY, CNRS, UMR 6033, F-33076 Bordeaux, France; University Sleep Clinic, University Hospital of Bordeaux (CHU Bordeaux), Place Amélie Raba-Leon, F-33076 Bordeaux, France
| | - Charlotte Kervran
- University of Bordeaux, F-33076 Bordeaux, France; I-prev, MéRISP/PHARES, CIC 1401, Inserm U1219, Bordeaux Population Health Research Center (BPH), F-33076 Bordeaux, France
| | - Fuschia Serre
- University of Bordeaux, F-33076 Bordeaux, France; SANPSY, CNRS, UMR 6033, F-33076 Bordeaux, France; Pôle Interétablissement d'Addictologie, CH Ch. Perrens and CHU de Bordeaux, F-33076 Bordeaux, France
| | - Marc Auriacombe
- University of Bordeaux, F-33076 Bordeaux, France; SANPSY, CNRS, UMR 6033, F-33076 Bordeaux, France; Pôle Interétablissement d'Addictologie, CH Ch. Perrens and CHU de Bordeaux, F-33076 Bordeaux, France.
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21
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Coelho J, Taillard J, Bernard A, Lopez R, Fond G, Boyer L, Lucas G, Alla F, Buysse DJ, Wallace ML, Verdun-Esquer C, Geoffroy PA, d’Incau E, Philip P, Micoulaud-Franchi JA. Emotional Exhaustion, a Proxy for Burnout, Is Associated with Sleep Health in French Healthcare Workers without Anxiety or Depressive Symptoms: A Cross-Sectional Study. J Clin Med 2023; 12:jcm12051895. [PMID: 36902682 PMCID: PMC10004252 DOI: 10.3390/jcm12051895] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/14/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
Burnout is frequent among healthcare workers, and sleep problems are suspected risk factors. The sleep health framework provides a new approach to the promotion of sleep as a health benefit. The aim of this study was to assess good sleep health in a large sample of healthcare workers and to investigate its relationship with the absence of burnout among healthcare workers while considering anxiety and depressive symptoms. A cross-sectional Internet-based survey of French healthcare workers was conducted in summer 2020, at the end of the first COVID-19 lockdown in France (March to May 2020). Sleep health was assessed using the RU-SATED v2.0 scale (RegUlarity, Satisfaction, Alertness, Timing, Efficiency, Duration). Emotional exhaustion was used as a proxy for overall burnout. Of 1069 participating French healthcare workers, 474 (44.3%) reported good sleep health (RU-SATED > 8) and 143 (13.4%) reported emotional exhaustion. Males and nurses had a lower likelihood of emotional exhaustion than females and physicians, respectively. Good sleep health was associated with a 2.5-fold lower likelihood of emotional exhaustion and associations persisted among healthcare workers without significant anxiety and depressive symptoms. Longitudinal studies are needed to explore the preventive role of sleep health promotion in terms of the reduction in burnout risk.
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Affiliation(s)
- Julien Coelho
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
- Correspondence: ; Tel.: +33-64570-6212
| | - Jacques Taillard
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
| | - Adèle Bernard
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Régis Lopez
- Department of Neurology, Sleep Disorders Center, Gui-de-Chauliac Hospital, CHU Montpellier, F-34000 Montpellier, France
- Inserm, U1061, Université Montpellier 1, F-34000 Montpellier, France
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
- Fondation FondaMental, F-94000 Créteil, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
- Fondation FondaMental, F-94000 Créteil, France
| | - Guillaume Lucas
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
| | - François Alla
- Pôle de Santé Publique, CHU Bordeaux, F-33000 Bordeaux, France
| | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | | | - Pierre-Alexis Geoffroy
- Département de Psychiatrie et D’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat—Claude Bernard, F-75018 Paris, France
- GHU Paris—Psychiatry & Neurosciences, 1 Rue Cabanis, F-75014 Paris, France
- Inserm, FHU I2-D2, Université de Paris, NeuroDiderot, F-75019 Paris, France
| | - Emmanuel d’Incau
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Pierre Philip
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
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22
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Micoulaud-Franchi JA, Gauld C, Mcgonigal A. Networked vision of epilepsy and mental symptoms: Proposal for a "city map of traffic lights". Epilepsy Behav 2023; 141:109118. [PMID: 36801164 DOI: 10.1016/j.yebeh.2023.109118] [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] [Received: 01/23/2023] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/19/2023]
Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Sleep Medicine Unit, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France; UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, 33 076 Bordeaux, France.
| | - Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, France
| | - Aileen Mcgonigal
- Epilepsy Unit, Neurosciences Centre, Mater Hospital and Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, Australia
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23
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Serafino AM, Gozé T, Hauck C, Gauld C, Micoulaud-Franchi JA, Naudin J, Cermolacce M. Le Praecox Feeling : présentation historique du concept et aspects épistémologiques. Annales Médico-psychologiques, revue psychiatrique 2023. [DOI: 10.1016/j.amp.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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24
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Martin VP, Lopez R, Dauvilliers Y, Rouas JL, Philip P, Micoulaud-Franchi JA. Sleepiness in adults: An umbrella review of a complex construct. Sleep Med Rev 2023; 67:101718. [PMID: 36455433 DOI: 10.1016/j.smrv.2022.101718] [Citation(s) in RCA: 5] [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: 04/08/2022] [Revised: 10/21/2022] [Accepted: 11/10/2022] [Indexed: 11/21/2022]
Abstract
Sleepiness involves many dimensions that require investigation. Since sleepiness is often defined operationally, we exhaustively inventoried all the assessment tools designed to measure it in an umbrella review, without any preconceptions, i.e. a review of reviews. We included all reviews and systematic reviews related to sleepiness assessment tools published up to March 2021. Three investigators independently assessed the eligibility of studies for inclusion and identified 36 relevant reviews. In total, 99 tools were identified and classified into 8 categories. We classified them depending on their category, their publication year and the number of mentions in the 36 included reviews. The 6 most frequently cited were the Epworth sleepiness scale, the multiple sleep latency test, the maintenance of wakefulness test, the Stanford sleepiness scale, the Karolinska sleepiness scale, and the psychomotor vigilance task. Despite the limitation that we may have missed some recently developed tools, this historical perspective on sleepiness measurement is a first step toward a better delineation of the different dimensions underlying the constructs of sleepiness, and will serve as a basis for further discussion in the clinical and research sleep community.
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Affiliation(s)
- Vincent P Martin
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400, Talence, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France.
| | - Régis Lopez
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Yves Dauvilliers
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Jean-Luc Rouas
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400, Talence, France
| | - Pierre Philip
- Service de Médecine Universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Service de Médecine Universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France.
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25
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Gauld C, Martin VP, Richaud A, Baillieul S, Vicente L, Perromat JL, Zreik I, Taillard J, Geoffroy PA, Lopez R, Micoulaud-Franchi JA. Systematic Item Content and Overlap Analysis of Self-Reported Multiple Sleep Disorder Screening Questionnaires in Adults. J Clin Med 2023; 12:jcm12030852. [PMID: 36769500 PMCID: PMC9918039 DOI: 10.3390/jcm12030852] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
Sleep disorders are defined on the basis of diagnostic criteria presented in medical classifications. However, no consensus has emerged on the exact list of operational symptoms that should be systematically investigated in the field of sleep medicine. We propose a systematic analysis of sleep symptoms that figure in a set of self-reported multiple sleep disorder screening questionnaires for adult populations, to identify the content overlap of symptoms that probe the presence of central sleep symptoms, and to highlight the potential level of heterogeneity among sleep disorder questionnaires. The method comprises three steps: (i) the selection of self-reported multiple sleep disorder screening questionnaires; (ii) item extraction and selection; (iii) the extraction of symptoms from items. Frequency of sleep symptoms and content overlap (Jaccard Index) are analyzed. We extracted 469 items that provide 60 different symptoms from 12 questionnaires. Insomnia, somnolence, and sleep-related breathing symptoms were found in all the questionnaires. The mean overlap among all questionnaires evaluated with the Jaccard Index is 0.44, i.e., moderate similarity. Despite limitations related to the selection of questionnaires and the symptom extraction and harmonization, this study underlines the need to standardize sleep symptom contents for sleep medicine in order to enhance the practicability, reliability, and validity of sleep disorder diagnoses.
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Affiliation(s)
- Christophe Gauld
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hospices Civils de Lyon & Université de Lyon 1, 69500 Bron, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, 69500 Bron, France
| | - Vincent P. Martin
- CNRS, Bordeaux INP, LaBRI, UMR 5800, University of Bordeaux, 33400 Talence, France
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | - Alexandre Richaud
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33076 Bordeaux, France
| | - Sébastien Baillieul
- HP2 Laboratory, INSERM U1042, Grenoble Alpes University, 38400 Grenoble, France
- Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, 38700 Grenoble, France
| | - Lucie Vicente
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | | | - Issa Zreik
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | - Jacques Taillard
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | - Pierre Alexis Geoffroy
- Département de Psychiatrie et d’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, 75018 Paris, France
- GHU Paris-Psychiatry & Neurosciences, 1 Rue Cabanis, 75014 Paris, France
- NeuroDiderot, Inserm, Université de Paris, FHU I2-D2, 75019 Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 67000 Strasbourg, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), Université de Montpellier, 34000 Montpellier, France
- Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, 34000 Montpellier, France
| | - Jean-Arthur Micoulaud-Franchi
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33076 Bordeaux, France
- Correspondence: ; Tel.: +33-622-364-019
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Gauld C, Lopez R, Philip P, Taillard J, Morin CM, Geoffroy PA, Micoulaud-Franchi JA. A Systematic Review of Sleep–Wake Disorder Diagnostic Criteria Reliability Studies. Biomedicines 2022; 10:biomedicines10071616. [PMID: 35884924 PMCID: PMC9313077 DOI: 10.3390/biomedicines10071616] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 12/02/2022] Open
Abstract
The aim of this article is to provide a systematic review of reliability studies of the sleep–wake disorder diagnostic criteria of the international classifications used in sleep medicine. Electronic databases (ubMed (1946–2021) and Web of Science (—2021)) were searched up to December 2021 for studies computing the Cohen’s kappa coefficient of diagnostic criteria for the main sleep–wake disorder categories described in the principal classifications. Cohen’s kappa coefficients were extracted for each main sleep–wake disorder category, for each classification subtype, and for the different types of methods used to test the degree of agreement about a diagnosis. The database search identified 383 studies. Fifteen studies were analyzed in this systematic review. Insomnia disorder (10/15) and parasomnia disorder (7/15) diagnostic criteria were the most studied. The reliability of all sleep–wake disorders presented a Cohen’s kappa with substantial agreement (Cohen’s kappa mean = 0.66). The two main reliability methods identified were “test–retest reliability” (11/15), principally used for International Classification of Sleep Disorders (ICSD), and “joint interrater reliability” (4/15), principally used for Diagnostic and Statistical Manual of Mental Disorders (DSM) subtype diagnostic criteria, in particularl, the DSM-5. The implications in terms of the design of the methods used to test the degree of agreement about a diagnosis in sleep medicine are discussed.
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Affiliation(s)
- Christophe Gauld
- Department of Child Psychiatry, Hospices Civils de Lyon, 69000 Lyon, France;
- UMR CNRS 8590 IHPST, Sorbonne University, 75007 Paris, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, 34000 Montpellier, France;
- Inserm, Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, 34000 Montpellier, France
| | - Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33 076 Bordeaux, France;
- CNRS, SANPSY, Université de Bordeaux, UMR6033, 33000 Bordeaux, France;
| | - Jacques Taillard
- CNRS, SANPSY, Université de Bordeaux, UMR6033, 33000 Bordeaux, France;
| | - Charles M. Morin
- École de Psychologie, Université Laval, 2325 Rue des Bibliothèques, Québec City, QC G1V 0A6, Canada;
- Centre D’étude des Troubles du Sommeil, Université Laval, 2325 Rue des Bibliothèques, Québec City, QC G1V 0A6, Canada
| | - Pierre Alexis Geoffroy
- Département de Psychiatrie et d’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat—Claude Bernard, 75018 Paris, France;
- GHU Paris—Psychiatry & Neurosciences, 1 Rue Cabanis, 75014 Paris, France
- NeuroDiderot, Inserm, Université de Paris, FHU I2-D2, 75019 Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 67000 Strasbourg, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33 076 Bordeaux, France;
- CNRS, SANPSY, Université de Bordeaux, UMR6033, 33000 Bordeaux, France;
- Correspondence: ; Tel.: +33-(0)5-57-82-01-82
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Gauld C, Rhanmi H, Philip P, Micoulaud-Franchi JA. Validation of the French Cues to CPAP Use Questionnaire in patients with OSAS: A step forward for evaluating cues to CPAP use in order to predict treatment adherence. J Psychosom Res 2022; 158:110943. [PMID: 35580454 DOI: 10.1016/j.jpsychores.2022.110943] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The cues to starting CPAP are important in patients with Obstructive Sleep Apnea Syndrome (OSAS) to predict CPAP use and behavioral change. The Cues to CPAP Use Questionnaire (CCUQ) is a short practical self-reported scale to evaluate such cues to action. This study sought to examine the psychometric reliability and validity of the French version. METHODS A forward-backward translation of the CCUQ was performed. Principal research tools were CCUQ, SEMSA and ESS. Subjects with OSAS were invited to complete the CCUQ just before CPAP initiation and 10 days after CPAP initiation. The ESS was completed just before CPAP initiation and one month after CPAP initiation. The SEMSA was completed just before CPAP initiation. Statistical analyses methods aim to evaluate the psychometric properties of the French CCUQ version in terms of its construct validity, internal structural validity, test-retest and external validity. Mean CPAP use on the previous month was recorded at one, six and twelve months after CPAP initiation. RESULTS A total of 140 patients with OSAS were included with 61.4% of men and a mean age of 55.3 (±12.9), BMI of 29.8 (±4.9), initial ESS of 11.97 (±5.68), and initial AHI 37.2/h (±19.3). Factor analysis confirmed the three-factor structure of the CCUQ. Cronbach's alpha coefficient was 0.64. Test-retest reliability (at t-0 and at 10 days) of the CCUQ was satisfactory. External validity shown significant correlation of the CCUQ with SEMSA and of the dimension "Partner cues" of the CCUQ with mean CPAP use at one month. CONCLUSION The French CCUQ scale is a reliable and valid tool for measuring cues to action in adults with OSAS initiating CPAP treatment. Further studies are necessary to confirm the predictive value of cues to action and self-efficacy for CPAP use and adherence. Such investigations would underpin public health CPAP interventions in accordance with models of behavioral change.
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Affiliation(s)
- Christophe Gauld
- Service de Psychopathologie de l'Enfant et du Développement, Hospices Civils de Lyon, Lyon, France; UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France
| | - Hatim Rhanmi
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France
| | - Pierre Philip
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, France.
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Gauld C, Maquet J, Micoulaud-Franchi JA, Dumas G. Popular and Scientific Discourse on Autism: Representational Cross-Cultural Analysis of Epistemic Communities to Inform Policy and Practice. J Med Internet Res 2022; 24:e32912. [PMID: 35704359 PMCID: PMC9244652 DOI: 10.2196/32912] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background Social media provide a window onto the circulation of ideas in everyday folk psychiatry, revealing the themes and issues discussed both by the public and by various scientific communities. Objective This study explores the trends in health information about autism spectrum disorder within popular and scientific communities through the systematic semantic exploration of big data gathered from Twitter and PubMed. Methods First, we performed a natural language processing by text-mining analysis and with unsupervised (machine learning) topic modeling on a sample of the last 10,000 tweets in English posted with the term #autism (January 2021). We built a network of words to visualize the main dimensions representing these data. Second, we performed precisely the same analysis with all the articles using the term “autism” in PubMed without time restriction. Lastly, we compared the results of the 2 databases. Results We retrieved 121,556 terms related to autism in 10,000 tweets and 5.7x109 terms in 57,121 biomedical scientific articles. The 4 main dimensions extracted from Twitter were as follows: integration and social support, understanding and mental health, child welfare, and daily challenges and difficulties. The 4 main dimensions extracted from PubMed were as follows: diagnostic and skills, research challenges, clinical and therapeutical challenges, and neuropsychology and behavior. Conclusions This study provides the first systematic and rigorous comparison between 2 corpora of interests, in terms of lay representations and scientific research, regarding the significant increase in information available on autism spectrum disorder and of the difficulty to connect fragments of knowledge from the general population. The results suggest a clear distinction between the focus of topics used in the social media and that of scientific communities. This distinction highlights the importance of knowledge mobilization and exchange to better align research priorities with personal concerns and to address dimensions of well-being, adaptation, and resilience. Health care professionals and researchers can use these dimensions as a framework in their consultations to engage in discussions on issues that matter to beneficiaries and develop clinical approaches and research policies in line with these interests. Finally, our study can inform policy makers on the health and social needs and concerns of individuals with autism and their caregivers, especially to define health indicators based on important issues for beneficiaries.
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Affiliation(s)
- Christophe Gauld
- Department of Child Psychiatry, Université de Lyon, Lyon, France
| | - Julien Maquet
- Department of Internal Medicine, Toulouse University, Toulouse, France
| | | | - Guillaume Dumas
- Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL, United States.,Center of Research, Centre Hospitalier Universitaire Sainte Justine, Montréal, QC, Canada
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Philip P, Micoulaud-Franchi JA, Bioulac S, Taillard J, Guichard K, Dauvilliers Y, Bastien C, Sagaspe P. 0409 Self-perceived sleep during the Maintenance of Wakefulness Test: how does it predict accidental risk in patients with sleep disorders? Sleep 2022. [DOI: 10.1093/sleep/zsac079.406] [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 objective of this study is to determine whether the feeling of having slept or not during the Maintenance of Wakefulness Test (MWT) is associated with the occurrence of self-reported sleep-related traffic near misses and accidents in patients with sleep disorders.
Methods
This study was conducted in patients hospitalized in a French sleep center to perform a 4 × 40 min MWT. Relationship between mean sleep latency on the MWT, feeling of having slept or not during MWT trials and sleep-related near misses and accidents reported during the past year was analyzed.
Results
One hundred and ninety-two patients suffering from OSAS, idiopathic hypersomnia, narcolepsy, restless leg syndrome or insufficient sleep syndrome were included. One hundred and sixty-five patients presented no or one misjudgment of feeling of having slept during MWT trials while 27 presented more than two misjudgments. Almost half of the latter (48.1%) reported a sleepiness-related traffic near miss or accident in the past year versus only one third (27.9%) for the former (p < 0.05). Multivariate logistic regression showed that patients with more than two misjudgments had a 2.52-fold (95% CI, 1.07–5.95, p < 0.05) increase in the risk of reporting a sleepiness-related near miss/accident.
Conclusion
Misjudgment in self-perceived sleep during the MWT is associated with the occurrence of self-reported sleepiness-related traffic near misses and accidents in the past year in patients suffering from sleep disorders. Asking about the perception of the occurrence of sleep during the MWT could be used to improve driving risk assessment in addition to sleep latencies.
Support (If Any)
This was not an industry supported study. This project was supported by a grant from the French Sleep Society (SFRMS).
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Affiliation(s)
- Pierre Philip
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France
| | | | - Stéphanie Bioulac
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France
| | - Jacques Taillard
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France
| | - Kelly Guichard
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France
| | | | - Célyne Bastien
- CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Patricia Sagaspe
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France
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Coelho J, Micoulaud-Franchi JA, Nguyen D, Wiet AS, Taillard J, Philip P. 0046 Circadian misalignment is associated with Covid-19 infection. Sleep 2022. [PMCID: PMC9384125 DOI: 10.1093/sleep/zsac079.044] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Sleep disturbances are frequently reported in patients infected by Covid-19, but the role of sleep-wake behaviors as a risk factor to contract Covid-19 has up to now poorly been studied. The aim of this study was to explore the relationship between usual sleep-wake behaviors and the risk of Covid-19 infection in a population of subjects suspect of contact or infection with SARS-CoV-2. Methods Cross-sectionnal monocentric study set during a non-confined period in winter 2021. Recruitment took place in a Covid-19 ambulatory screening platform. Subjects between 18 and 45 years old were included whether they were symptomatic or not, healthcare workers or not, in contact with a Covid-19 case or not. They were asked about their usual sleep-wake behaviors. Usual sleep duration and sleep timing were explored during workdays and free days. Circadian misalignment was defined as at least 2 hours shift of circadian alignment (defined as the difference between mid‐sleep during workdays and mid‐sleep during free days, mid sleep as the middle between bedtime and getting up time). Results One thousand eighteen subjects were included in our study (acceptance rate: 10.8%, 39% of men, mean age of 28±8). Habitual mean sleep duration was equivalent in both groups (7h47 vs 7h49, p=0.733). Circadian misalignment greater than 2 hours concerned 33% of subjects in the Covid-19 group versus 20% of the control group (p=0.026). After adjustment on age, gender, BMI and work schedules, subjects presenting a circadian misalignment superior to 2 hours had 2.07 more chances to be tested positive than subjects which respected on identical sleep-wake timing between workdays and free days (OR=2.07, 95%CI= [1.12-3.80], p=0.024). Conclusion Altered sleep not only is present in subjects infected by Covid-19 but could be responsible of a higher change to be infected. Chronobiological impact on immune system and higher chances to be exposed to social contacts could explain our findings which deserve to be confirmed through a future large cohort study. Ultimately regular sleep-wake pattern could constitute a privileged prevention target to fight Covid-19 infection. Support (If Any)
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Micoulaud-Franchi JA, Kotwas I, Arthuis M, Soncin L, Rontani P, Daquin G, Cermolacce M, Bartolomei F, McGonigal A. Screening for epilepsy-specific anxiety symptoms: French validation of the EASI. Epilepsy Behav 2022; 128:108585. [PMID: 35180578 DOI: 10.1016/j.yebeh.2022.108585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/24/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES (1) To translate and validate the Epilepsy Anxiety Survey Instrument (EASI) in French people with epilepsy (PWE); (2) to further investigate the screening properties of each dimension of the EASI in terms of Diagnostic and Statistical Manual of Mental Disorders (DSM) anxiety disorders and of epilepsy-specific anxiety disorders, namely, anticipatory anxiety of seizures (AAS) and epileptic social phobia. METHODS Following back-translation, the French EASI was tested in PWE > 18 years using the Mini-International Neuropsychiatric Interview (MINI) as gold standard for DSM anxiety disorders. We added 3 original questions to explore epilepsy-specific anxiety symptoms. The Generalized Anxiety Disorders-7 (GAD-7), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and Adverse Events Profile were performed for external validity. Receiver operator characteristics (ROC) were analyzed. RESULTS One hundred and forty nine native French speakers with epilepsy were included. Concerning DSM disorders, around 25% had GAD, 18% Agoraphobia, and <10% Social Phobia or Panic Disorder. Concerning possible epilepsy-specific anxiety disorder, 35% had AAS and 38% had epileptic social phobia. Bi-dimensional structure of the EASI was confirmed. Internal and external validity was satisfactory. ROC analysis showed AUC of 0.83 for detection of GAD and AUC 0.79 for other DSM anxiety disorders. ROC analysis of the 8-item French brEASI showed good performance for detection of GAD (AUC 0.83) and other DSM anxiety disorders (AUC 0.76) but not for epilepsy-specific anxiety symptoms (AUC 0.63). Conversely, dimension 2 of the French EASI (=10 items) allowed good detection of epilepsy-specific anxiety symptoms (AUC 0.78); cutoff > 4, sensitivity 82.4, specificity 66.7. CONCLUSION Epilepsy-specific anxiety symptoms were prevalent, in around 60%. The French version of the EASI showed robust performance. The French 8-item brEASI allows screening for all DSM anxiety disorders with superior performance than the GAD-7, but is less suited to screening for epilepsy-specific anxiety. We propose the "Epilepsy-Specific Anxiety" (ESA) 10-item screening instrument, based on dimension 2 of the EASI, as a complementary clinical and research tool.
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Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Sleep Medicine Unit, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital of Bordeaux, 33 076 Bordeaux, France
| | - Iliana Kotwas
- APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
| | - Marie Arthuis
- APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
| | - Lisa Soncin
- APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
| | - Pauline Rontani
- APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
| | - Geraldine Daquin
- APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
| | - Michel Cermolacce
- University Department of Psychiatry, APHM, Sainte Marguerite Hospital, Marseille, France
| | - Fabrice Bartolomei
- APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France; Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Aileen McGonigal
- APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France; Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.
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Lopez R, Lefevre L, Barateau L, Micoulaud-Franchi JA, Dauvilliers Y, Schenck CH. A series of 8 cases of sleep-related psychogenic dissociative disorders and proposed updated diagnostic criteria. J Clin Sleep Med 2022; 18:563-573. [PMID: 34534064 PMCID: PMC8804993 DOI: 10.5664/jcsm.9654] [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] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES To identify the most relevant clinical and video-polysomnographic characteristics of patients with sleep-related dissociative disorders (SRDDs) and to propose a framework for new diagnostic criteria. METHODS We searched potential SRDD cases from the scientific literature and from a database of patients referred for clinical and video-polysomnographic assessment in a single sleep disorders center for disruptive nocturnal behaviors (n = 731). The most relevant clinical and neurophysiological characteristics of the cases were extracted and a descriptive analysis was performed. RESULTS Twenty-six SRDD cases (8 new and 18 previously published cases) were reviewed. Almost all cases of SRDDs occurred in a context of past traumatic events or abuse and were associated with at least 1 comorbid psychiatric disorder. We highlighted 4 relevant clinical characteristics of SRDD useful for the differential diagnosis with parasomnias: episodes of long duration of more than 1 hour (90.9%), self-inflicted injuries (83.3%), occurrence while awake close to bedtime (35.7%), and the presence of daytime dissociative symptoms (72.7%). The video-polysomnography documented typical episodes of SRDD with prolonged wakefulness before, during, and after the event in 11/26 cases. New diagnostic criteria for SRDD were proposed, with 3 levels of certainty for the diagnosis based on clinical, video-polysomnographic, and homemade video findings. CONCLUSIONS More than 30 years after its formal identification, SRDD is not currently recognized as an official diagnostic entity. We better delineate the clinical and neurophysiological features of SRDD and propose a framework for its reinstatement in the next revisions of the sleep and psychiatric disorders classifications. CITATION Lopez R, Lefevre L, Barateau L, Micoulaud-Franchi J-A, Dauvilliers Y, Schenck CH. A series of 8 cases of sleep-related psychogenic dissociative disorders and proposed updated diagnostic criteria. J Clin Sleep Med. 2022;18(2):563-573.
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Affiliation(s)
- Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy, Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France,Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, Montpellier, France,Address correspondence to: Régis Lopez, MD, PhD, Centre national de référence narcolepsie hypersomnies, Département de Neurologie, CHU de Montpellier, Hôpital Gui de Chauliac, 80, avenue Augustin Fliche, 34295 Montpellier Cedex 5, France; Tel: (33) 4 67 33 74 78; Fax: (33) 4 67 33 72 85;
| | - Lou Lefevre
- National Reference Centre for Orphan Diseases, Narcolepsy, Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Lucie Barateau
- National Reference Centre for Orphan Diseases, Narcolepsy, Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France,Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, Montpellier, France
| | - Jean-Arthur Micoulaud-Franchi
- Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France,USR CNRS 3413 SANPSY, University Hospital of Bordeaux, Bordeaux, France
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy, Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France,Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, Montpellier, France
| | - Carlos H. Schenck
- Minnesota Regional Sleep Disorders Center, Minneapolis, Minnesota,Department of Psychiatry, Hennepin County Medical Center, Minneapolis, Minnesota,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
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Martin VP, Rouas JL, Philip P, Fourneret P, Micoulaud-Franchi JA, Gauld C. How Does Comparison With Artificial Intelligence Shed Light on the Way Clinicians Reason? A Cross-Talk Perspective. Front Psychiatry 2022; 13:926286. [PMID: 35757203 PMCID: PMC9218339 DOI: 10.3389/fpsyt.2022.926286] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
In order to create a dynamic for the psychiatry of the future, bringing together digital technology and clinical practice, we propose in this paper a cross-teaching translational roadmap comparing clinical reasoning with computational reasoning. Based on the relevant literature on clinical ways of thinking, we differentiate the process of clinical judgment into four main stages: collection of variables, theoretical background, construction of the model, and use of the model. We detail, for each step, parallels between: i) clinical reasoning; ii) the ML engineer methodology to build a ML model; iii) and the ML model itself. Such analysis supports the understanding of the empirical practice of each of the disciplines (psychiatry and ML engineering). Thus, ML does not only bring methods to the clinician, but also supports educational issues for clinical practice. Psychiatry can rely on developments in ML reasoning to shed light on its own practice in a clever way. In return, this analysis highlights the importance of subjectivity of the ML engineers and their methodologies.
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Affiliation(s)
- Vincent P Martin
- Université de Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR5800, Talence, France.,Université de Bordeaux, CNRS, SANPSY, UMR6033, CHU de Bordeaux, Bordeaux, France
| | - Jean-Luc Rouas
- Université de Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR5800, Talence, France
| | - Pierre Philip
- Université de Bordeaux, CNRS, SANPSY, UMR6033, CHU de Bordeaux, Bordeaux, France.,University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France
| | - Pierre Fourneret
- Department of Child Psychiatry, Hospices Civils de Lyon, Lyon, France
| | - Jean-Arthur Micoulaud-Franchi
- Université de Bordeaux, CNRS, SANPSY, UMR6033, CHU de Bordeaux, Bordeaux, France.,University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France
| | - Christophe Gauld
- Department of Child Psychiatry, Hospices Civils de Lyon, Lyon, France.,IHPST, CNRS UMR 8590, Sorbonne University, Paris, France
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Gauld C, Fourneret P, Micoulaud-Franchi JA. Why Is Psychiatry so Intimately Linked to the Brain? Front Psychiatry 2022; 13:872957. [PMID: 35722577 PMCID: PMC9201069 DOI: 10.3389/fpsyt.2022.872957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/16/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Christophe Gauld
- Service de Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, Lyon, France.,UMR CNRS 8590 IHPST, Sorbonne University, Paris, France
| | - Pierre Fourneret
- Service de Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, Lyon, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Service of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
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Gauld C, Micoulaud-Franchi JA. Why could sleep medicine never do without polysomnography? J Sleep Res 2021; 31:e13541. [PMID: 34927296 DOI: 10.1111/jsr.13541] [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: 10/07/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 12/12/2022]
Abstract
Given the clinical, methodological, conceptual and modelling challenges within the field of sleep medicine, polysomnography (PSG) has emerged as a central diagnostic tool over time. It has been highly beneficial to clinical practice over the years, thanks to the scientific data that it provides. More recently, sleep medicine has sought answers in precision medicine, broadening its quest for biomarkers that take into account environmental factors, big data, and nosological refinement. However, despite these innovative developments that are relatively independent of PSG, sleep medicine remains intimately associated with the latter. The aim of this paper was to show the central role of PSG for sleep medicine. Indeed, PSG is central to sleep medicine, not only due to the empirical data it provides but also because it represents an obligatory passage point (OPP) within the discipline. It crystallizes debate, pulls disparate types of data together, and facilitates a common language for the different specialties involved in sleep medicine, thereby lending legitimacy and credibility to the specialty. Thus, the role of polysomnography as an OPP in the field of sleep medicine reinforces the discipline, especially because critics (e.g., of the Apnea Hypopnea Index) cannot easily find fault with it.
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Affiliation(s)
- Christophe Gauld
- Department of Child Psychiatry, Paedopsychiatry Service, University of Lyon, Lyon, France.,UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France
| | - Jean-Arthur Micoulaud-Franchi
- Services of Functional Exploration of the Nervous System, University Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
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Coelho J, Lopez R, Richaud A, Buysse DJ, Wallace ML, Philip P, Micoulaud-Franchi JA. Toward a multi-lingual diagnostic tool for the worldwide problem of sleep health: The French RU-SATED validation. J Psychiatr Res 2021; 143:341-349. [PMID: 34563876 DOI: 10.1016/j.jpsychires.2021.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Sleep health is "a multidimensional pattern of sleep-wakefulness, adapted to individual, social, and environmental demands, that promotes physical and mental well-being". The RU-SATED is a short practical self-reported symptom scale that is a reliable valid tool for the rapid evaluation of sleep health. This study sought to examine the psychometric validity of the French version. METHODS We conducted an observational cross-sectional study. All professionals working in Bordeaux University Hospital were asked to answer an internet-based questionnaire assessing sleep, mental and physical health outcomes. Sleep health was measured using the French RU-SATED scale obtained by a rigorous reverse translation process. Psychometric validity included factor structure, internal structural validity, concurrent validity and external validity of the measure, with sleep, mental and physical health outcomes. RESULTS A total of 1,562 participants were included with 80.5% of women and a mean age of 40.0 (±11.2). Sleep health was within the average range (M = 8.2, SD = 2.4) on the RU-SATED. Confirmatory factor analyses showed acceptable model fit measures. Cronbach's alpha coefficient was 0.57 and ranged from 0.46 to 0.58 when removing each item. The correlation between items with the overall corrected scores ranged from 0.19 to 0.43. The "Efficiency" item showed poor psychometric properties. Most items were highly correlated with their appropriate sleep outcome. All items showed a strong association with positive mental and physical health outcomes. DISCUSSION The French RU-SATED scale is a reliable valid tool for measuring sleep health in adults. Nevertheless, future studies should better evaluate the reliability and validity of the "Efficiency" item. It is also important to explore how the RU-SATED can be used to evaluate the impact of sleep hygiene strategies in promoting public health in accordance with models of sleep behavior change.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France.
| | - Régis Lopez
- Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Inserm, U1061, Université Montpellier 1, Montpellier, France
| | - Alexandre Richaud
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Pierre Philip
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
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Morin CM, Vézina-Im LA, Ivers H, Micoulaud-Franchi JA, Philip P, Lamy M, Savard J. Prevalent, Incident, and Persistent Insomnia in a Population-Based Cohort Tested Before (2018) and During the First-Wave of COVID-19 Pandemic (2020). Sleep 2021; 45:6410639. [PMID: 34698868 PMCID: PMC8574325 DOI: 10.1093/sleep/zsab258] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [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: 03/08/2021] [Revised: 06/24/2021] [Indexed: 11/26/2022] Open
Abstract
Study Objectives High rates of sleep and mental health problems have been reported during the COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This study documented rates of prevalent, incident, and persistent insomnia and psychological symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data (2018). Methods Data were derived from a longitudinal, population-based study of insomnia in Canada. When the first lockdown started in the province of Quebec, a subsample of participants who had completed the latest 2018 follow-up were surveyed (April to May 2020) about their sleep, insomnia, and psychological symptoms since the beginning of the pandemic. Prevalence, incidence, and persistence rates of insomnia, and severity of stress, anxiety, and depressive symptoms were estimated, as well as their associations with confinement, loneliness, social support, use of electronics, and other lifestyle changes occurring during the pandemic. A sleep/health survey and validated questionnaires of insomnia, sleep quality, stress, fatigue, anxiety, and depression were administered at both assessments. Results The sample consisted of 594 adults (mean age: 48.3 ± 13.1 years; 64.0% women). Prevalence of insomnia increased from 25.4% to 32.2% (symptoms) and from 16.8% to 19% (syndrome) from 2018 to 2020, for an overall 26.7% increase in insomnia rates. Of those classified as good sleepers in 2018 (n = 343), 32.6% (n = 112) had developed new insomnia during the COVID-19 pandemic. Among participants who had insomnia in 2018, the persistence rate was 76.5% 2 years later. There was a significant worsening of sleep quality, fatigue, anxiety, and depression (all ps < .005) during the COVID-19 pandemic compared to 2018. Significant associations were found between sleep and psychological symptoms and with living alone and being in confinement, lower social support, increased time using electronic devices, reduced physical exercise, and higher financial stress. Conclusions The COVID-19 pandemic is associated with significant increases in insomnia and psychological symptoms compared to the pre-pandemic period. Large scale public sleep and mental health intervention programs should be prioritized during and after a pandemic such as the COVID-19.
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Affiliation(s)
- Charles M Morin
- École de psychologie et Centre d'étude des troubles du sommeil, Université Laval, Québec, Canada.,Centre de recherche CERVO/BRAIN Research Center, Québec, Canada
| | - Lydi-Anne Vézina-Im
- École de psychologie et Centre d'étude des troubles du sommeil, Université Laval, Québec, Canada.,Centre de recherche CERVO/BRAIN Research Center, Québec, Canada
| | - Hans Ivers
- École de psychologie et Centre d'étude des troubles du sommeil, Université Laval, Québec, Canada.,Centre de recherche CERVO/BRAIN Research Center, Québec, Canada
| | - Jean-Arthur Micoulaud-Franchi
- Sleep Clinic, University Hospital of Bordeaux, 33 076 Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital of Bordeaux, 33 076 Bordeaux, France
| | - Pierre Philip
- Sleep Clinic, University Hospital of Bordeaux, 33 076 Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital of Bordeaux, 33 076 Bordeaux, France
| | - Manon Lamy
- École de psychologie et Centre d'étude des troubles du sommeil, Université Laval, Québec, Canada.,Centre de recherche CERVO/BRAIN Research Center, Québec, Canada
| | - Josée Savard
- École de psychologie et Centre d'étude des troubles du sommeil, Université Laval, Québec, Canada.,Centre de recherche du CHU de Québec
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Gauld C, Bartolomei F, Micoulaud-Franchi JA, McGonigal A. Symptom network analysis of anxiety and depression in epilepsy. Seizure 2021; 92:211-215. [PMID: 34600300 DOI: 10.1016/j.seizure.2021.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/11/2021] [Revised: 09/12/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE Anxiety symptoms and depressive symptoms are frequent in PWE and associated with poorer outcomes. Investigation of specific characteristics of anxiety and depressive symptoms in PWE is of interest. METHODS We used psychometric analyses in symptom networks using screening tools validated in PWE: Generalized Anxiety Disorder 7 (GAD-7) and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). We conducted an estimation to build the NDDIE and GAD-7 network, analyzed network inferences (especially centrality measures) and performed network robustness analyses as well as modularity-based community detection. RESULTS 145 PWE were included. The criteria with highest centrality was "Trouble relaxing" (G4) from the GAD-7, which represents a possible substantial symptom at the interface of anxiety and depressive comorbidities in epilepsy. Robustness was very moderate, despite results consistent with the literature. The two communities of nodes corresponded to criteria of the two scales. CONCLUSION Epilepsy is a unique model for studying psychiatric symptoms since correlation with cerebral mechanisms can be assessed. "Trouble relaxing" as a key symptom is of interest, since this relates to the "Arousal" construct of the RDoC. Limitations of this study are the number of patients, single population, limits of psychometric analysis and network analysis, and a moderate robustness. Nevertheless, arousal is linked to seizure control, and thus these observations are of relevance to future investigation of pathophysiological mechanisms of psychopathology in epilepsy.
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Affiliation(s)
- Christophe Gauld
- Department of Psychiatry, University of Grenoble, Avenue du Maquis du Grésivaudan, 38 000 Grenoble, France; UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France.
| | - Fabrice Bartolomei
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France; APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of functional exploration of the nervous system, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Aileen McGonigal
- Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France; APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France.
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Gauld C, Micoulaud-Franchi JA, Dumas G. Comment on Starke et al.: "Computing schizophrenia: ethical challenges for machine learning in psychiatry": From machine learning to student learning: pedagogical challenges for psychiatry - Corrigendum. Psychol Med 2021; 51:2514. [PMID: 33658093 DOI: 10.1017/s0033291721000684] [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] [Indexed: 11/06/2022]
Affiliation(s)
- Christophe Gauld
- Department of Psychiatry, University of Grenoble, Avenue du Maquis du Grésivaudan, 38 000 Grenoble, France
- UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of functional exploration of the nervous system, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France
- USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Guillaume Dumas
- Precision Psychiatry and Social Physiology Laboratory, CHU Sainte-Justine Research Center, Department of Psychiatry, University of Montreal, Quebec, Canada
- Human Brain and Behavior Laboratory, Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, Florida, USA
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Gauld C, Micoulaud-Franchi JA, Dumas G. Comment on Starke et al.: 'Computing schizophrenia: ethical challenges for machine learning in psychiatry': from machine learning to student learning: pedagogical challenges for psychiatry. Psychol Med 2021; 51:2509-2511. [PMID: 33087200 DOI: 10.1017/s0033291720003906] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Christophe Gauld
- Department of Psychiatry, University of Grenoble, Avenue du Maquis du Grésivaudan, 38 000Grenoble, France
- UMR CNRS 8590 IHPST, Sorbonne University, Paris1, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of functional exploration of the nervous system, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076Bordeaux, France
- USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Guillaume Dumas
- Precision Psychiatry and Social Physiology Laboratory, CHU Sainte-Justine Research Center, Department of Psychiatry, University of Montreal, Quebec, Canada
- Human Brain and Behavior Laboratory, Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, Florida, USA
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Gauld C, Lopez R, Morin CM, Maquet J, Mcgonigal A, Geoffroy PA, Fakra E, Philip P, Dumas G, Micoulaud-Franchi JA. Why do sleep disorders belong to mental disorder classifications? A network analysis of the "Sleep-Wake Disorders" section of the DSM-5. J Psychiatr Res 2021; 142:153-159. [PMID: 34359009 DOI: 10.1016/j.jpsychires.2021.07.050] [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: 03/02/2021] [Revised: 07/12/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
This article proposes to investigate how Sleep disorders have been conceptualized within the DSM-5 through symptom network analysis of the diagnostic criteria of the "Sleep-Wake Disorders" section in the DSM-5. We hypothesize that the analysis of the most central symptoms will allow us to better analyze the position of Sleep disorders in Mental disorders. We thus i) extracted the symptoms of the DSM-5 diagnostic criteria of Sleep-Wake disorders, ii) built the Sleep-Wake disorder DSM-5 network representation, and iii) quantified its structure at local and global levels using classical symptom network analysis. Thirty-four different symptoms were identified among the 53 DSM-5 diagnostic criteria of the 9 main disorders of the "Sleep-Wake Disorders" section. The symptom network structure of this section showed that the most central sleep symptoms are "Daytime Sleepiness", the Insomnia symptoms group ("Insomnia initiating", "Insomnia maintaining" and "Non-restorative sleep"), and Behavioral sleep symptoms (such as "Altered oniric activity", "Ambulation", "Abnormal responsiveness"). This network analysis shown that the belonging of Sleep-Wake disorders in the DSM-5 have been associated with central sleep symptoms considered as "Mental", given their phenomenality (qualitative nature of the experience) and subjectivity (in personal mental lives). Such a symptom network analysis can serve as an organizing framework to better understand the complexity of Sleep-Wake disorders by promoting research to connect the architecture of the symptom network to relevant biological, psychological and sociocultural factors.
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Affiliation(s)
- Christophe Gauld
- Department of Psychiatry, University of Grenoble, Avenue du Maquis du Grésivaudan, 38 000, Grenoble, France; UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France
| | - Régis Lopez
- Department of Psychiatry and Addictive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat, 46 rue Henri Huchard, 75018, Paris, France; Inserm, U1061, Université Montpellier 1, Montpellier, France
| | - Charles M Morin
- École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Quebec City, Canada
| | - Julien Maquet
- Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Centre d'investigation clinique 1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Aileen Mcgonigal
- Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Epileptology Department, Marseille, France
| | - Pierre-Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018, Paris, France; GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France; Université de Paris, NeuroDiderot, Inserm, F-75019, Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, F-67000, Strasbourg, France
| | - Eric Fakra
- Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France; INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric disorders: neuroscience Research and clinical Research, PSYR2 Team, Lyon, France
| | - Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076, Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital of Bordeaux, 33 076, Bordeaux, France
| | - Guillaume Dumas
- Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL, 33431, USA; Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076, Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital of Bordeaux, 33 076, Bordeaux, France.
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Martin VP, Rouas JL, Micoulaud-Franchi JA, Philip P, Krajewski J. How to Design a Relevant Corpus for Sleepiness Detection Through Voice? Front Digit Health 2021; 3:686068. [PMID: 34713156 PMCID: PMC8521834 DOI: 10.3389/fdgth.2021.686068] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/19/2021] [Indexed: 12/27/2022] Open
Abstract
This article presents research on the detection of pathologies affecting speech through automatic analysis. Voice processing has indeed been used for evaluating several diseases such as Parkinson, Alzheimer, or depression. If some studies present results that seem sufficient for clinical applications, this is not the case for the detection of sleepiness. Even two international challenges and the recent advent of deep learning techniques have still not managed to change this situation. This article explores the hypothesis that the observed average performances of automatic processing find their cause in the design of the corpora. To this aim, we first discuss and refine the concept of sleepiness related to the ground-truth labels. Second, we present an in-depth study of four corpora, bringing to light the methodological choices that have been made and the underlying biases they may have induced. Finally, in light of this information, we propose guidelines for the design of new corpora.
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Affiliation(s)
- Vincent P. Martin
- Laboratoire Bordelais de Recherche en Informatique, University of Bordeaux, CNRS–UMR 5800, Bordeaux INP, Talence, France
| | - Jean-Luc Rouas
- Laboratoire Bordelais de Recherche en Informatique, University of Bordeaux, CNRS–UMR 5800, Bordeaux INP, Talence, France
| | | | - Pierre Philip
- Sommeil, Addiction et Neuropsychiatrie, University of Bordeaux, CNRS–USR 3413, CHU Pellegrin, Bordeaux, France
| | - Jarek Krajewski
- Engineering Psychology, Rhenish University of Applied Science, Cologne, Germany
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Dupuy L, Morin CM, de Sevin E, Taillard J, Salles N, Bioulac S, Auriacombe M, Micoulaud-Franchi JA, Philip P. Smartphone-based virtual agents and insomnia management: A proof-of-concept study for new methods of autonomous screening and management of insomnia symptoms in the general population. J Sleep Res 2021; 31:e13489. [PMID: 34535942 DOI: 10.1111/jsr.13489] [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] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/06/2021] [Accepted: 09/06/2021] [Indexed: 01/23/2023]
Abstract
Insomnia is the most frequent sleep disorder, and the COVID-19 crisis has massively increased its prevalence in the population, due to psychosocial stress or direct viral contamination. KANOPEE_2 is a smartphone-based application that provides interactions with a virtual agent to autonomously screen and alleviate insomnia symptoms through an intervention programme giving personalized advices regarding sleep hygiene, relaxation techniques and stimulus-control. In this proof-of-concept study, we tested the effects of KANOPEE_2 among users from all over the country (France) who downloaded the app between 1 June and 26 October 2020 (to focus on effects after the end of COVID-19 confinement). Outcome measures include insomnia severity (Insomnia Severity Index) and sleep/wake schedules measured by a sleep diary. One-thousand and thirty-four users answered the screening interview (Mage = 43.76 years; SD = 13.14), and 108 completed the two-step programme (Mage = 46.64 years; SD = 13.63). Of those who answered the screening, 42.8% did not report sleep complaints, while 57.2% presented mild-to-severe insomnia symptoms. At the end of the intervention, users reported significantly fewer sleep complaints compared with the beginning of the intervention (Insomnia Severity Indexbeginning = 13.58; Insomnia Severity Indexend = 11.30; p < 0.001), and significantly increased their sleep efficiency (sleep efficiencybeginning = 76.46%; sleep efficiencyend = 80.17%; p = 0.013). KANOPEE_2 is a promising solution both to provide autonomous evaluation of individuals' sleep hygiene and reduce insomnia symptoms over a brief and simple intervention. These results are very encouraging for addressing the issue of insomnia management in people exposed to major psychosocial stress and the consequences of COVID-19 infection.
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Affiliation(s)
- Lucile Dupuy
- Université de Bordeaux, SANPSY USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France
| | - Charles M Morin
- École de psychologie, Université Laval, Québec, Québec, Canada.,Centre d'étude des troubles du sommeil, Centre de recherche CERVO, Institut universitaire en santé mentale de Québec, Québec, Québec, Canada
| | - Etienne de Sevin
- Université de Bordeaux, SANPSY USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France
| | - Jacques Taillard
- Université de Bordeaux, SANPSY USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France
| | - Nathalie Salles
- Université de Bordeaux, SANPSY USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France
| | - Stéphanie Bioulac
- Université de Bordeaux, SANPSY USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France.,Service de médecine universitaire du sommeil, CHU de Bordeaux, Bordeaux, France
| | - Marc Auriacombe
- Université de Bordeaux, SANPSY USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Université de Bordeaux, SANPSY USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France.,Service de médecine universitaire du sommeil, CHU de Bordeaux, Bordeaux, France
| | - Pierre Philip
- Université de Bordeaux, SANPSY USR 3413, Bordeaux, France.,CNRS, SANPSY, USR 3413, Bordeaux, France.,Service de médecine universitaire du sommeil, CHU de Bordeaux, Bordeaux, France
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Gauld C, Lopez R, Geoffroy PA, Morin CM, Guichard K, Giroux É, Dauvilliers Y, Dumas G, Philip P, Micoulaud-Franchi JA. A systematic analysis of ICSD-3 diagnostic criteria and proposal for further structured iteration. Sleep Med Rev 2021; 58:101439. [DOI: 10.1016/j.smrv.2021.101439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022]
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45
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Gauld C, Lopez R, Morin C, Geoffroy PA, Maquet J, Desvergnes P, McGonigal A, Dauvilliers Y, Philip P, Dumas G, Micoulaud-Franchi JA. Symptom network analysis of the sleep disorders diagnostic criteria based on the clinical text of the ICSD-3. J Sleep Res 2021; 31:e13435. [PMID: 34269498 DOI: 10.1111/jsr.13435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/08/2021] [Accepted: 06/24/2021] [Indexed: 01/04/2023]
Abstract
The third edition of the International Classification of Sleep Disorders (ICSD-3) is the authoritative clinical text for the diagnosis of sleep disorders. An important issue of sleep nosology is to better understand the relationship between symptoms found in conventional diagnostic manuals and to compare classifications. Nevertheless, to our knowledge, there is no specific exhaustive work on the general structure of the networks of symptoms of sleep disorders as described in diagnostic manuals. The general aim of the present study was to use symptom network analysis to explore the diagnostic criteria in the ICSD-3 manual. The ICSD-3 diagnostic criteria related to clinical manifestations were systematically identified, and the units of analysis (symptoms) were labelled from these clinical manifestation diagnostic criteria using three rules ("Conservation", "Splitting", "Lumping"). A total of 37 of the 43 main sleep disorders with 160 units of analysis from 114 clinical manifestations in the ICSD-3 were analysed. A symptom network representing all individual ICSD-3 criteria and connections between them was constructed graphically (network estimation), quantified with classical metrics (network inference with global and local measures) and tested for robustness. The global measure of the sleep symptoms network shows that it can be considered as a small world, suggesting a strong interconnection between symptoms in the ICSD-3. Local measures show the central role of three kinds of bridge sleep symptoms: daytime sleepiness, insomnia, and behaviour during sleep symptoms. Such a symptom network analysis of the ICSD-3 structure could provide a framework for better systematising and organising symptomatology in sleep medicine.
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Affiliation(s)
- Christophe Gauld
- Department of Psychiatry, University of Grenoble, Grenoble, France.,UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France
| | - Régis Lopez
- Department of Neurology, Sleep Disorders Center, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,Inserm, Université Montpellier 1, Montpellier, U1061, France
| | - Charles Morin
- École de psychologie, Université Laval, Québec City, Québec, Canada.,Centre d'étude des troubles du sommeil, Institut Universitaire en Santé Mentale de Québec, Quebec City, Canada
| | - Pierre A Geoffroy
- Département de Psychiatrie et d'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France.,GHU Paris - Psychiatry and Neurosciences, Paris, France.,NeuroDiderot, Université de Paris, Paris, Inserm, France.,CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
| | - Julien Maquet
- Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Centre d'investigation clinique 1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Pierre Desvergnes
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France
| | - Aileen McGonigal
- Epileptology Department, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Aix Marseille University, Marseille, France
| | - Yves Dauvilliers
- Department of Neurology, Sleep Disorders Center, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,Inserm, Université Montpellier 1, Montpellier, U1061, France
| | - Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital of Bordeaux, Bordeaux, France
| | - Guillaume Dumas
- Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, Florida, USA.,Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital of Bordeaux, Bordeaux, France
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Chapron SA, Nourredine M, Dondé C, Haesebaert F, Micoulaud-Franchi JA, Geoffroy PA, Rolland B. Efficacy and safety of topiramate for reducing impulsivity: A transdiagnostic systematic review and meta-analysis of a common clinical use. Fundam Clin Pharmacol 2021; 36:4-15. [PMID: 34212434 DOI: 10.1111/fcp.12710] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/24/2021] [Indexed: 11/29/2022]
Abstract
Impulsivity is an important transdiagnostic feature of many psychiatric disorders, as well as a marker of poorer outcome. Topiramate is broadly used for reducing impulsivity in various neuropsychiatric disorders, but no systematic review or meta-analysis has ever explored whether evidence supports this clinical use. We conducted a systematic review and meta-analysis of the literature, using PubMed, PsycInfo and Cochrane databases. We included all studies assessing the efficacy of topiramate in adults with high levels of impulsivity, based on either psychometric or neuropsychological measures. Seven articles were included, involving 578 participants. Important heterogeneity in designs and quality features was observed. Topiramate lowered impulsivity levels in two of the studies that used the Barratt Impulsiveness Scale (BIS) (401 participants) and in one of the studies that used neuropsychological measures (63 participants). Four other studies found no effect of topiramate on impulsivity. A larger reduction in the BIS-11 overall score, with a mean difference of 2.57 (95% confidence interval -4.12 to -1.02), was found in the topiramate group than the placebo group using a random effects model. However, one study accounted for the major part (85.5%) of it, and most included studies presented a high risk of bias. The use of a self-assessment scale induced an additional risk of self-report bias. No clear-cut evidence was found for a transdiagnostic effectiveness of topiramate in reducing impulsivity levels. However, encouraging results were found in some specific disorders.
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Affiliation(s)
- Sophie-Athéna Chapron
- Academic Department of Addiction Medicine of Lyon (SUAL), Le Vinatier Hospital, Bron, France
| | - Mikail Nourredine
- Academic Department of Addiction Medicine of Lyon (SUAL), Le Vinatier Hospital, Bron, France
| | - Clément Dondé
- Department of Medicine, University Grenoble Alpes, Grenoble, France.,Psychiatry Department, University Hospital Grenoble Alpes, Grenoble, France.,INSERM U1216, Brain Behavior and Neuromodulation Team, Grenoble Institute Neuroscience, La Tronche, France
| | - Frédéric Haesebaert
- Faculty of Medicine Lyon-Est, University Claude Bernard Lyon 1, Lyon, France.,Department SUR-CL3R-PEPS, Le Vinatier Hospital, Bron, France
| | - Jean-Arthur Micoulaud-Franchi
- USR CNRS 3413 SANPSY, Pellegrin University Hospital, University of Bordeaux, France.,University Sleep Clinic, Services of functional exploration of the nervous system, University Hospital of Bordeaux, Bordeaux, France
| | - Pierre Alexis Geoffroy
- Department of Psychiatry and Addictive Medicine, University Hospital Bichat-Claude Bernard, Public Hospitals of Paris, Paris, France.,INSERM U1141, NeuroDiderot, Paris University, Paris, France
| | - Benjamin Rolland
- Academic Department of Addiction Medicine of Lyon (SUAL), Le Vinatier Hospital, Bron, France.,Academic Department of Addiction Medicine of Lyon (SUAL), Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.,INSERM U1028, CNRS UMR5292, PSY2R Team, Lyon Neuroscience Research Center, University Claude Bernard Lyon 1, Lyon, France
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Guichard K, Micoulaud-Franchi JA, Philip P, Taillard J. Sleep deprivation therapy to reset the circadian pacemaker in a non-24-hour sleep-wake disorder: a case report. J Clin Sleep Med 2021; 17:1503-1506. [PMID: 33792535 DOI: 10.5664/jcsm.9294] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
NONE Non-24-hour sleep-wake disorder is 1 of several chronic circadian rhythm sleep-wake disorders. It is defined as progressive daily shifts in sleep onset and wake times. It mainly affects patients who are sight-impaired, is relatively rare in sighted patients, and is difficult to treat, with no guidelines. This case report discusses non-24-hour sleep-wake disorder in a sighted young man who complained of alternating severe insomnia and excessive sleepiness, with a sleep agenda and actigraphic data showing a daily delay of approximately 2 hours. A novel therapy by total sleep deprivation followed by a combination of morning light therapy and nocturnal melatonin administration was efficient in stopping his free-running sleep-wake pattern both immediately and in the long term. The treatment combination for 6 months resulted in stable circadian entrainment to a 24-hour cycle. Compliance with chronotherapy was maintained over the course of follow-up.
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Affiliation(s)
- Kelly Guichard
- Clinique du Sommeil, Bordeaux University Hospital, Bordeaux, France.,Université de Bordeaux, Sommeil - addiction - neuropsychiatrie SANPSY, Bordeaux, France.,Nouvelle Clinique Bel Air, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Clinique du Sommeil, Bordeaux University Hospital, Bordeaux, France.,Université de Bordeaux, Sommeil - addiction - neuropsychiatrie SANPSY, Bordeaux, France.,Centre National de la Recherche Scientific (CNRS), unité de service et de recherche 3413, SANPSY, Bordeaux, France
| | - Pierre Philip
- Clinique du Sommeil, Bordeaux University Hospital, Bordeaux, France.,Université de Bordeaux, Sommeil - addiction - neuropsychiatrie SANPSY, Bordeaux, France.,Centre National de la Recherche Scientific (CNRS), unité de service et de recherche 3413, SANPSY, Bordeaux, France
| | - Jacques Taillard
- Université de Bordeaux, Sommeil - addiction - neuropsychiatrie SANPSY, Bordeaux, France.,Centre National de la Recherche Scientific (CNRS), unité de service et de recherche 3413, SANPSY, Bordeaux, France
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48
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Sagaspe P, Micoulaud-Franchi JA, Bioulac S, Taillard J, Guichard K, Bonhomme E, Dauvilliers Y, Bastien CH, Philip P. Self-perceived sleep during the Maintenance of Wakefulness Test: how does it predict accidental risk in patients with sleep disorders? Sleep 2021; 44:6309942. [PMID: 34173829 DOI: 10.1093/sleep/zsab159] [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: 12/08/2020] [Revised: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES To determine whether the feeling of having slept or not during the Maintenance of Wakefulness Test (MWT) is associated with the occurrence of self-reported sleep-related traffic near misses and accidents in patients with sleep disorders. METHODS This study was conducted in patients hospitalized in a French sleep center to perform a 4*40 min MWT. Relationship between mean sleep latency on the MWT, feeling of having slept or not during MWT trials and sleep-related near misses and accidents reported during the past year was analyzed. RESULTS 192 patients suffering from OSAS, idiopathic hypersomnia, narcolepsy, restless leg syndrome or insufficient sleep syndrome were included. 165 patients presented no or one misjudgment of feeling of having slept during MWT trials while 27 presented more than two misjudgments. Almost half of the latter (48.1%) reported a sleepiness-related traffic near miss or accident in the past year versus only one third (27.9%) for the former (P<.05). Multivariate logistic regression showed that patients with more than two misjudgments had a 2.52-fold (95% CI, 1.07-5.95, P<.05) increase in the risk of reporting a sleepiness-related near miss/accident. CONCLUSIONS Misjudgment in self-perceived sleep during the MWT is associated with the occurrence of self-reported sleepiness-related traffic near misses and accidents in the past year in patients suffering from sleep disorders. Asking about the perception of the occurrence of sleep during the MWT could be used to improve driving risk assessment in addition to sleep latencies.
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Affiliation(s)
- Patricia Sagaspe
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Stéphanie Bioulac
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jacques Taillard
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Kelly Guichard
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Emilien Bonhomme
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France
| | - Yves Dauvilliers
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France.,PSNREC, University of Montpellier, INSERM, Montpellier, France
| | - Célyne H Bastien
- School of Psychology, Laval University, Quebec, Canada.,CERVO Research Centre, Beauport, Quebec, Canada
| | - Pierre Philip
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
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49
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d'Incau E, Gauld C, Philip P, Micoulaud-Franchi JA. Sleep bruxism pulled between two worlds. J Sleep Res 2021; 30:e13351. [PMID: 33860556 DOI: 10.1111/jsr.13351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Emmanuel d'Incau
- Oral and Dental Medicine Department, University Hospital of Bordeaux, Bordeaux, France.,School of Dental Sciences, University of Bordeaux, Bordeaux, France
| | - Christophe Gauld
- Department of Psychopathology of Child and Adolescent Development, Neurological Hospital, Hospices Civils de Lyon, Bron, France.,UMR CNRS 8590 IHPST, Sorbonne University, Paris, France
| | - Pierre Philip
- University Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
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50
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Sanz-Arigita E, Daviaux Y, Joliot M, Dilharreguy B, Micoulaud-Franchi JA, Bioulac S, Taillard J, Philip P, Altena E. Brain reactivity to humorous films is affected by insomnia. Sleep 2021; 44:6193794. [PMID: 33772591 DOI: 10.1093/sleep/zsab081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/18/2020] [Revised: 03/15/2021] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES Emotional reactivity to negative stimuli has been investigated in insomnia, but little is known about emotional reactivity to positive stimuli and its neural representation. METHODS We used 3T fMRI to determine neural reactivity during the presentation of standardized short, 10-40-s, humorous films in insomnia patients (n=20, 18 females, aged 27.7 +/- 8.6 years) and age-matched individuals without insomnia (n=20, 19 females, aged 26.7 +/- 7.0 years), and assessed humour ratings through a visual analogue scale (VAS). Seed-based functional connectivity was analysed for left and right amygdala networks: group-level mixed-effects analysis (FLAME; FSL) was used to compare amygdala connectivity maps between groups. RESULTS fMRI seed-based analysis of the amygdala revealed stronger neural reactivity in insomnia patients than in controls in several brain network clusters within the reward brain network, without humour rating differences between groups (p = 0.6). For left amygdala connectivity, cluster maxima were in the left caudate (Z=3.88), left putamen (Z=3.79) and left anterior cingulate gyrus (Z=4.11), while for right amygdala connectivity, cluster maxima were in the left caudate (Z=4.05), right insula (Z=3.83) and left anterior cingulate gyrus (Z=4.29). Cluster maxima of the right amygdala network were correlated with hyperarousal scores in insomnia patients only. CONCLUSIONS Presentation of humorous films leads to increased brain activity in the neural reward network for insomnia patients compared to controls, related to hyperarousal features in insomnia patients, in the absence of humor rating group differences. These novel findings may benefit insomnia treatment interventions.
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Affiliation(s)
| | - Yannick Daviaux
- Sommeil, Addiction et Neuropsychiatrie, Univ. Bordeaux, USR, Bordeaux, France.,Sommeil, Addiction et Neuropsychiatrie, CNRS, USR, Bordeaux, France
| | - Marc Joliot
- Univ. Bordeaux, CNRS, IMN, UMR, Bordeaux, France.,CEA, IMN, UMR 5293, Groupe d'Imagerie Neurofonctionnelle, Bordeaux, France
| | | | - Jean-Arthur Micoulaud-Franchi
- Sommeil, Addiction et Neuropsychiatrie, Univ. Bordeaux, USR, Bordeaux, France.,Sommeil, Addiction et Neuropsychiatrie, CNRS, USR, Bordeaux, France
| | - Stéphanie Bioulac
- Sommeil, Addiction et Neuropsychiatrie, Univ. Bordeaux, USR, Bordeaux, France.,Sommeil, Addiction et Neuropsychiatrie, CNRS, USR, Bordeaux, France
| | - Jacques Taillard
- Sommeil, Addiction et Neuropsychiatrie, Univ. Bordeaux, USR, Bordeaux, France.,Sommeil, Addiction et Neuropsychiatrie, CNRS, USR, Bordeaux, France
| | - Pierre Philip
- Sommeil, Addiction et Neuropsychiatrie, Univ. Bordeaux, USR, Bordeaux, France.,Sommeil, Addiction et Neuropsychiatrie, CNRS, USR, Bordeaux, France
| | - Ellemarije Altena
- Sommeil, Addiction et Neuropsychiatrie, Univ. Bordeaux, USR, Bordeaux, France.,Sommeil, Addiction et Neuropsychiatrie, CNRS, USR, Bordeaux, France
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