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Fabbri M. Mindfulness, Subjective Cognitive Functioning, Sleep Timing and Time Expansion during COVID-19 Lockdown: A Longitudinal Study in Italy. Clocks Sleep 2023; 5:313-332. [PMID: 37366659 DOI: 10.3390/clockssleep5020024] [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: 04/08/2023] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023] Open
Abstract
During the COVID-19 lockdown, a distortion of time passage has been widely reported in association with a change in daily rhythm. However, several variables related to these changes have not been considered. The purpose of the present study was to assess the changes in dispositional mindfulness, time experience, sleep timing and subjective memory functioning. A longitudinal study was conducted on 39 Italian adults (53.85% males; 35.03 ± 14.02 years) assessing mindfulness, ad hoc questions of sleep habits during workdays and free days, chronotypes, subjective time experience, and memory functioning before (December 2019-March 2020) and during (April 2020-May 2020) the first Italian COVID-19 lockdown. Participants reported delayed sleep timing, a slowdown in the perception of the present time, a decrease of time pressure, and an increase in the feeling of time expansion/boredom. In addition to correlations between mindfulness, memory functioning, and subjective sleep duration during workdays, a mediation model showed that changes in the dispositional mindfulness determined a delay of bedtime during workdays through the mediation effect of increased feeling of time expansion/boredom. This finding highlighted the role of mindfulness in reducing the feeling of time expansion/boredom for regulating the sleep timing. The theoretical and practical implications of the findings are discussed.
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Affiliation(s)
- Marco Fabbri
- Department of Psychology, University of Campania "Luigi Vanvitelli", 81100 Caserta, CE, Italy
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2
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Calvello C, Fernandes M, Lupo C, Maramieri E, Placidi F, Izzi F, Castelli A, Pagano A, Mercuri N, Liguori C. Sleep architecture in drug-naïve adult patients with epilepsy: Comparison between focal and generalized epilepsy. Epilepsia Open 2023; 8:165-172. [PMID: 36529529 PMCID: PMC9978090 DOI: 10.1002/epi4.12687] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Sleep impairment is one of the most common comorbidities affecting people with epilepsy (PWE). The bidirectional relation between epilepsy and sleep has been widely established. Several studies investigated subjective sleep quality and daytime vigilance in PWE, highlighting frequent complaints of sleep fragmentation, difficulties in falling asleep, and daytime sleepiness. The present study aimed to evaluate sleep structure in drug-naive PWE, distributed on the basis of epilepsy type, and compared with controls. METHODS This observational study included adult patients newly diagnosed with epilepsy and drug-naive as well as a control group of healthy subjects. All PWE and controls underwent a dynamic 24-h EEG with signals for sleep recording to evaluate sleep architecture, structure, continuity, and fragmentation. RESULTS Twenty-four PWE were included and distributed in two groups based on epilepsy type. Eleven patients were included in the generalized epilepsy group (63.6% male; 34.91 ± 9.80 years) and 13 patients in the focal epilepsy group (53.8% male; 38.69 ± 12.74 years). The control group included 16 subjects (56.3% male; 32.75 ± 12.19 years). Patients with generalized or focal epilepsy had a significantly lower sleep efficiency than controls. Moreover, both patient groups presented the alteration of markers of sleep fragmentation and loss of continuity, with higher indices of sleep stage transitions and arousal. Finally, the two patient groups presented less REM sleep than controls. SIGNIFICANCE This study highlighted the alteration of sleep quality, continuity, and stability in both patients with focal or generalized epilepsy compared with controls, also in the absence of ictal events. This sleep impairment resulted in the reduction of REM sleep. Therefore, these findings may be explained by the increase in awakenings and sleep stage shifts, which may be attributed to both sleep networks impairment and neurotransmission dysfunction in PWE, and also possibly triggered by paroxysmal interictal abnormalities.
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Affiliation(s)
- Carmen Calvello
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Mariana Fernandes
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Clementina Lupo
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Elena Maramieri
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Fabio Placidi
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
- Epilepsy Centre, Neurology UnitUniversity Hospital Tor VergataRomeItaly
| | - Francesca Izzi
- Epilepsy Centre, Neurology UnitUniversity Hospital Tor VergataRomeItaly
| | | | - Andrea Pagano
- Epilepsy Centre, Neurology UnitUniversity Hospital Tor VergataRomeItaly
| | | | - Claudio Liguori
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
- Epilepsy Centre, Neurology UnitUniversity Hospital Tor VergataRomeItaly
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3
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Conte F, Malloggi S, De Rosa O, Di Iorio I, Romano F, Giganti F, Ficca G. Sleep Continuity, Stability and Cyclic Organization Are Impaired in Insomniacs: A Case-Control Study. Int J Environ Res Public Health 2023; 20:1240. [PMID: 36673991 PMCID: PMC9859102 DOI: 10.3390/ijerph20021240] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
The possibility of distinguishing insomniacs from good sleepers based on polysomnography (PSG) remains an open question. While these groups show modest differences in traditional PSG parameters, some studies suggest that finer measures may be more useful. Here we assess differences between good sleepers (GS), poor sleepers (PS) and insomniacs (IN) in classical PSG measures as well as in sleep continuity, stability and cyclic organization. PSG-monitored sleep (two nights) of 17 IN (diagnosed through a standard clinical interview; Pittsburgh Sleep Quality Index (PSQI) ≥ 5, Insomnia Severity Index (ISI) > 14) was compared to that of 33 GS (PSQI < 5) and 20 PS (PSQI ≥ 5, ISI ≤ 14). Compared to GS, IN were impaired in sleep macrostructure (sleep latency, sleep efficiency, WASO%) and in continuity, stability and organization, whereas PS only showed disrupted continuity and stability. Spindle parameters were comparable between IN and GS, but the former displayed enhanced power in fast frequency bands. Our findings support the hypothesis of a continuum between individuals with self-reported poor sleep and insomniacs. Further, they add to extant data on impaired sleep continuity, stability and organization in poor sleepers and elderly individuals, underlining the utility of including these measures in standard sleep assessments.
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Affiliation(s)
- Francesca Conte
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy
| | - Serena Malloggi
- Department NEUROFARBA, University of Firenze, Via di San Salvi 12, 50135 Firenze, Italy
| | - Oreste De Rosa
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy
| | - Ilaria Di Iorio
- Department NEUROFARBA, University of Firenze, Via di San Salvi 12, 50135 Firenze, Italy
| | - Federica Romano
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy
| | - Fiorenza Giganti
- Department NEUROFARBA, University of Firenze, Via di San Salvi 12, 50135 Firenze, Italy
| | - Gianluca Ficca
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy
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4
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Tubbs AS, Taneja K, Ghani SB, Nadorff MR, Drapeau CW, Karp JF, Fernandez FX, Perlis ML, Grandner MA. Sleep continuity, timing, quality, and disorder are associated with suicidal ideation and suicide attempts among college students. J Am Coll Health 2023:1-9. [PMID: 36596225 DOI: 10.1080/07448481.2022.2155828] [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: 03/27/2022] [Revised: 09/12/2022] [Accepted: 10/23/2022] [Indexed: 06/17/2023]
Abstract
Objective: To evaluate sleep continuity, timing, quality, and disorder in relation to suicidal ideation and attempts among college students. Participants: Eight hundred eighty-five undergraduates aged 18-25 in the southwestern United States. Methods: Participants completed questionnaires on sleep, suicide risk, mental health, and substance use. Differences in sleep variables were compared by lifetime and recent suicidal ideation and suicide attempts using covariate-adjusted and stepwise regression models. Results: A total of 363 (41.0%) individuals reported lifetime suicidal ideation, of whom 172 (47.4%) reported suicidal ideation in the last 3 months and 97 (26.7%) had attempted suicide in their lifetime. Sleep disturbances were prevalent among those with lifetime suicidal ideation or a lifetime suicide attempt. Insomnia was identified as the best predictor of recent suicidal ideation, but this relationship did not survive adjustment for covariates. Conclusions: Sleep continuity, quality, and sleep disorders are broadly associated with suicidal thoughts and behaviors among college students.
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Affiliation(s)
- Andrew S Tubbs
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Krishna Taneja
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Sadia B Ghani
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Mississippi, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Christopher W Drapeau
- Department of Health Policy and Management, School of Public Health, Indiana University, Indianapolis, Indiana, USA
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, Indiana, USA
| | - Jordan F Karp
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | | | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Michael A Grandner
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
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Brownlow JA, Miller KE, Ross RJ, Barilla H, Kling MA, Bhatnagar S, Mellman TA, Gehrman PR. The association of polysomnographic sleep on posttraumatic stress disorder symptom clusters in trauma-exposed civilians and veterans. Sleep Adv 2022; 3:zpac024. [PMID: 36171859 PMCID: PMC9510784 DOI: 10.1093/sleepadvances/zpac024] [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] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/15/2022] [Indexed: 01/29/2023]
Abstract
Study Objectives Self-reported sleep disturbance has been established as a risk factor and predictor for posttraumatic stress disorder (PTSD); however, less is known about the relationship between objective sleep and PTSD symptom clusters, and the specific role of hyperarousal. The present study examined the relationships between sleep continuity and architecture on PTSD symptom clusters. Methods Participants underwent two in-laboratory sleep studies to assess sleep continuity and architecture. They also completed the Clinician-Administered PTSD-IV scale and the Structured Clinical Interview for the DSM-IV to assess for PTSD diagnosis and other psychiatric disorders. Results Sleep continuity (i.e. total sleep time, sleep efficiency percent, wake after sleep onset, sleep latency) was significantly related to PTSD Cluster B (reexperiencing) symptom severity (R 2 = .27, p < .001). Sleep architecture, specifically Stage N1 sleep, was significantly associated with PTSD Cluster B (t = 2.98, p = .004), C (Avoidance; t = 3.11, p = .003), and D (Hyperarosual; t = 3.79, p < .001) symptom severity independently of Stages N2, N3, and REM sleep. REM sleep variables (i.e. REM latency, number of REM periods) significantly predicted Cluster D symptoms (R 2 = .17, p = .002). Conclusions These data provide evidence for a relationship between objective sleep and PTSD clusters, showing that processes active during Stage N1 sleep may contribute to PTSD symptomatology in civilians and veterans. Further, these data suggest that arousal mechanisms active during REM sleep may also contribute to PTSD hyperarousal symptoms.This paper is part of the War, Trauma, and Sleep Across the Lifespan Collection. This collection is sponsored by the Sleep Research Society.
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Affiliation(s)
- Janeese A Brownlow
- Corresponding author. Janeese A. Brownlow, Department of Psychology, Delaware State University, 1200 N DuPont Highway, Dover, DE 19901, USA.
| | - Katherine E Miller
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Richard J Ross
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Holly Barilla
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Mitchel A Kling
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Seema Bhatnagar
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Philip R Gehrman
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA,Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
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Soreca I, Conklin CA, Vella EJ, Salkeld RP, Joyce CJ, Mumma JM, Jakicic JM, Kupfer DJ. Can exercise alleviate sleep disturbances during acute nicotine withdrawal in cigarette smokers? Exp Clin Psychopharmacol 2022; 30:82-92. [PMID: 33119386 PMCID: PMC8415013 DOI: 10.1037/pha0000390] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Sleep disturbances, including insomnia (difficulty falling or staying asleep), are common nicotine withdrawal symptoms particularly during the initial stage of nicotine abstinence, and increase the likelihood of relapse within the first 4 weeks of quitting. Although clinically recognized as a key symptom of nicotine withdrawal, sleep disturbances are not addressed in the clinical guidelines for nicotine dependence treatment. Unfortunately, Nicotine Replacement Therapy (NRT) and other pharmacologic interventions do not attenuate withdrawal-provoked sleep disturbances, with several even exacerbating sleep disruption. The present study tested the impact of 30-min of daily moderate exercise, morning versus evening, on key polysomnographic indicators of sleep disturbances during initial 3 days (72 hr) of nicotine withdrawal. Forty-nine daily smokers (53% male) completed 3 separate abstinence periods, during which they completed either morning exercise, evening exercise, or a nonexercising magazine reading control condition. Order of condition was counterbalanced across subjects with a 1-week wash out in between each 3-day abstinence period. Exercise engagement mitigated several changes in sleep architecture associated with acute nicotine deprivation and other time-related effects on sleep, specifically frequency of arousals (B = -2.8, SE = .95; t(1271) = -3.0, p = .003) and reductions in sleep maintenance (B = .58, SE = .21; t(1270) = 2.8, p = .005). Additionally, smokers who reported greater perceived withdrawal severity had the longest latency to fall asleep but experienced the greatest attenuation of this effect following PM exercise. Overall, results suggest a role for exercise as an adjunct smoking cessation treatment to specifically target sleep disturbances during early acute nicotine withdrawal. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Isabella Soreca
- Pittsburgh Veterans Administration Healthcare System, Pittsburgh PA
| | | | | | | | | | - Joel M. Mumma
- University of Pittsburgh, Department of Psychiatry, Pittsburgh PA
| | - John M. Jakicic
- University of Pittsburgh, Department of Health and Physical Activity, Pittsburgh PA
| | - David J. Kupfer
- University of Pittsburgh, Department of Psychiatry, Pittsburgh PA
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Conte F, De Rosa O, Albinni B, Mango D, Coppola A, Malloggi S, Giangrande D, Giganti F, Barbato G, Ficca G. Learning Monologues at Bedtime Improves Sleep Quality in Actors and Non-Actors. Int J Environ Res Public Health 2021; 19:11. [PMID: 35010270 PMCID: PMC8750122 DOI: 10.3390/ijerph19010011] [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] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Several studies show that pre-sleep learning determines changes in subsequent sleep, including improvements of sleep quality. Our aims were to confirm this finding using a more ecological task (learning a theatrical monologue) and to investigate whether the effect is modulated by expertise. Using a mixed design, we compared polysomnographic recordings of baseline sleep (BL, 9-h TIB) to those of post-training sleep (TR, with the same TIB but preceded by the training session), in one group of actors (N = 11) and one of non-actors (N = 11). In both groups, TR appears reorganized and re-compacted by the learning session, as shown, among others, by a significant decrease of WASO%, awakenings, arousals, and state transitions and by a trend towards an increased number of complete cycles and total cycle time. Concerning memory performance, the number of synonyms produced was significantly higher in the morning relative to immediate recall. No between-groups differences emerged either for sleep or memory variables. Our data confirm pre-sleep learning's beneficial effect on sleep quality in an ecological context. While expertise appears not to influence memory-related sleep mechanisms, results on morning recall support the recent view that sleep's role in memory processes consists in trace "transformation" for adaptive purposes, rather than rote consolidation.
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Affiliation(s)
- Francesca Conte
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy; (O.D.R.); (B.A.); (D.M.); (A.C.); (D.G.); (G.B.); (G.F.)
| | - Oreste De Rosa
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy; (O.D.R.); (B.A.); (D.M.); (A.C.); (D.G.); (G.B.); (G.F.)
| | - Benedetta Albinni
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy; (O.D.R.); (B.A.); (D.M.); (A.C.); (D.G.); (G.B.); (G.F.)
| | - Daniele Mango
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy; (O.D.R.); (B.A.); (D.M.); (A.C.); (D.G.); (G.B.); (G.F.)
| | - Alessia Coppola
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy; (O.D.R.); (B.A.); (D.M.); (A.C.); (D.G.); (G.B.); (G.F.)
| | - Serena Malloggi
- Department Neurofarba, University of Firenze, Via di San Salvi 12, 50135 Firenze, Italy; (S.M.); (F.G.)
| | - Davide Giangrande
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy; (O.D.R.); (B.A.); (D.M.); (A.C.); (D.G.); (G.B.); (G.F.)
| | - Fiorenza Giganti
- Department Neurofarba, University of Firenze, Via di San Salvi 12, 50135 Firenze, Italy; (S.M.); (F.G.)
| | - Giuseppe Barbato
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy; (O.D.R.); (B.A.); (D.M.); (A.C.); (D.G.); (G.B.); (G.F.)
| | - Gianluca Ficca
- Department of Psychology, University of Campania L. Vanvitelli, Viale Ellittico 31, 81100 Caserta, Italy; (O.D.R.); (B.A.); (D.M.); (A.C.); (D.G.); (G.B.); (G.F.)
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Chen K, Lv Y, Long X, Liu W, Zhou J. The Association between Insomnia-like Sleep Pattern Changes and Cognitive Dysfunction: Possible Mechanism and Therapeutic Strategy. Curr Alzheimer Res 2021; 18:858-875. [PMID: 34875989 DOI: 10.2174/1567205018666211207095048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/10/2021] [Revised: 10/10/2021] [Accepted: 11/11/2021] [Indexed: 11/22/2022]
Abstract
The prevalence of sleep disorders and cognitive dysfunction has overwhelmingly increased, with insomnia and Alzheimer's disease (AD) being the most common form. A multitude of studies have linked the alterations in sleep continuity or sleep architecture with cognitive impairment bilaterally, but the management of disrupted sleep patterns in preclinical AD could be more beneficial since there is no cure for AD. This review mainly focuses on the altered sleep patterns in insomnia, and summarizes potential pathways underlying the relationship between insomnia and cognitive impairment, aiming to establish certain sleep pattern changes as biomarkers for cognitive decline and explore potential therapeutic targets based on evidence from research advances.
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Affiliation(s)
- Kangzhi Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha. China
| | - Yefan Lv
- Department of Neurology, Xiangya Hospital, Central South University, Changsha. China
| | - Xiaoyan Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha. China
| | - Weiping Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha. China
| | - Jinxia Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha. China
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Porteous M, Fogel S, Ray L, Hickie IB, Carpenter JS, Louati K, Robillard R. Increased spindle density correlates with sleep continuity improvements following an eight-week course of a melatonin agonist in people with depression: A proof-of-concept study with agomelatine. Eur J Neurosci 2021; 54:5112-5119. [PMID: 34089546 DOI: 10.1111/ejn.15340] [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: 12/03/2020] [Revised: 04/27/2021] [Accepted: 05/23/2021] [Indexed: 11/27/2022]
Abstract
Sleep fragmentation and reductions in sleep spindles have been observed in individuals with depression. Sleep spindles are known to play a protective role for sleep, and there are indications that melatonin agents can enhance spindles in healthy people. Whether agomelatine, a melatonin agonist indicated for the treatment of depression, may increase spindle density sufficiently to impact sleep continuity in people with depression remains unknown. This proof-of-concept study investigated changes in spindles following agomelatine intake in young adults with depression and assessed how they may relate to potential changes in sleep continuity and depressive symptoms. This study was based on an open-label design. Fifteen participants between 17 and 28 years of age (mean = 22.2; standard deviation [SD] = 3.4) with a diagnosis of a depressive disorder underwent polysomnography before and after an intervention including a 1 hr psychoeducation session centered on sleep and circadian rhythms, and an 8-week course of agomelatine (25-50 mg) with a guided sleep phase advance. Fast spindle density significantly increased from pre- to post-intervention. This increase in spindle density significantly correlated with a reduction in wake after sleep onset, and a similar trend was found with increased sleep efficiency. There was no significant correlation between spindle parameters and depressive symptoms. These findings suggest that agomelatine may contribute to enhanced sleep consolidation, possibly in part through the modulation of spindle production. This should be confirmed by larger randomized control trials.
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Affiliation(s)
- Meggan Porteous
- Sleep Research Unit, University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, Canada.,Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Stuart Fogel
- Sleep Research Unit, University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, Canada.,Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Laura Ray
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Joanne S Carpenter
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Khaoula Louati
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Rebecca Robillard
- Sleep Research Unit, University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, ON, Canada.,Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
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10
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Yap Y, Slavish DC, Taylor DJ, Bei B, Wiley JF. Bi-directional relations between stress and self-reported and actigraphy-assessed sleep: a daily intensive longitudinal study. Sleep 2021; 43:5586815. [PMID: 31608395 DOI: 10.1093/sleep/zsz250] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/13/2019] [Indexed: 11/15/2022] Open
Abstract
STUDY OBJECTIVES Stress is associated with poor and short sleep, but the temporal order of these variables remains unclear. This study examined the temporal and bi-directional associations between stress and sleep and explored the moderating role of baseline sleep complaints, using daily, intensive longitudinal designs. METHODS Participants were 326 young adults (Mage = 23.24 ± 5.46), providing >2,500 nights of sleep altogether. Prospective total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE) were measured using actigraphy and sleep diaries. Perceived stress was reported three times daily between: 11:00-15:00, 15:30-19:30, and 20:00-02:00. Sleep complaints were measured at baseline using the PROMIS sleep disturbance scale. Within- and between-person sleep and stress variables were tested using cross-lagged multilevel models. RESULTS Controlling for covariates and lagged outcomes, within-person effects showed that higher evening stress predicted shorter actigraphic and self-reported TST (both p < .01). Conversely, shorter actigraphic and self-reported TST predicted higher next-day stress (both p < .001). Longer self-reported SOL and WASO (both p < .001), as well as lower actigraphic (p < .01) and self-reported SE (p < .001), predicted higher next-day stress. Between-person effects emerged only for self-reported TST predicting stress (p < .01). No significant results were found for the moderating role of baseline sleep complaints. CONCLUSIONS Results demonstrated bi-directional relations between stress and sleep quantity, and a consistent direction of worse sleep quantity and continuity predicting higher next-day stress. Results highlighted within-individual daily variation as being more important than between-individual differences when examining sleep and daytime functioning associations.
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Affiliation(s)
- Yang Yap
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, Texas
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, Tucson, Arizona
| | - Bei Bei
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Joshua F Wiley
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
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Dorokhov VB, Tkachenko ON, Sakharov DS, Arsenyev GN, Taranov AO. [Effects of weak low-frequency electromagnetic field on sleep structure during daytime sleep]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:65-70. [PMID: 33580764 DOI: 10.17116/jnevro202112101165] [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: 11/17/2022]
Abstract
OBJECTIVE To test the hypothesis that weak electromagnetic fields of low frequencies (0.5-26 Hz) could affect daytime sleep features and structure. MATERIAL AND METHODS Parameters of daytime sleep continuity were compared in the study with counterbalanced control/exposition (40 min exposure to electromagnetic field at 1 Hz/0.004 μT) scheme in 22 healthy volunteers. Nonlinear regression model was used to assess daytime sleep continuity. RESULTS Exposure to a weak electromagnetic field of ultra-low frequency significantly improved the quality of sleep, assessed by the indicator of sleep continuity, namely, there were fewer transitions from the second and deeper stages of sleep to the first stage and to the state of wakefulness (p<0.0001). CONCLUSION The results can be used to develop non-pharmacological methods of sleep correction, as well as to improve the quality of short-term sleep and its positive effect on well-being, cognitive function and working capacity.
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Affiliation(s)
- V B Dorokhov
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
| | - O N Tkachenko
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
| | - D S Sakharov
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
| | - G N Arsenyev
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
| | - A O Taranov
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
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Osgood JM, Finan PH, Hinman SJ, So CJ, Quartana PJ. Combat exposure, post-traumatic stress symptoms, and health-related behaviors: the role of sleep continuity and duration. Sleep 2020; 42:5250906. [PMID: 30561746 DOI: 10.1093/sleep/zsy257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 11/29/2018] [Accepted: 12/14/2018] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES Aggression, substance misuse, and other health risk behaviors are common among combat veterans. We examined whether sleep quality and quantity predict the association between combat exposure, post-traumatic stress symptoms, and adverse health-related behaviors. METHODS Soldiers (N = 2420) from a brigade combat team completed surveys assessing combat experiences, and psychological and behavioral health factors, approximately 3 months following deployment to Afghanistan in 2011. RESULTS Respondents were 93.5% male; 73% were age 18-29 years old. The response rate was 80% (3076/3832); 94% (2876/3076) of the soldiers who attended the recruitment briefings consented to participate in this research. Complete data were available across the variables used in this study for up to 2420 soldiers. Sleep continuity disturbance accounted for the association of combat exposure with post-traumatic stress symptoms and aggression, alcohol use, and risky behavior. Moreover, for soldiers who reported sleep duration of <6 hr per day, the indirect association of combat exposure and post-traumatic stress on aggression, alcohol use, risky behavior, and opioid use was strongest. CONCLUSIONS This study is the first to model sleep problems as a predictor of the association between combat exposure and post-traumatic stress symptoms and frequently reported health-related behavior problems. Sleep disturbance is highly prevalent among Warfighters. While not fully preventable in operational contexts, these problems can be effectively mitigated postdeployment with appropriate policy and intervention resources. Improving the sleep characteristics of combat-exposed soldiers following deployment should reduce subsequent post-traumatic stress and related health compromising behavior, thereby enhancing force readiness.
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Affiliation(s)
- Jeffrey M Osgood
- Walter Reed Army Institute of Research, Center for Military Psychiatry and Neuroscience, Silver Spring, MD
| | | | - Sarah J Hinman
- Walter Reed Army Institute of Research, Center for Military Psychiatry and Neuroscience, Silver Spring, MD
| | - Christine J So
- Walter Reed Army Institute of Research, Center for Military Psychiatry and Neuroscience, Silver Spring, MD
| | - Phillip J Quartana
- Walter Reed Army Institute of Research, Center for Military Psychiatry and Neuroscience, Silver Spring, MD
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Cerasuolo M, Conte F, Cellini N, Fusco G, Giganti F, Malloggi S, Ficca G. The effect of complex cognitive training on subsequent night sleep. J Sleep Res 2019; 29:e12929. [PMID: 31651070 DOI: 10.1111/jsr.12929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/07/2019] [Revised: 08/03/2019] [Accepted: 09/13/2019] [Indexed: 11/30/2022]
Abstract
Using a nap design, we have recently shown that training at a complex cognitive task at bedtime improves objective sleep quality by reducing sleep fragmentation. In order to extend our findings to nighttime sleep, here we assess the impact of a multi-componential cognitive task at bedtime on the subsequent sleep episode of subjects reporting habitual bad sleep, allegedly characterized by high sleep fragmentation. In a within-subjects design, 20 subjective bad sleepers underwent polysomnographic recording in three conditions: (a) baseline sleep (BL); (b) post-training sleep (TR), preceded by a complex ecological task, i.e. a modified version of the word game Ruzzle; (c) post-active control sleep (AC), preceded by a control task. Sleep in TR was more organized (higher number of cycles and longer time spent in cycles) and showed lower microarousal frequency than in AC and BL. As for sleep continuity (total and brief awakening frequency) and other stability measures (state transition and functional uncertainty period frequency, time in functional uncertainty), both TR and AC showed significant improvements compared with BL. Arousal frequency was also reduced in TR relative to BL. Our results show a clear impact of cognitive training on subsequent night sleep, basically consisting of an increase in sleep continuity, stability and organization. In our sample of bad sleepers, these post-training changes end up representing a notable sleep improvement, also consistently reflected in subjective sleep quality perception. Therefore, ecological pre-sleep cognitive training should be further studied as an easily accessible complementary approach in standard therapies for sleep-disordered populations.
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Affiliation(s)
- Mariangela Cerasuolo
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Francesca Conte
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padova, Padova, Italy
| | - Giuseppina Fusco
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Fiorenza Giganti
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Firenze, Firenze, Italy
| | - Serena Malloggi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Firenze, Firenze, Italy
| | - Gianluca Ficca
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
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Matthews KA, Hall MH, Lee L, Kravitz HM, Chang Y, Appelhans BM, Swanson LM, Neal-Perry GS, Joffe H. Racial/ethnic disparities in women's sleep duration, continuity, and quality, and their statistical mediators: Study of Women's Health Across the Nation. Sleep 2019; 42:zsz042. [PMID: 30778560 PMCID: PMC6519910 DOI: 10.1093/sleep/zsz042] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/09/2019] [Accepted: 02/08/2019] [Indexed: 11/15/2022] Open
Abstract
STUDY OBJECTIVES To describe racial/ethnic differences in sleep duration, continuity, and perceived sleep quality in postmenopausal women and to identify statistical mediators of differences in sleep characteristics. METHODS Recruited from the observational Study of Women's Health Across the Nation (SWAN), 1,203 (548 white, 303 black, 147 Chinese, 132 Japanese, and 73 Hispanic; mean age 65 years, 97% postmenopausal) women participated in a week-long actigraphy and daily diary study in 2013-2015. Actigraphic measures of sleep duration and wake after sleep onset (WASO), and diary-rated sleep quality were averaged across the week. Candidate mediators included health-related variables; stress; and emotional well-being assessed up to 13 times across 18 years from baseline to sleep study. RESULTS Whites slept longer than other groups; the significant mediators were concurrent financial hardship and increasing number of stressors for Hispanics or Japanese versus whites. Whites had less WASO than blacks and Hispanics; significant mediators were concurrent number of health problems, physical inactivity, waist circumference, vasomotor symptoms, number of life stressors, and financial hardship, and increasing number of health problems from baseline to sleep study. Whites reported better sleep quality than blacks, Chinese, and Japanese; significant mediators were concurrent physical inactivity, vasomotor symptoms, positive affect, and depressive symptoms. CONCLUSIONS Sleep differences between blacks or Hispanics versus whites were mediated by health problems, number of stressors, and financial hardship, whereas sleep differences between Chinese or Japanese versus whites were mediated by emotional well-being. This is the first study using formal mediational approaches.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Laisze Lee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Howard M Kravitz
- Department of Psychiatry, Rush University Medical Center, Chicago, IL
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Yuefang Chang
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA
| | | | | | | | - Hadine Joffe
- Connors Center for Women’s Health and Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
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Datta AN, Trachsel D. [A Child's Sleep: A Book with Seven Seals? A Guide to Systematic Problem Identification and Solution]. Praxis (Bern 1994) 2019; 108:89-95. [PMID: 30722739 DOI: 10.1024/1661-8157/a003161] [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] [Indexed: 06/09/2023]
Abstract
A Child's Sleep: A Book with Seven Seals? A Guide to Systematic Problem Identification and Solution Abstract. The sleep of a child can be influenced and sometimes disturbed by many, often development-associated, phenomena. This results not only in a burden for the child, but regularly also for the parents, who in their need for help, often seek the advice of the attending physician. The child- and adolescent-specific questionnaire BEARS, which was developed by J. Owens and K. Mindell, allows the first diagnostic steps and classifications based on the most important symptoms such as bedtime problems, excessive daytime sleepiness, waking up at night, problems with regularity and sleep duration as well as nocturnal breathing disorders. The aim of this article is to show that important conclusions can be drawn in the everyday practice as to which symptoms need to be clarified how and how urgently, and which belong in the hands of a specialized sleep center.
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Affiliation(s)
- Alexandre N Datta
- 1 Abteilung für Neuro- und Entwicklungspädiatrie, Universitäts-Kinderspital beider Basel, Universität Basel
- 2 Zentrum für Schlafmedizin der Basler Universitätskliniken USB, UKBB, UPK, Basel
| | - Daniel Trachsel
- 2 Zentrum für Schlafmedizin der Basler Universitätskliniken USB, UKBB, UPK, Basel
- 3 Abteilung für pädiatrische Pneumologie und Intensivmedizin, Universitäts-Kinderspital beider Basel, Universität Basel
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Abstract
OBJECTIVE Physical activity benefits executive control, but the mechanism through which this benefit occurs is unclear. Sleep is a candidate mechanism given that it improves with exercise and has restorative effects on the prefrontal cortex. The present cross-sectional study examined the mediating role of sleep in the relationship between physical activity and executive control in young and older adults. PARTICIPANTS Young (n = 59) and older (n = 53) community-dwelling adults ages 21-30 and 55-80. METHODS Participants wore an accelerometer for one week to assess sleep efficiency, total sleep time, and physical activity, operationalized as metabolic equivalent of task (METs) during time spent awake. Cognition was assessed in the laboratory across multiple measures of executive control, memory recall, and processing speed. Mediation analyses tested the role of sleep efficiency in the cross-sectional relationship between METs and cognitive performance accounting for age, sex, and education. RESULTS METs were significantly associated with performance before, but not after accounting for covariates. METs were associated with sleep efficiency but not total sleep time. Sleep efficiency, but not total sleep time, mediated the relationship between METs and working memory, switching, verbal ability and fluency, and recall. Age group did not moderate the mediating role of sleep efficiency in the relationship between METs and performance. CONCLUSION Sleep efficiency is one pathway by which physical activity may be associated with executive control across young and older adults.
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Affiliation(s)
- Kristine A Wilckens
- a Department of Psychiatry , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania
| | - Kirk I Erickson
- b Department of Psychology , University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Mark E Wheeler
- c School of Psychology , Georgia Institute of Technology , Atlanta , Georgia
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Levendowski DJ, Ferini-Strambi L, Gamaldo C, Cetel M, Rosenberg R, Westbrook PR. The Accuracy, Night-to-Night Variability, and Stability of Frontopolar Sleep Electroencephalography Biomarkers. J Clin Sleep Med 2017; 13:791-803. [PMID: 28454598 PMCID: PMC5443740 DOI: 10.5664/jcsm.6618] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/11/2017] [Accepted: 03/22/2017] [Indexed: 12/21/2022]
Abstract
STUDY OBJECTIVES To assess the validity of sleep architecture and sleep continuity biomarkers obtained from a portable, multichannel forehead electroencephalography (EEG) recorder. METHODS Forty-seven subjects simultaneously underwent polysomnography (PSG) while wearing a multichannel frontopolar EEG recording device (Sleep Profiler). The PSG recordings independently staged by 5 registered polysomnographic technologists were compared for agreement with the autoscored sleep EEG before and after expert review. To assess the night-to-night variability and first night bias, 2 nights of self-applied, in-home EEG recordings obtained from a clinical cohort of 63 patients were used (41% with a diagnosis of insomnia/depression, 35% with insomnia/obstructive sleep apnea, and 17.5% with all three). The between-night stability of abnormal sleep biomarkers was determined by comparing each night's data to normative reference values. RESULTS The mean overall interscorer agreements between the 5 technologists were 75.9%, and the mean kappa score was 0.70. After visual review, the mean kappa score between the autostaging and five raters was 0.67, and staging agreed with a majority of scorers in at least 80% of the epochs for all stages except stage N1. Sleep spindles, autonomic activation, and stage N3 exhibited the least between-night variability (P < .0001) and strongest between-night stability. Antihypertensive medications were found to have a significant effect on sleep quality biomarkers (P < .02). CONCLUSIONS A strong agreement was observed between the automated sleep staging and human-scored PSG. One night's recording appeared sufficient to characterize abnormal slow wave sleep, sleep spindle activity, and heart rate variability in patients, but a 2-night average improved the assessment of all other sleep biomarkers. COMMENTARY Two commentaries on this article appear in this issue on pages 771 and 773.
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Affiliation(s)
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Sleep Disorders Center, Università Vita-Salute San Raffaele, Milan, Italy
| | - Charlene Gamaldo
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mindy Cetel
- Integrative Insomnia and Sleep Health Center, San Diego, California
| | - Robert Rosenberg
- Sleep Disorders Center of Prescott Valley, Prescott Valley, Arizona
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White KH, Rumble ME, Benca RM. Sex Differences in the Relationship Between Depressive Symptoms and Actigraphic Assessments of Sleep and Rest-Activity Rhythms in a Population-Based Sample. Psychosom Med 2017; 79:479-84. [PMID: 27922568 DOI: 10.1097/PSY.0000000000000434] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Depression is often associated with disruptions in sleep and circadian rhythms. We aimed to confirm these relationships via actigraphic assessment in a large, population-based sample and test whether sex moderates these relationships. METHODS A total of 418 participants (age = 35-85 years, mean [standard deviation] = 57.04 [11.47]) completed questionnaires and 1 week of actigraphy, used to calculate sleep and rest-activity statistics including mesor (mean activity level), amplitude (height of rhythm), and acrophase (time of day that rhythm peaks). RESULTS Depressive symptoms, assessed via Center for Epidemiologic Studies Depression Scale, were associated with disrupted sleep and rest-activity rhythms. Furthermore, men demonstrated longer sleep onset latency (SOL, B = -13.28, p < .001), longer wake time after sleep onset (B = -6.26, p < .01), lower sleep efficiency (B = 5.91, p < .001), and lower total sleep time (TST, B = 33.16, p < .001) than women. Sex moderated the relationship between depression and SOL, TST, mesor, and amplitude; sex-stratified models revealed that higher depression scores were associated with greater SOL (B = 1.05, p < .001) and less TST (B = -0.87, p < .10) for women with higher depressive symptoms, but lower mesor (B = -1.75, p < .01) and amplitude (B = -1.94, p < .01) for men with higher depressive symptoms. CONCLUSIONS Depressive symptoms were related to disrupted sleep continuity and rest-activity rhythms in this population-based sample; however, these relationships differed by sex. Women with greater depressive symptoms exhibited difficulty with sleep continuity, whereas men with greater depressive symptoms demonstrated disruption throughout the 24-hour rhythm.
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Roth T, Dauvilliers Y, Guinta D, Alvarez-Horine S, Dynin E, Black J. Effect of sodium oxybate on disrupted nighttime sleep in patients with narcolepsy. J Sleep Res 2016; 26:407-414. [PMID: 27807903 DOI: 10.1111/jsr.12468] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/16/2016] [Indexed: 12/01/2022]
Abstract
This post hoc analysis evaluated the dose-related effects of sodium oxybate on sleep continuity and nocturnal sleep quality in patients with narcolepsy-cataplexy. Polysomnography data, including shifts to Stage N1/Wake, were from a randomized, placebo-controlled trial of sodium oxybate. Patients were ≥16 years old with a diagnosis of narcolepsy including symptoms of cataplexy and excessive daytime sleepiness. Treatment was for 8 weeks with placebo or sodium oxybate 4.5, 6 or 9 g administered as two equally divided nightly doses. Relative to baseline, significant dose-dependent reductions in the number of shifts per hour from Stages N2/3/rapid eye movement and Stages N2/3 to Stage N1/Wake were observed at week 8 with sodium oxybate (P < 0.05); sodium oxybate 6- and 9-g doses also resulted in similar reductions in shifts per hour of rapid eye movement to Stage N1/Wake (both P < 0.05). Across all shift categories, the shift reductions with sodium oxybate 9 g were significantly greater than those observed with placebo (P < 0.05). Improvements from baseline in reported sleep quality were significantly greater with sodium oxybate 4.5 and 9 g at week 8 (P < 0.05). Correlations between change from baseline in number of shifts per hour to Stage N1/Wake and cataplexy frequency, patient-reported nocturnal sleep quality, and excessive daytime sleepiness assessed using the Epworth Sleepiness Scale were numerically highest for the sodium oxybate 9-g dose across all sleep stage shift categories. In these patients with narcolepsy, sodium oxybate showed improvements in the sleep continuity and nocturnal sleep quality that are characteristic of disrupted nighttime sleep (ClinicalTrials.gov identifier NCT00049803).
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Affiliation(s)
| | - Yves Dauvilliers
- National Reference Network for Narcolepsy, Sleep Disorder Center, Gui de Chauliac hospital, CHU Montpellier, INSERM, U1061, Montpellier, France
| | | | | | - Efim Dynin
- Jazz Pharmaceuticals, Palo Alto, CA, USA
| | - Jed Black
- Jazz Pharmaceuticals, Palo Alto, CA, USA.,Stanford Center for Sleep Research and Medicine, Redwood City, CA, USA
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Prather AA, Janicki-Deverts D, Hall MH, Cohen S. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep 2015; 38:1353-9. [PMID: 26118561 DOI: 10.5665/sleep.4968] [Citation(s) in RCA: 198] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/16/2015] [Indexed: 01/12/2023] Open
Abstract
STUDY OBJECTIVES Short sleep duration and poor sleep continuity have been implicated in the susceptibility to infectious illness. However, prior research has relied on subjective measures of sleep, which are subject to recall bias. The aim of this study was to determine whether sleep, measured behaviorally using wrist actigraphy, predicted cold incidence following experimental viral exposure. DESIGN, MEASUREMENTS, AND RESULTS A total of 164 healthy men and women (age range, 18 to 55 y) volunteered for this study. Wrist actigraphy and sleep diaries assessed sleep duration and sleep continuity over 7 consecutive days. Participants were then quarantined and administered nasal drops containing the rhinovirus, and monitored over 5 days for the development of a clinical cold (defined by infection in the presence of objective signs of illness). Logistic regression analysis revealed that actigraphy- assessed shorter sleep duration was associated with an increased likelihood of development of a clinical cold. Specifically, those sleeping < 5 h (odds ratio [OR] = 4.50, 95% confidence interval [CI], 1.08-18.69) or sleeping between 5 to 6 h (OR = 4.24, 95% CI, 1.08-16.71) were at greater risk of developing the cold compared to those sleeping > 7 h per night; those sleeping 6.01 to 7 h were at no greater risk (OR = 1.66; 95% CI 0.40-6.95). This association was independent of prechallenge antibody levels, demographics, season of the year, body mass index, psychological variables, and health practices. Sleep fragmentation was unrelated to cold susceptibility. Other sleep variables obtained using diary and actigraphy were not strong predictors of cold susceptibility. CONCLUSIONS Shorter sleep duration, measured behaviorally using actigraphy prior to viral exposure, was associated with increased susceptibility to the common cold.
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Affiliation(s)
- Aric A Prather
- Department of Psychiatry, University of California, San Francisco, CA
| | | | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Sheldon Cohen
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
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Moscou-Jackson G, Finan PH, Campbell CM, Smyth JM, Haythornthwaite JA. The effect of sleep continuity on pain in adults with sickle cell disease. J Pain 2015; 16:587-93. [PMID: 25842346 DOI: 10.1016/j.jpain.2015.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 02/18/2015] [Accepted: 03/20/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED This analysis examined the influence of quantifiable parameters of daily sleep continuity, primarily sleep duration and sleep fragmentation, on daily pain in adults with sickle cell disease. Seventy-five adults with sickle cell disease completed baseline psychosocial measures and daily morning (sleep) and evening (pain) diaries over a 3-month period. Mixed-effect modeling was used to examine daily between- and within-subjects effects of sleep continuity parameters on pain, as well as the synergistic effect of sleep fragmentation and sleep duration on pain. Results revealed that nights of shorter sleep duration and time in bed, increased fragmentation, and less efficient sleep (relative to one's own mean) were followed by days of greater pain severity. Further, the analgesic benefit of longer sleep duration was attenuated when sleep fragmentation was elevated. These results suggest that both the separate and combined effects of sleep duration and fragmentation should be considered in evaluating pain in adults with sickle cell disease. PERSPECTIVE Subjective parameters of sleep continuity (eg, sleep duration, fragmentation, and efficiency) predict clinical pain in individuals with sickle cell disease. Additionally, sleep duration should not be considered in isolation, and its association with pain may be qualified by sleep fragmentation. Research and practice should include assessments of both when addressing pain severity.
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Affiliation(s)
- Gyasi Moscou-Jackson
- Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, Maryland.
| | - Patrick H Finan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Joshua M Smyth
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania
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Coussens S, Baumert M, Kohler M, Martin J, Kennedy D, Lushington K, Saint D, Pamula Y. Movement distribution: a new measure of sleep fragmentation in children with upper airway obstruction. Sleep 2014; 37:2025-34. [PMID: 25325486 DOI: 10.5665/sleep.4264] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 06/24/2013] [Accepted: 05/17/2014] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To develop a measure of sleep fragmentation in children with upper airway obstruction based on survival curve analysis of sleep continuity. DESIGN Prospective repeated measures. SETTING Hospital sleep laboratory. PARTICIPANTS 92 children aged 3.0 to 12.9 years undergoing 2 overnight polysomnographic (PSG) sleep studies, 6 months apart. Subjects were divided into 3 groups based on their obstructive apnea and hypopnea index (OAHI) and other upper airway obstruction (UAO) symptoms: primary snorers (PS; n = 24, OAHI <1), those with obstructive sleep apnea syndrome (OSAS; n = 20, OAHI ≥1) and non-snoring controls (C; n = 48, OAHI <1). INTERVENTIONS Subjects in the PS and OSAS groups underwent tonsillectomy and adenoidectomy between PSG assessments. MEASUREMENTS AND RESULTS Post hoc measures of movement and contiguous sleep epochs were exported and analyzed using Kaplan-Meier estimates of survival to generate survival curves for the 3 groups. Statistically significant differences were found between these group curves for sleep continuity (P < 0.05) when using movement events as the sleep fragmenting event, but not if stage 1 NREM sleep or awakenings were used. CONCLUSION Using conventional indices of sleep fragmentation in survival curve analysis of sleep continuity does not provide a useful measure of sleep fragmentation in children with upper airway obstruction. However, when sleep continuity is defined as the time between gross body movements, a potentially useful clinical measure is produced.
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Affiliation(s)
- Scott Coussens
- School of Medical Sciences, University of Adelaide, Adelaide, Australia: Department of Respiratory and Sleep Medicine, Children, Youth and Women's Health Service, North Adelaide, Australia
| | - Mathias Baumert
- Cardiovascular Research Centre, Royal Adelaide Hospital and School of Medicine, University of Adelaide, Adelaide, Australia: Children's Research Centre, University of Adelaide, Adelaide, Australia
| | - Mark Kohler
- Children's Research Centre, University of Adelaide, Adelaide, Australia
| | - James Martin
- Department of Respiratory and Sleep Medicine, Children, Youth and Women's Health Service, North Adelaide, Australia
| | - Declan Kennedy
- Department of Respiratory and Sleep Medicine, Children, Youth and Women's Health Service, North Adelaide, Australia: Children's Research Centre, University of Adelaide, Adelaide, Australia
| | - Kurt Lushington
- School of Psychology, University of South Australia, Adelaide, Australia
| | - David Saint
- School of Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Yvonne Pamula
- Department of Respiratory and Sleep Medicine, Children, Youth and Women's Health Service, North Adelaide, Australia
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Lazowski LK, Townsend B, Hawken ER, Jokic R, du Toit R, Milev R. Sleep architecture and cognitive changes in olanzapine-treated patients with depression: a double blind randomized placebo controlled trial. BMC Psychiatry 2014; 14:202. [PMID: 25030264 PMCID: PMC4223523 DOI: 10.1186/1471-244x-14-202] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [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: 07/17/2013] [Accepted: 07/10/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Disturbance in sleep quality is a symptom of Major Depressive Disorder (MDD) and Bipolar Disorder (BD) and thus improving quality of sleep is an important aspect of successful treatment. Here, a prospective, double-blind, randomized, placebo-controlled study examined the effect of olanzapine (an atypical antipsychotic) augmentation therapy on sleep architecture, specifically slow wave sleep (SWS), in the treatment of depression. The effect of olanzapine augmentation therapy on other features of sleep (e.g., sleep continuity) and depression (e.g., illness severity and cognitive function) were also determined. METHODS Patients currently experiencing a major depressive episode and who were on a stable medication were included. Sleep architecture was measured by overnight ambulatory polysomnography. Illness severity was determined using the Montgomery-Asberg Depression Rating Scale (MADRS). Cognitive function was examined using Cambridge Neuropsychological Test Automated Battery (CANTAB): Spatial Working Memory (SWM), Spatial Span (SSP), and Reaction Time (RTI) tasks. Polysomnographs, clinical measures and cognitive tests were administered at baseline, after 2-4 days of treatment and after 28-31 days of treatment. Twenty-five patients participated in the study (N = 10, N = 15 for placebo and olanzapine treated groups respectively). RESULTS The primary objective of the study was to assess the objective (polysomnographic) changes in sleep quality, defined as changes in SWS, following olanzapine treatment for depression. Latency to but not duration of SWS was found to significantly differ between olanzapine- and placebo-treated participants (Hedge's g: 0.97, 0.13 respectively). A significant improvement in olanzapine-treated participants over placebo-treated participants was observed in secondary outcome measures, including sleep efficiency, total sleep time, and sleep latency. Secondary objectives assessed the subjective changes in sleep quality parameters and correlated them with measures of illness severity and changes in cognition. MADRS scores were significantly improved in olanzapine-treated participants over time but not more than placebo treatment. There was no significant difference between olanzapine- and placebo-treated participants in SWM, SSP or RTI tasks. CONCLUSIONS Olanzapine augmentation treatment generally did not improve SWS but did improve sleep continuity and depression. Olanzapine may be one of few medications that improve sleep continuity, thus directly targeting symptoms of depression. TRIAL REGISTRATION ClinicalTrials.gov, NCT00520507.
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Affiliation(s)
- Lauren K Lazowski
- Centre for Neuroscience Studies, Queen’s University, Kingston, Canada
| | - Ben Townsend
- Department of Psychology, Carleton University, Ottawa, Canada
| | - Emily R Hawken
- Centre for Neuroscience Studies, Queen’s University, Kingston, Canada,Department of Psychiatry, Queen’s University, 752 King Street West, Kingston, ON K7L 4X3, Canada
| | - Ruzica Jokic
- Department of Psychiatry, Queen’s University, 752 King Street West, Kingston, ON K7L 4X3, Canada
| | - Regina du Toit
- Department of Psychiatry, Queen’s University, 752 King Street West, Kingston, ON K7L 4X3, Canada
| | - Roumen Milev
- Department of Psychiatry, Queen's University, 752 King Street West, Kingston, ON K7L 4X3, Canada.
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Wilckens KA, Woo SG, Erickson KI, Wheeler ME. Sleep continuity and total sleep time are associated with task-switching and preparation in young and older adults. J Sleep Res 2014; 23:508-16. [PMID: 24697907 DOI: 10.1111/jsr.12148] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 08/14/2013] [Accepted: 02/20/2014] [Indexed: 01/05/2023]
Abstract
Ageing is associated with changes in sleep and decline executive functions, such as task-switching and task preparation. Given that sleep affects executive function, age-related changes in executive function may be attributable to changes in sleep. The present study used a sleep detection device to examine whether or not wake time after sleep onset and total sleep time moderated age differences in task-switching performance and participants' ability to reduce switch costs when given time to prepare. Participants were cognitively healthy [Mini Mental State Examination > 26] younger (n = 54; mean age = 22.9; 67.8% female) and older (n = 45; mean age 62.8; 71.1% female) adults. Using a task-switching paradigm, which manipulated preparation time, we found that smaller global switch costs were associated with lower wake time after sleep onset and longer total sleep time. Greater preparation effects on local switch costs and adoption of a task-set were associated with lower wake time after sleep onset, although this effect was significant only in older adults when stratified by age group. This association was independent of inhibition and working memory abilities. The lack of interactions between sleep and age group indicated that age differences in switch costs were not moderated by better sleep. Our results suggest that young and older adults may benefit similarly from lower wake time after sleep onset and longer total sleep time in overall performance, and individuals with less wake time after sleep onset are more likely to engage preparatory strategies to reduce switch costs and boost task-switching performance.
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Affiliation(s)
- Kristine A Wilckens
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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25
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Kline CE, Irish LA, Krafty RT, Sternfeld B, Kravitz HM, Buysse DJ, Bromberger JT, Dugan SA, Hall MH. Consistently high sports/exercise activity is associated with better sleep quality, continuity and depth in midlife women: the SWAN sleep study. Sleep 2013; 36:1279-88. [PMID: 23997360 DOI: 10.5665/sleep.2946] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To examine relationships between different physical activity (PA) domains and sleep, and the influence of consistent PA on sleep, in midlife women. DESIGN Cross-sectional. SETTING Community-based. PARTICIPANTS 339 women in the Study of Women's Health Across the Nation Sleep Study (52.1 ± 2.1 y). INTERVENTIONS None. MEASUREMENTS AND RESULTS Sleep was examined using questionnaires, diaries and in-home polysomnography (PSG). PA was assessed in three domains (Active Living, Household/Caregiving, Sports/Exercise) using the Kaiser Physical Activity Survey (KPAS) up to 4 times over 6 years preceding the sleep assessments. The association between recent PA and sleep was evaluated using KPAS scores immediately preceding the sleep assessments. The association between the historical PA pattern and sleep was examined by categorizing PA in each KPAS domain according to its pattern over the 6 years preceding sleep assessments (consistently low, inconsistent/consistently moderate, or consistently high). Greater recent Sports/Exercise activity was associated with better sleep quality (diary "restedness" [P < 0.01]), greater sleep continuity (diary sleep efficiency [SE; P = 0.02]) and depth (higher NREM delta electroencephalographic [EEG] power [P = 0.04], lower NREM beta EEG power [P < 0.05]), and lower odds of insomnia diagnosis (P < 0.05). Consistently high Sports/Exercise activity was also associated with better Pittsburgh Sleep Quality Index scores (P = 0.02) and higher PSG-assessed SE (P < 0.01). Few associations between sleep and Active Living or Household/Caregiving activity (either recent or historical pattern) were noted. CONCLUSION Consistently high levels of recreational physical activity, but not lifestyle- or household-related activity, are associated with better sleep in midlife women. Increasing recreational physical activity early in midlife may protect against sleep disturbance in this population.
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Affiliation(s)
- Christopher E Kline
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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26
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Conte F, Carobbi G, Errico BM, Ficca G. The effects of pre-sleep learning on sleep continuity, stability, and organization in elderly individuals. Front Neurol 2012; 3:109. [PMID: 22798956 PMCID: PMC3394199 DOI: 10.3389/fneur.2012.00109] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Accepted: 06/16/2012] [Indexed: 12/14/2022] Open
Abstract
Several studies have consistently shown that pre-sleep learning is associated to changes of sleep structure. Whereas previous research has mainly focused on sleep states, namely REM and NREM amount, very little attention has been paid to the hypothesis that pre-sleep learning might improve sleep continuity, stability, and cyclic organization, which are often impaired in aging. Thus, aim of this research was to assess, in a sample of 18 healthy elderly subjects, whether a memory task administered at bedtime would determine changes in any sleep parameter, with special regard to sleep continuity, stability, and organization. To this purpose, a baseline sleep (BL), i.e., a normal sleep with 9-h time in bed (TIB), was compared to a post-training sleep (TR), with the same TIB but preceded by an intensive training session. For the latter, a verbal declarative task was used, consisting in learning paired-word lists, rehearsed, and recalled for three times in a row. To control for individual learning abilities, subjects were administered several sets of lists with increasing difficulty, until they reached an error rate ≥20% at third recall. Relative to BL, TR shows a significant reduction in the frequency of brief awakenings, arousals, state transitions, "functional uncertainty" (FU) periods, and in the percentage of time in FU over total sleep time (TST). A significant increase in the number of complete cycles, total cycle time (TCT), and TCT/TST proportion was also found. All these changes are evenly distributed over the sleep episode. No sleep stage measure display significant changes, apart from a slight reduction in the percentage of Stage 1. Scores at retest are negatively correlated with both the frequency of arousals and of state transitions. Our data suggest that pre-sleep learning can yield a beneficial re-organizing effect on elderlies' sleep quality. The inverse correlation between recall scores and the measures of sleep continuity and stability provides further support to the role of these features in memory processes.
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Affiliation(s)
- F. Conte
- Department of Psychology, University of Naples IICaserta, Italy
| | - G. Carobbi
- Department of Psychology, University of Naples IICaserta, Italy
| | - B. M. Errico
- Department of Psychology, University of Naples IICaserta, Italy
| | - G. Ficca
- Department of Psychology, University of Naples IICaserta, Italy
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27
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Kravitz HM, Avery E, Sowers M, Bromberger JT, Owens JF, Matthews KA, Hall M, Zheng H, Gold EB, Buysse DJ. Relationships between menopausal and mood symptoms and EEG sleep measures in a multi-ethnic sample of middle-aged women: the SWAN sleep study. Sleep 2011; 34:1221-32. [PMID: 21886360 PMCID: PMC3157664 DOI: 10.5665/sleep.1244] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES Examine associations of vasomotor and mood symptoms with visually scored and computer-generated measures of EEG sleep. DESIGN Cross-sectional analysis. SETTING Community-based in-home polysomnography (PSG). PARTICIPANTS 343 African American, Caucasian, and Chinese women; ages 48-58 years; pre-, peri- or post-menopausal; participating in the Study of Women's Health Across the Nation Sleep Study (SWAN Sleep Study). INTERVENTIONS None. MEASUREMENTS AND RESULTS Measures included PSG-assessed sleep duration, continuity, and architecture, delta sleep ratio (DSR) computed from automated counts of delta wave activity, daily diary-assessed vasomotor symptoms (VMS), questionnaires to collect mood (depression, anxiety) symptoms, medication, and lifestyle information, and menopausal status using bleeding criteria. Sleep outcomes were modeled using linear regression. Nocturnal VMS were associated with longer sleep time. Higher anxiety symptom scores were associated with longer sleep latency and lower sleep efficiency, but only in women reporting nocturnal VMS. Contrary to expectations, VMS and mood symptoms were unrelated to either DSR or REM latency. CONCLUSIONS Vasomotor symptoms moderated associations of anxiety with EEG sleep measures of sleep latency and sleep efficiency and was associated with longer sleep duration in this multi-ethnic sample of midlife women.
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Affiliation(s)
- Howard M Kravitz
- Department of Psychiatry and 2Department of Preventive Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
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28
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Abstract
STUDY OBJECTIVES Sleep continuity is commonly assessed with polysomnographic measures such as sleep efficiency, sleep stage percentages, and the arousal index. The aim of this study was to examine whether the transition rate between different sleep stages could be used as an index of sleep continuity to predict self-reported sleep quality independent of other commonly used metrics. DESIGN AND SETTING Analysis of the Sleep Heart Health Study polysomnographic data. PARTICIPANTS A community cohort. MEASUREMENTS AND RESULTS Sleep recordings on 5,684 participants were deemed to be of sufficient quality to allow visual scoring of NREM and REM sleep. For each participant, we tabulated the frequency of transitions between wake, NREM sleep, and REM sleep. An overall transition rate was determined as the number of all transitions per hour sleep. Stage-specific transition rates between wake, NREM sleep, and REM sleep were also determined. A 5-point Likert scale was used to assess the subjective experience of restless and light sleep the morning after the sleep study. Multivariable regression models showed that a high overall sleep stage transition rate was associated with restless and light sleep independent of several covariates including total sleep time, percentages of sleep stages, wake time after sleep onset, and the arousal index. Compared to the lowest quartile of the overall transition rate (<7.76 events/h), the odds ratios for restless sleep were 1.27, 1.42, and 1.38, for the second (7.77-10.10 events/h), third (10.11-13.34 events/h), and fourth (≥13.35 events/h) quartiles, respectively. Analysis of stage-specific transition rates showed that transitions between wake and NREM sleep were also independently associated with restless and light sleep. CONCLUSIONS Assessing overall and stage-specific transition rates provides a complementary approach for assessing sleep continuity. Incorporating such measures, along with conventional metrics, could yield useful insights into the significance of sleep continuity for clinical outcomes.
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Affiliation(s)
- Alison Laffan
- Departments of
Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Brian Caffo
- Departments of
Biostatistics, Johns Hopkins University, Baltimore, MD
| | - Bruce J. Swihart
- Departments of
Biostatistics, Johns Hopkins University, Baltimore, MD
| | - Naresh M. Punjabi
- Departments of
Epidemiology, Johns Hopkins University, Baltimore, MD
- Departments of
Medicine, Johns Hopkins University, Baltimore, MD
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29
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Phillips B, Mannino DM. Do insomnia complaints cause hypertension or cardiovascular disease? J Clin Sleep Med 2007; 3:489-94. [PMID: 17803012 PMCID: PMC1978336] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE We prospectively investigated odds ratios (ORs) for development of hypertension or cardiovascular disease by endorsement of sleep complaints. METHODS The Atherosclerosis Risk in Communities (ARIC) Study is a prospective, population-based study of cardiovascular disease. Our study sample was 8757 ARIC participants without hypertension and 11,863 ARIC participants without cardiovascular disease at baseline. We applied multivariate regression analysis to predict the ORs of development of hypertension or cardiovascular disease over 6 years of follow-up by endorsement of symptoms of difficulty falling asleep (DFA), waking up repeatedly (SCD), awakening tired and fatigued (NRS), or combinations of these symptoms. We controlled for age, sex, alcohol intake, income, smoking, diabetes, heart disease, menopausal status, depression, educational level, Body Mass Index, respiratory symptoms, and pulmonary function. RESULTS Endorsement of all 3 sleep complaints predicted a slightly increased risk of cardiovascular disease (OR 1.5, 1.1-2.0) but not of hypertension. Endorsement of either DFA or SCA predicted slightly increased risk of hypertension (OR 1.2, 1.03-1.3) CONCLUSIONS The definition of insomnia affects its impact. A combination of 3 sleep complaints (DFA, SCD, NRS) predicted a slightly increased risk of cardiovascular disease but not hypertension, and a complaint of either DFA or SCD predicted increased hypertensive risk. It is not clear whether these modest and inconsistent effects are of clinical significance.
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Affiliation(s)
- Barbara Phillips
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY 50636-0284, USA.
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Abstract
STUDY OBJECTIVES There is accumulating evidence that the common cold produces impairments in psychomotor vigilance. This has led some investigators to hypothesize that such illnesses may also have disruptive effects on sleep. While several self-report studies suggest that viral illness may influence sleep parameters, no studies have assessed polysomnographically recorded sleep following viral infections. DESIGN Parallel control group comparison. SETTING Sleep laboratory in a large urban medical center. PARTICIPANTS Twenty-one men and women with susceptibility to the rhinovirus type 23. INTERVENTIONS Nasal inoculation with rhinovirus type 23. MEASUREMENTS Polysomnographically recorded sleep for five nights (2300-0700 h) post-viral inoculation. Twice daily (1030 and 1430 h) performance assessment during each experimental day using auditory vigilance and divided attention tasks. A multiple sleep latency test (MSLT) was performed daily for the duration of the study. RESULTS In symptomatic individuals, total sleep time decreased an average of 23 min, consolidated sleep decreased an average of 36 min, and sleep efficiency was reduced by an average of 5% during the active viral period (experimental days/nights 3-5) compared with the incubation period. Psychomotor performance was impaired. These changes were significantly greater than those observed in asymptomatic individuals. CONCLUSIONS The common cold can have detrimental effects on sleep and psychomotor performance in symptomatic individuals during the initial active phase of the illness.
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Affiliation(s)
- C L Drake
- Sleep Disorders and Research Center, Henry Ford Hospital, 2799 West Grand Boulevard, CFP3, Detroit, MI 48202, USA.
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