Left sidedness and sleep difficulty: the alinormal syndrome

Non-Right Handedness is Associated with More Time Awake After Sleep Onset and Higher Daytime Sleepiness Than Right Handedness: Objective (Actigraphic) and Subjective Data from a Large Community Sample

PURPOSE

Handedness has been linked to various physiological and pathological phenomena including memory function and psychiatric disorders. Also for sleep, several studies have reported associations. However, large-scale studies including a broad age span of participants and studies analyzing women and men separately are lacking.

METHODS

Therefore, objective sleep data were determined using at-home actigraphy from 1764 healthy participants (18 to 80 years, 908 women), averaging five consecutive nights. In addition, subjective sleep-related data were captured by self-report diaries, the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the Morningness-Eveningness-Questionnaire (MEQ). Handedness was determined with the Edinburgh Handedness Inventory (EHI) providing information on the direction (left vs right) and the degree of handedness (strong vs weak). To address the potential endocrine effects, premenopausal women (≤45 years) and postmenopausal women (≥55 years) were analyzed separately. This was also done for men.

RESULTS

The degree and direction of handedness were correlated with "wake after sleep onset" (WASO) in the total sample and all women (the more right-handed/lateralized the shorter WASO). In postmenopausal women, additionally, time in bed (TIB) and total sleep time (TST) were correlated. There were no other significant associations between an objective sleep variable and handedness. In both premenopausal women and >55-year-old men subjective quality of sleep (PSQI) was correlated with direction and degree of handedness (the more right-handed/lateralized the better). In the total sample and postmenopausal women, the degree and direction of handedness were negatively correlated with daytime sleepiness. The chronotype was not associated with handedness in any group.

CONCLUSION

While associations were not consistent in all groups, overall, right-handedness tended to be associated with better sleep and less daytime sleepiness. Handedness and sleep seemed to be differentially associated in women and men, being in line with endocrine interactions.

Sleep Behaviors and Handedness in Gifted and Non-Gifted Children

Patterns of sleep behaviors appear to differ across students with special needs including those classified with developmental disorders, attention-deficit/hyperactivity disorder, and autism. One understudied segment of the special needs population is that of gifted children, students who bring their own unique set of behavioral characteristics. In the present study, it was hypothesized that because of unique cognitive and socio-emotional intensities, gifted children would experience elevated levels of sleep disturbance in comparison to their non-gifted peers. Handedness was also surveyed for additional insight into cerebral organization. The study's participants were 35 gifted and 23 non-gifted students between the ages of 8-12. To measure sleep behaviors, data from the Child Sleep Habits Questionnaire (Abbreviated), Sleep Self-Report, and a sleep diary were collected. To assess handedness, the Edinburgh Handedness Inventory was administered. Results indicated that although gifted students did trend toward experiencing more sleep disturbance, when compared to non-gifted students, no significant differences were found in mean bedtime, hours slept, sleeping problems, or use of electronic devices before bedtime. In terms of handedness, gifted participants displayed more left-hand bias. Although no differences were found between sleep patterns of gifted vs. non-gifted children, this study adds to the limited evidential base on gifted children, handedness, and sleep. Additional research on sleep behaviors within this special needs cohort may be warranted.

Four meta-analyses across 164 studies on atypical footedness prevalence and its relation to handedness

Human lateral preferences, such as handedness and footedness, have interested researchers for decades due to their pronounced asymmetries at the population level. While there are good estimates on the prevalence of handedness in the population, there is no large-scale estimation on the prevalence of footedness. Furthermore, the relationship between footedness and handedness still remains elusive. Here, we conducted meta-analyses with four different classification systems for footedness on 145,135 individuals across 164 studies including new data from the ALSPAC cohort. The study aimed to determine a reliable point estimate of footedness, to study the association between footedness and handedness, and to investigate moderating factors influencing footedness. We showed that the prevalence of atypical footedness ranges between 12.10% using the most conservative criterion of left-footedness to 23.7% including all left- and mixed-footers as a single non-right category. As many as 60.1% of left-handers were left-footed whereas only 3.2% of right-handers were left-footed. Males were 4.1% more often non-right-footed compared to females. Individuals with psychiatric and neurodevelopmental disorders exhibited a higher prevalence of non-right-footedness. Furthermore, the presence of mixed-footedness was higher in children compared to adults and left-footedness was increased in athletes compared to the general population. Finally, we showed that footedness is only marginally influenced by cultural and social factors, which play a crucial role in the determination of handedness. Overall, this study provides new and useful reference data for laterality research. Furthermore, the data suggest that footedness is a valuable phenotype for the study of lateral motor biases, its underlying genetics and neurodevelopment.

Impact of right-handedness on anaesthetic sensitivity, intra-operative awareness and postoperative mortality

Anatomical, neurological and behavioural research has suggested differences between the brains of right- and non-right-handed individuals, including differences in brain structure, electroencephalogram patterns, explicit memory and sleep architecture. Some studies have also found decreased longevity in left-handed individuals. We therefore aimed to determine whether handedness independently affects the relationship between volatile anaesthetic concentration and the bispectral index, the incidence of definite or possible intra-operative awareness with explicit recall, or postoperative mortality. We studied 5585 patients in this secondary analysis of data collected in a multicentre clinical trial. There were 4992 (89.4%) right-handed and 593 (10.6%) non-right-handed patients. Handedness was not associated with (a) an alteration in anaesthetic sensitivity in terms of the relationship between the bispectral index and volatile anaesthetic concentration (estimated effect on the regression relationship -0.52 parallel shift; 95% CI -1.27 to 0.23, p = 0.17); (b) the incidence of intra-operative awareness with 26/4992 (0.52%) right-handed vs 1/593 (0.17%) non-right-handed (difference = 0.35%; 95% CI -0.45 to 0.63%; p = 0.35); or (c) postoperative mortality rates (90-day relative risk for non-right-handedness 1.19, 95% CI 0.76-1.86; p = 0.45). Thus, no change in anaesthetic management is indicated for non-right-handed patients.

Handedness and drinking behaviour

OBJECTIVES

A number of papers have investigated whether there is an association between handedness and alcohol consumption hypothesizing that alcoholism may be a consequence of atypical cerebral lateralization or a response to the stress involved in being a minority in a right-handed world. Research to date has mostly used small clinical samples, some without a comparison group. This paper exams this issue using a large population-based random sample.

DESIGN

A large multi-country data set of nationally representative samples of the non-institutional population aged 50 years and older from 12 European countries was used (N= 27,428). methods: Logistic regression was used to model the frequency with which individuals self-report the frequency of alcohol consumption. A series of models with differing numbers of potential confounders are estimated. The predictors of frequent and infrequent drinking are investigated separately.

RESULTS

After controlling for a number of confounders it is shown that left-handers do drink more often. However, this is due to them being less likely to drink rarely (less than once a month) or not at all.

CONCLUSIONS

The evidence suggests that while there is an association between left-handedness and frequency of alcohol consumption there is no reason to believe that it is associated with excessive alcohol consumption or risky drinking.

[Left-handedness and health]

Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.

Handedness Correlates with Actigraphically Measured Sleep in a Controlled Environment

The relationship between hand preference and duration of sleep was assessed in 40 healthy subjects using self-report estimates, sleep diaries, and wrist activity monitors during an uncontrolled 7-day at-home phase and during a controlled overnight stay in a sleep laboratory. Handedness was unrelated to any index of sleep duration when assessed in the unregulated home environment. In the controlled environment of the laboratory, however, greater right-hand dominance was positively correlated with more minutes of obtained sleep and greater sleep efficiency. Findings were consistent with previous reports which suggest measures of brain lateralization may be related to sleep and health but further suggest that these relationships may be easily obscured by extraneous environmental factors when assessed in an uncontrolled setting.

Why are some people left-handed? An evolutionary perspective

Since prehistoric times, left-handed individuals have been ubiquitous in human populations, exhibiting geographical frequency variations. Evolutionary explanations have been proposed for the persistence of the handedness polymorphism. Left-handedness could be favoured by negative frequency-dependent selection. Data have suggested that left-handedness, as the rare hand preference, could represent an important strategic advantage in fighting interactions. However, the fact that left-handedness occurs at a low frequency indicates that some evolutionary costs could be associated with left-handedness. Overall, the evolutionary dynamics of this polymorphism are not fully understood. Here, we review the abundant literature available regarding the possible mechanisms and consequences of left-handedness. We point out that hand preference is heritable, and report how hand preference is influenced by genetic, hormonal, developmental and cultural factors. We review the available information on potential fitness costs and benefits acting as selective forces on the proportion of left-handers. Thus, evolutionary perspectives on the persistence of this polymorphism in humans are gathered for the first time, highlighting the necessity for an assessment of fitness differences between right- and left-handers.

Home-recorded sleep architecture as a function of handedness II: Consistent right- versus consistent left-handers

Examination of individual differences in sleep architecture may help elucidate the mechanisms involved in sleep-related pathologies and cerebral processes involved in sleep. We (Propper et al., Brain Cogn. 2004;54:186-197) previously reported that degree or strength (i.e., inconsistent vs. consistent) of hand preference was more important than direction (i.e., left vs. right) of hand preference in examining sleep architecture-hand preference relationships. However, that study confounded direction and degree of hand preference; only 1 consistently left-handed individual was included in the consistently handed group. Here, we describe a comparison of the sleep of consistently left- versus consistently right-handed individuals. The basic pattern of results here and in previous work suggests that individual differences in sleep architecture are influenced by both degree and direction of handedness. Handedness differences in sleep architecture may reflect individual differences in cerebral organization on one hand and sleep stage mediated differences in cerebral interaction on the other.

An assessment of sleep architecture as a function of degree of handedness in college women using a home sleep monitor

The present study examined sleep architecture as a function of handedness in a population of undergraduate college women using a home sleep monitor. Compared to strongly handed individuals, participants with a tendency toward mixed-handedness had a shorter sleep latency and spent a greater percentage of their sleep period asleep and less awake. Increasing mixed-handedness was also associated with increased NREM; strong-handedness was associated with increased REM. Results are placed in a neurophysiological framework wherein corpus callosum mediated differences in interhemispheric interaction during Wake, REM, and NREM on the one hand, and individual differences in corpus callosum morphology and hemispheric communication as a function of handedness on the other, interact to result in handedness differences in sleep architecture.

Differences in language performance in variations of lateralization

Language proficiency was studied in 489 primary-school-aged children classified as extreme left-, extreme right-, mild left-, and mild right-handers on the basis of both hand-preference and hand-skill, using a test battery of seven measures. An ANOVA run on factor scores showed neither significant association of language proficiency with variations of lateralization regarding hand-preference and hand-skill nor differences in factor structure derived from a principal component analysis between extreme vs. mild hand-preference and hand-skill groups. Moreover, low language proficiency was not significantly associated with specific patterns of lateralization in hand-preference subgroups. In contrast, low language performers with poor hand-skill were significantly overrepresented both in the extreme left-handed group alone and when combined with the extreme right-handed, in comparison to mild left- and mild right-handed with respect to population. The data are not consistently accommodated by the theory of balanced polymorphism (mainly Annett, 1978, 1985 Annett & Manning, 1989 ). Alternately, factors such as lag of maturation ( Bishop, 1980, 1984, 1990a, 1990b ), delay of growth ( Geschwind & Galaburda, 1985b ), and developmental instability associated with unique patterns of variations in lateralization ( Yeo, Gangestad, & Daniel, 1993 ) are discussed as possible factors accounting for the present results.

Do left-handed competitors have an innate superiority in sports?

This study assessed handedness distributions among (a) sporting competitors (n = 1,112) and nonsporting university students (n = 1,112), (b) sporting competitors engaging in interactive (n = 576) and in noninteractive sports (n = 536), and (c) sporting competitors engaging in direct interactive (n = 219) and indirect interactive (n = 357) sports. Chi-squared showed that there were statistically significant differences in proportions of left-handed persons in (a) sporting competitors and nonsporting university students, (b) sporting competitors engaging in interactive and noninteractive sports, (c) sporting competitors engaging in interactive sports and nonsporting university students, and (d) sporting competitors engaging in direct interactive and indirect interactive sports. It appears that left-handers are more common among those who engage in competitive manual activities. This superiority of the left-handers may be fully explained by a consideration of tactical or strategic factors associated with handedness during sporting interactions. The results with important implications for the measurement and evaluation of handedness are discussed in the light of the current findings on laterality.

Consistency of hand use and sleep problems

In this study, we measured the relationship between the consistency of hand use and three symptoms of insomnia, i.e., delayed sleep onset, frequent awakenings during sleep, and trouble returning to sleep after an awakening. For each of these insomnia-related symptoms, university students who were classified as inconsistent in the use of their hands (n = 30) were significantly more likely to report problems than their consistent hand-use peers (n = 30). These data were discussed both in relation to the literature on handedness classification and sleep problems and the emerging literature on consistency of hand use and health-related problems.

Do the hands talk on mind's behalf? Differences in language ability between left- and right-handed children

Two hundred seventy children of school age, 135 of whom were left-handed and an equivalent number of whom were right-handed, have been examined in the present study using a test battery of nine language ability measures: Vocabulary, Similarities, Comprehension (WISC-R), Deductive Reasoning, Inductive Reasoning, Sentence Completion, Comprehension of Sentential Semantics, Comprehension of Syntax, and Text Processing. The data analysis has indicated that: (1) One-factor solution applies both to the right- and left-handed population according to Standard Error Scree Method (Zoski & Jurs, 1996) with regard to language ability measures. (2) Handedness discriminates between right-handers (superior) and left-handers (inferior) in language ability. (3) There have been subgroups of left-handed children who differ in language ability distribution compared with right-handed children according to Hierarchical Cluster Analysis. (4) Extreme versus mild bias to hand preference and hand skill do not differentiate performance subgroups neither within the left-handed nor within the right-handed main group. (5) Sex and familial sinistrality do not affect performance. The results are discussed in relation to (a) "human balanced polymorphism" theory advocated by Annett (mainly Annett, 1985, 1993a; Annett & Manning, 1989), (b) potential pathology (mainly Bishop, 1984, 1990a; Coren & Halpern, 1991; Satz, Orsini, Saslow & Henry, 1985) and "developmental instability" (Yeo, Gangestad & Daniel, 1993), and delay of left-hemisphere maturation in left-handed individuals (Geschwind & Galaburda, 1985a,b, 1987), by pointing out the strength and weaknesses of these theoretical approaches in accounting for the present data.

The prevalence of self-reported sleep disturbances in young adults

The prevalence of seven common patterns of sleep disturbance (delayed sleep onset, frequent wakenings, early wakening, waking tired, disrupted sleep, day napping and nightmares) was assessed in 2,782 young adults (age 17 to 30 years). Only 36% of the sample reported that they were completely free of any sleep disturbance. The data suggest that the various sleep complaints are relatively independent, with low intercorrelations. There were significant sex differences for some problems. Women were more likely to have nightmares, delayed sleep onset and frequent night wakenings, while males were more likely to engage in day napping. These data provide a measure of the prevalence of common sleep disorders and are presented in a format which should facilitate their use for comparative or normative purposes.

Handedness and sleep apnea

Left-handedness is associated with shorter life span. Many of the factors contributing to this higher mortality (eg, alcohol consumption, automobile accident, smoking) are the same as in patients with sleep apnea, who also have higher mortality than nonapneic controls. The authors hypothesized that (1) there is a higher prevalence of sinistrality in patients suspected of having sleep apnea than in the general population, and (2) left-handed persons with sleep apnea have a more severe disorder than right-handed ones. These hypotheses were tested in a prospective cohort of 970 patients referred to a sleep disorders center because of suspected sleep apnea. All patients underwent nocturnal polysomnography and measurements of blood pressure. Sixty-one patients were left-handed. The distribution of handedness as a function of age in this cohort was similar to that in the general population. There were 486 patients with an apnea/hypopnea index greater than 10; of these, 34 were left-handed, and 452 were right-handed. Oxygen saturation, blood pressure, age, smoking history, and body mass index were similar in both groups. Left-handed patients with sleep apnea had a significantly higher respiratory disturbance index (RDI) than the right-handed ones (52 +/- 30 vs 38 +/- 35 [p < 0.005]). Right-handed patients were distributed equally among RDI quartiles, but 41 percent of the left-handed patients were within the highest RDI quartile, compared to 12 percent within the lowest quartile. Sinistrality appears to be associated with more severe sleep apnea, which may help to explain the higher mortality seen among the left-handed persons.

Left-handedness and tongue-rolling ability

948 undergraduates at The Ohio State University were administered the 10-item Edinburgh Handedness Inventory and asked to indicate the extent to which they could turn up the sides of their tongues. Significantly fewer left-handers than right-handers (62.8% and 74.8%, respectively) reported being able to turn up either or both sides. Sex differences in tongue-rolling ability were also noted. Among the 403 men included in the final sample, 77.4% could roll their tongues, whereas only 69.7% of the 491 women could do so.