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Fattal D, Platti N, Hester S, Wendt L. Vivid dreams are associated with a high percentage of REM sleep: a prospective study in veterans. J Clin Sleep Med 2023; 19:1661-1668. [PMID: 37128719 PMCID: PMC10476037 DOI: 10.5664/jcsm.10642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/03/2023]
Abstract
STUDY OBJECTIVES Vivid dreams are dreams that feel real or are associated with dream enactment behavior. They are prevalent in veterans, especially in those with psychiatric disorders such as post-traumatic stress disorders. Such psychiatric disorders have known association with abnormalities in rapid eye movement (REM) sleep. Vivid dreams are also described in neurological conditions, such Lewy body dementias, which are also associated with REM sleep abnormality. Although vivid dreams occur in neuropsychiatric disorders that have REM sleep abnormalities, there are no studies that have directly investigated an association between vivid dreams and REM sleep. We sought to study vivid dreams and REM sleep in veterans. METHODS Veterans undergoing polysomnography at our hospital were invited to enroll. Participants completed a dream-related questionnaire the morning after their polysomnography. RESULTS We prospectively enrolled 505 veterans. After a night in the sleep laboratory, 196 of 504 (39%) reported experiencing a dream, and, of those, 117 of 190 (62%) described their dream as vivid. Discrepancies in patient totals are secondary to missing questionnaire data. Our novel finding is that participants with a high percentage of REM sleep (above 25%) were more than twice likely to report a vivid dream than participants with a lower percentage of REM sleep (P < .0001). Nonvivid dreams were not associated with a high percentage of REM sleep. CONCLUSIONS Vivid dreams are associated with a high percentage of REM sleep. Further research into the role of REM sleep abnormalities in vivid dreams may help to advance understanding of neuropsychiatric disorders. CITATION Fattal D, Platti N, Hester S, Wendt L. Vivid dreams are associated with a high percentage of REM sleep: a prospective study in veterans. J Clin Sleep Med. 2023;19(9):1661-1668.
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Affiliation(s)
- Deema Fattal
- Neurology Department, University of Iowa, Iowa City, Iowa
- Iowa City VA Medical Center, Iowa City, Iowa
| | - Nicole Platti
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa
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Reynolds AM, Spaeth AM, Hale L, Williamson AA, LeBourgeois MK, Wong SD, Hartstein LE, Levenson JC, Kwon M, Hart CN, Greer A, Richardson CE, Gradisar M, Clementi MA, Simon SL, Reuter-Yuill LM, Picchietti DL, Wild S, Tarokh L, Sexton-Radek K, Malow BA, Lenker KP, Calhoun SL, Johnson DA, Lewin D, Carskadon MA. Pediatric sleep: current knowledge, gaps, and opportunities for the future. Sleep 2023; 46:zsad060. [PMID: 36881684 PMCID: PMC10334737 DOI: 10.1093/sleep/zsad060] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/19/2023] [Indexed: 03/09/2023] Open
Abstract
This White Paper addresses the current gaps in knowledge, as well as opportunities for future studies in pediatric sleep. The Sleep Research Society's Pipeline Development Committee assembled a panel of experts tasked to provide information to those interested in learning more about the field of pediatric sleep, including trainees. We cover the scope of pediatric sleep, including epidemiological studies and the development of sleep and circadian rhythms in early childhood and adolescence. Additionally, we discuss current knowledge of insufficient sleep and circadian disruption, addressing the neuropsychological impact (affective functioning) and cardiometabolic consequences. A significant portion of this White Paper explores pediatric sleep disorders (including circadian rhythm disorders, insomnia, restless leg and periodic limb movement disorder, narcolepsy, and sleep apnea), as well as sleep and neurodevelopment disorders (e.g. autism and attention deficit hyperactivity disorder). Finally, we end with a discussion on sleep and public health policy. Although we have made strides in our knowledge of pediatric sleep, it is imperative that we address the gaps to the best of our knowledge and the pitfalls of our methodologies. For example, more work needs to be done to assess pediatric sleep using objective methodologies (i.e. actigraphy and polysomnography), to explore sleep disparities, to improve accessibility to evidence-based treatments, and to identify potential risks and protective markers of disorders in children. Expanding trainee exposure to pediatric sleep and elucidating future directions for study will significantly improve the future of the field.
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Affiliation(s)
| | - Andrea M Spaeth
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ariel A Williamson
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Monique K LeBourgeois
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Sachi D Wong
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Lauren E Hartstein
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Jessica C Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Misol Kwon
- Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - Chantelle N Hart
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
- The Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ashley Greer
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Cele E Richardson
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | | | - Michelle A Clementi
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stacey L Simon
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lilith M Reuter-Yuill
- Comprehensive Speech and Therapy Center, Western Michigan University, Kalamazoo, MI, USA
| | - Daniel L Picchietti
- University of Illinois School of Medicine, Carle Illinois College of Medicine, Carle Foundation Hospital, and University of Illinois School of Medicine, Urbana, IL, USA
| | - Salome Wild
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Leila Tarokh
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Beth A Malow
- Departments of Neurology and Pediatrics, Burry Chair in Cognitive Childhood Development, Vanderbilt University Medical Center, Nashville, TN, USA
- Sleep Disorders Division, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristina P Lenker
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Daniel Lewin
- Department of Pulmonary and Sleep Medicine, Children’s National Hospital, Washington, DC, USA
| | - Mary A Carskadon
- Bradley Hospital Sleep Lab, Warren Alpert Medical School, Brown University, Providence, RI, USA
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Guo R, Vaughan DT, Rojo ALA, Huang YH. Sleep-mediated regulation of reward circuits: implications in substance use disorders. Neuropsychopharmacology 2023; 48:61-78. [PMID: 35710601 PMCID: PMC9700806 DOI: 10.1038/s41386-022-01356-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 12/11/2022]
Abstract
Our modern society suffers from both pervasive sleep loss and substance abuse-what may be the indications for sleep on substance use disorders (SUDs), and could sleep contribute to the individual variations in SUDs? Decades of research in sleep as well as in motivated behaviors have laid the foundation for us to begin to answer these questions. This review is intended to critically summarize the circuit, cellular, and molecular mechanisms by which sleep influences reward function, and to reveal critical challenges for future studies. The review also suggests that improving sleep quality may serve as complementary therapeutics for treating SUDs, and that formulating sleep metrics may be useful for predicting individual susceptibility to SUDs and other reward-associated psychiatric diseases.
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Affiliation(s)
- Rong Guo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- Allen Institute, Seattle, WA, 98109, USA
| | - Dylan Thomas Vaughan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Ana Lourdes Almeida Rojo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Yanhua H Huang
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA.
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA.
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Zhang F, Zhang B, Wang X, Huang C, Hu B. Effects of Tai Chi on insomnia in elderly people with chronic non-specific low back pain: A study protocol for a randomized controlled trial. Front Psychol 2023; 14:1105359. [PMID: 36910817 PMCID: PMC9998706 DOI: 10.3389/fpsyg.2023.1105359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/02/2023] [Indexed: 03/14/2023] Open
Abstract
Introduction Chronic non-specific low back pain (CNLBP) is a complex condition characterized by pain, dysfunction, disturbed sleep, anxiety, and depression, all of which impair the quality of life. Previous studies showed that practicing Tai Chi had effects on chronic low back pain. However, there is a lack of evidence on its impact on sleep. The trial will evaluate the use of Tai Chi as a treatment for insomnia in elderly people with CNLBP. Methods The study design will be a randomized, controlled, open-label trial. Participants (n = 106) will be recruited from the Hospital of Chengdu University of Traditional Chinese Medicine, Qing Yang District University for the Elderly, and Ci Tang Street Community. Participants will be randomly assigned to the Tai Chi group (n = 53) and the control group (n = 53). The Tai Chi group will undergo a Yang-style 24-form Tai Chi program for 8 weeks. The control group will have a waiting period of 8 weeks, followed by 8 weeks of Tai Chi practice. The primary outcomes of this study will be changes in sleep quality and pain intensity. Secondary outcomes of interest will include changes in the quality of pain, range of motion, physical performance, social support, and overall quality of life. Any adverse events and attendance rates will also be reported in this study. Clinical trial registration ChiCTR2200064977.
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Affiliation(s)
- Feng Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Boran Zhang
- Department of Physical Education, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaotong Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Chang Huang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Boyi Hu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Neitmann J, Hanke K, Humberg A, Siller B, Spiegler J, Juhnke K, Gilmore J, Odendahl R, Herting E, Göpel W, Härtel C, Fortmann I. Sleep problems in infancy and early school age in very preterm infants. Early Hum Dev 2022; 173:105656. [PMID: 35987047 DOI: 10.1016/j.earlhumdev.2022.105656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/10/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Sleep plays an important role for psychological and physical health, especially in infants at high risk for long-term neurodevelopmental impairment such as preterm infants. OBJECTIVE Our study aimed at determining risk factors for long-term sleep impairment in very-preterm (VPT; <32 weeks of gestation) infants. METHODS Sleep problems were analyzed in an observational study in infants of the German Neonatal Network born between January 1st 2009 and December 31st 2014. Parental questionnaires of n = 2928 VPT children were evaluated regarding the child's sleep behavior at five years of age. Univariate and logistic regression analyses were used to identify risk factors for delayed sleep onset and hyperactivity/inattention (Strength and Difficulties Questionnaire). In a second cohort of n = 342 VPT infants, sleep habits were evaluated at toddlers age via the Infant Sleep Questionnaire. RESULTS In our cohorts, 424/2928 (14.5 %) preterm children were diagnosed with delayed sleep onset at early school age while 57/342 (16.7 %) had sleep impairment in early infancy. Gestational age was not independently associated with sleep problems (i.e., early school age: OR 0.97, 95 % CI 0.9-1.1, p = 0.15). Notably, in both our cohorts, neonatal exposure to analgesics and sedatives was associated with a higher risk for sleep problems, i.e., early school age: exposure to sedatives: OR 1.31, 95%CI 1.02-1.7, p = 0.03. Sleep problems and drug exposure were both associated with hyperactivity/inattention. CONCLUSION Sleep problems of VPT children are unrelated to gestational age which suggests rather individual risk factors. The significant neonatal exposure to analgesics and sedatives may contribute to long-term sleep impairment.
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Affiliation(s)
- Johanna Neitmann
- Department of Pediatrics, University of Luebeck, Luebeck, Germany
| | - Kathrin Hanke
- Department of Pediatrics, University of Luebeck, Luebeck, Germany.
| | | | - Bastian Siller
- Department of Pediatrics, University of Luebeck, Luebeck, Germany.
| | - Juliane Spiegler
- Department of Pediatrics, University Hospital of Wuerzburg, Wuerzburg, Germany.
| | - Karla Juhnke
- Department of Pediatrics, University of Luebeck, Luebeck, Germany
| | - Jessica Gilmore
- Department of Pediatrics, University of Luebeck, Luebeck, Germany.
| | - Rainer Odendahl
- Department of Pediatrics, University of Luebeck, Luebeck, Germany.
| | - Egbert Herting
- Department of Pediatrics, University of Luebeck, Luebeck, Germany.
| | - Wolfgang Göpel
- Department of Pediatrics, University of Luebeck, Luebeck, Germany.
| | - Christoph Härtel
- Department of Pediatrics, University Hospital of Wuerzburg, Wuerzburg, Germany.
| | - Ingmar Fortmann
- Department of Pediatrics, University of Luebeck, Luebeck, Germany.
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Gargiulo AT, Peterson LM, Grafe LA. Stress, coping, resilience, and sleep during the COVID-19 pandemic: A representative survey study of US adults. Brain Behav 2021; 11:e2384. [PMID: 34661981 PMCID: PMC8613418 DOI: 10.1002/brb3.2384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic is a global health emergency resulting in widespread death and substantial disruption to daily life. Previous research has shown that novel disease outbreaks are associated with high stress levels and sleep impairments that lead to neuropsychiatric consequences. Therefore, it is vital to study both stress and protective factors such as coping and resilience that may hinder or help sleep quality during the COVID-19 pandemic. Further, as gender disparities exist in sleep quality, it is important to understand the relationship between pandemic-related stress, coping strategies, resilience, and sleep in bothgenders during the COVID-19 pandemic. METHODS Our study examined how gender, stress, coping, and resilience were associated with sleep cross-sectionally during the COVID-19 pandemic in a representative sample of US adults (N = 393). RESULTS Consistent with many recent studies, we found that worsened sleep quality in women compared to men persisted during the COVID-19 pandemic. Interestingly, pandemic-related stress was not significantly associated with sleep quality, but pandemicrelated coping was associated with sleep independent of robust controls and trait resilience. CONCLUSIONS Greater primary control engagement coping was associated with better sleep quality, while involuntary engagement coping was associated with poor sleep quality. Future research should extend the findings with actigraphy and explore ways to enhance beneficial coping and sleep health during pandemics.
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Affiliation(s)
- Andrew T. Gargiulo
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
| | - Laurel M. Peterson
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
| | - Laura A. Grafe
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
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Fekih-Romdhane F, Nefzi H, Sassi H, Cherif W, Cheour M. Sleep in first-episode schizophrenia patients, their unaffected siblings and healthy controls: A comparison. Early Interv Psychiatry 2021; 15:1167-1178. [PMID: 33037776 DOI: 10.1111/eip.13058] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 08/04/2020] [Accepted: 09/26/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Sleep disturbances in schizophrenia are common throughout its course including in the prodrome, and have been mainly attributed to severity of symptoms and antipsychotic use. We aimed to investigate whether early course patients with schizophrenia and young non-psychotic siblings of patients with schizophrenia also show sleep disturbances and whether sleep correlates with symptoms and functioning. METHODS Three study groups, that is, adults newly diagnosed with schizophrenia (n = 54), young non-psychotic siblings of schizophrenia patients (n = 56) and a sample of healthy controls matched to the patients and siblings (n = 61) were evaluated on Horne and Ostberg Morningness-Eveningness Questionnaire, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Severity of symptoms and functioning are assessed using the Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale, respectively. Age, gender, occupation and marital status were regarded as covariates, and differences between the three groups were evaluated using analysis of covariance. RESULTS Early course schizophrenia patients and non-psychotic siblings of schizophrenia patients showed significantly reduced sleep quality relative to healthy controls (P < .001). Schizophrenia patients had significantly higher daytime sleepiness compared to controls (P < .001). Chronotypes in schizophrenia patients and unaffected siblings did not significantly differ from those of the healthy controls. CONCLUSIONS Like chronic medicated schizophrenia patients, early course schizophrenia patients and young non-psychotic siblings of individuals with schizophrenia have sleep disturbances. These findings indicate that sleep markers can distinguish unaffected siblings of schizophrenia from healthy controls and serve as an endophenotype for schizophrenia.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Department of psychiatry "Ibn Omrane", Razi Hospital, Mannouba, Tunisia
| | - Houssem Nefzi
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Department of psychiatry "Ibn Omrane", Razi Hospital, Mannouba, Tunisia
| | - Hadhami Sassi
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Department of psychiatry "Ibn Omrane", Razi Hospital, Mannouba, Tunisia
| | - Wissal Cherif
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Department of psychiatry "Ibn Omrane", Razi Hospital, Mannouba, Tunisia
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Department of psychiatry "Ibn Omrane", Razi Hospital, Mannouba, Tunisia
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Moradi Farsani H, Afshari P, Sadeghniiat Haghighi K, Gholamzadeh Jefreh M, Abedi P, Haghighizadeh MH. The effect of group cognitive behavioural therapy for insomnia in postmenopausal women. J Sleep Res 2021; 30:e13345. [PMID: 33818845 DOI: 10.1111/jsr.13345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/30/2022]
Abstract
The menopausal period is associated with several complications in women. One of these complications is sleep disorders including insomnia disorder that can affect all aspects of personal life. The present study aimed to evaluate the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) on insomnia severity and sleep quality among postmenopausal women. This was a randomised clinical trial in which 46 women were recruited and randomly allocated into two groups, one receiving CBT-I and a control group. The CBT-I group received six sessions of training, while the control group received only usual care. A demographic questionnaire, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI), were used to collect the data. The ISI and PSQI were measured at baseline, 3 and 6 weeks after intervention, and in a 4-week follow-up. The Independent t test, the chi-square test, generalised estimating equation models, and Bonferroni correction were applied to analyse the data. According to our results, in the CBT-I group compared to the control group, the mean ISI, PSQI, sleep onset latency, sleep time, and sleep quality score reduced continuously from baseline to week 3 and from week 3 to week 6, and remained constant from week 6 to week 10. The mean sleep efficiency score improved significantly from baseline to week 3 in the CBT-I group and remained unchanged until the end of the study. CBT-I could significantly improve insomnia severity and sleep quality in postmenopausal women. Therefore, using this method is recommended for menopausal women with insomnia.
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Affiliation(s)
- Hadis Moradi Farsani
- Midwifery Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Poorandokht Afshari
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Hossein Haghighizadeh
- Faculty of Public Health, Department of Statistics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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D’Aurizio G, Caldarola A, Ninniri M, Avvantaggiato M, Curcio G. Sleep Quality and Psychological Status in a Group of Italian Prisoners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124224. [PMID: 32545743 PMCID: PMC7344845 DOI: 10.3390/ijerph17124224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/06/2020] [Accepted: 06/10/2020] [Indexed: 12/21/2022]
Abstract
Prison could be considered a prolonged stressful situation that can trigger not only a dysregulation of sleep patterns but can also bring out psychiatric illness, such as anxiety and depression symptoms. Our study is aimed at exploring sleep quality and sleep habits in an Italian prison ward with three different security levels, and to attempt to clarify how anxiety state and the total time spent in prison can moderate insomnia complaints. There were 129 participants divided into three groups who enrolled in this study: 50 were in the medium-security prison ward (Group 1), 58 were in the high-security prison ward (Group 2) and 21 were in the medium-security following a protocol of detention with reduced custodial measures (Group 3). All participants filled in a set of questionnaires that included the Beck Depression Inventory (BDI-2), the State-Trait Anxiety Inventory (STAI), the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Based on their responses, we observed that all participants showed poor sleep quality and insomnia, mild to moderate depressive symptoms that tended to a higher severity in Groups 1 and 3, and the presence of clinically significant anxiety symptoms, mainly in Groups 1 and 3. Our study shows that increased anxiety state-level and the presence of mood alteration corresponds to an increase in both poor sleep quality and, more specifically, insomnia complaints. Finally, we propose that TiP (total time in prison) could have an interesting and stabilizing paradox-function on anxiety state and insomnia.
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Affiliation(s)
- Giulia D’Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.D.); (A.C.)
| | - Angelica Caldarola
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.D.); (A.C.)
| | - Marianna Ninniri
- Penitentiary Institution-Casa Circondariale Lanciano, 66034 Chieti, Italy; (M.N.); (M.A.)
| | | | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.D.); (A.C.)
- Correspondence: ; Tel.: +39-0862-433407
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Appenzeller YE, Appelbaum PS, Trachsel M. Ethical and Practical Issues in Video Surveillance of Psychiatric Units. Psychiatr Serv 2020; 71:480-486. [PMID: 31847737 DOI: 10.1176/appi.ps.201900397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Video surveillance is used in inpatient psychiatry in many countries and institutions. However, its use varies considerably because of a lack of research, discussion, and agreement on best practice. This review provides an overview of current issues in the use of video surveillance in psychiatry, with a focus on ethical questions and their practical implications. METHODS A narrative review of literature on video surveillance in psychiatry was conducted. References were identified through searches of PubMed, CINAHL, MEDLINE, PsycINFO, and Google Scholar for articles published before December 2018. Sixteen articles in English and German were reviewed. RESULTS The ethical challenges and practical implications differ between surveillance of public spaces versus private areas, such as bedrooms or seclusion rooms. The most common reason for video surveillance was to increase security and safety. However, empirical evidence suggests that it is not useful in increasing security of shared spaces on psychiatric wards. Some evidence exists for clinical benefits of video surveillance in private spaces (e.g., allowing patients to sleep undisturbed). Video surveillance can increase patients' choices regarding monitoring options. The main ethical conflict lies in balancing patients' autonomy and privacy versus patient and staff security and safety. CONCLUSIONS Whether video monitoring is used in the most effective and ethical manner needs to be reconsidered. Available evidence does not support its use as a security measure. More research is needed to evaluate the benefits, risks, and best practices of using video monitoring for patient observation, with consideration given to increasing the role of patient consent.
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Affiliation(s)
- Yahel E Appenzeller
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland (Appenzeller, Trachsel); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Appelbaum)
| | - Paul S Appelbaum
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland (Appenzeller, Trachsel); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Appelbaum)
| | - Manuel Trachsel
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland (Appenzeller, Trachsel); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Appelbaum)
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11
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Sleep-EEG in patients with primary aldosteronism in comparison to healthy controls and patients with depression. J Psychiatr Res 2019; 112:52-60. [PMID: 30852427 DOI: 10.1016/j.jpsychires.2019.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/20/2019] [Accepted: 02/22/2019] [Indexed: 01/07/2023]
Abstract
The mineralocorticoid receptor (MR)/glucocorticoid receptor balance plays an important role in the pathophysiology of anxiety and depression. Aldosterone, a primary MR ligand, seems to be related to the pathophysiology of anxiety and depressive symptoms. The objective of this study was to investigate effects of aldosterone excess on sleep EEG, as sleep EEG is a tool to gain insight into psychoneuroendocrine function. Here, 19 untreated patients (9 males, 10 females) suffering from primary aldosteronism were investigated using sleep EEG and several rating scales for anxiety, depression, quality of life and sleep before starting specific treatment. Parameters were compared to age and sex matched healthy controls and patients with depression and correlated with laboratory findings and blood pressure. Patients had higher values for anxiety and depression compared to the general population, although a psychiatric disorder in their history was ruled out. Although sleep disturbances were reported in the Pittsburgh sleep quality index, sleep EEG did not show significant changes between patients and healthy controls. No depression specific pattern in sleep EEG was found. But in contrast to females, several sleep-EEG parameters of male PA patients differed significantly from patients with depression. There was a significant correlation between blood pressure and the severity of depression and anxiety in females. Correlation analysis between blood pressure and rating scales indicate a relationship between blood pressure and anxiety in women. In conclusion, these data suggest gender related effects of aldosterone excess in males and females.
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Stem-leaf saponins from Panax notoginseng counteract aberrant autophagy and apoptosis in hippocampal neurons of mice with cognitive impairment induced by sleep deprivation. J Ginseng Res 2019; 44:442-452. [PMID: 32372866 PMCID: PMC7195596 DOI: 10.1016/j.jgr.2019.01.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/21/2018] [Accepted: 01/28/2019] [Indexed: 01/09/2023] Open
Abstract
Backgroud Sleep deprivation (SD) impairs learning and memory by inhibiting hippocampal functioning at molecular and cellular levels. Abnormal autophagy and apoptosis are closely associated with neurodegeneration in the central nervous system. This study is aimed to explore the alleviative effect and the underlying molecular mechanism of stem–leaf saponins of Panax notoginseng (SLSP) on the abnormal neuronal autophagy and apoptosis in hippocampus of mice with impaired learning and memory induced by SD. Methods Mouse spatial learning and memory were assessed by Morris water maze test. Neuronal morphological changes were observed by Nissl staining. Autophagosome formation was examined by transmission electron microscopy, immunofluorescent staining, acridine orange staining, and transient transfection of the tf-LC3 plasmid. Apoptotic event was analyzed by flow cytometry after PI/annexin V staining. The expression or activation of autophagy and apoptosis-related proteins were detected by Western blotting assay. Results SLSP was shown to improve the spatial learning and memory of mice after SD for 48 h, accomanied with restrained excessive autophage and apoptosis, whereas enhanced activation of phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin signaling pathway in hippocampal neurons. Meanwhile, it improved the aberrant autophagy and apoptosis induced by rapamycin and re-activated phosphoinositide 3-kinase/Akt/mammalian target of rapamycin signaling transduction in HT-22 cells, a hippocampal neuronal cell line. Conclusion SLSP could alleviate cognitive impairment induced by SD, which was achieved probably through suppressing the abnormal autophagy and apoptosis of hippocampal neurons. The findings may contribute to the clinical application of SLSP in the prevention or therapy of neurological disorders associated with SD.
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Latif ZEH, Šaltytė Benth J, Solli KK, Opheim A, Kunoe N, Krajci P, Sharma-Haase K, Tanum L. Anxiety, Depression, and Insomnia Among Adults With Opioid Dependence Treated With Extended-Release Naltrexone vs Buprenorphine-Naloxone: A Randomized Clinical Trial and Follow-up Study. JAMA Psychiatry 2019; 76:127-134. [PMID: 30566177 PMCID: PMC6439739 DOI: 10.1001/jamapsychiatry.2018.3537] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Extended-release naltrexone (XR-NTX) is a promising alternative treatment of opioid addiction but has never been compared with opioid agonist treatment for effects on symptoms of anxiety, depression, and insomnia. OBJECTIVE To investigate whether XR-NTX unmasks or reinforces current comorbid symptoms of anxiety, depression, or insomnia compared with opioid agonist treatment. DESIGN, SETTING, AND PARTICIPANTS In this prospective randomized clinical trial, 159 men and women aged 18 to 60 years with opioid dependence were randomized to 12 weeks of treatment with either XR-NTX or combined buprenorphine-naloxone (BP-NLX) followed by a 9-month, open-label treatment study with participant choice of 1 of these 2 drugs. The study was conducted at outpatient addiction clinics in 5 urban hospitals in Norway, with the clinical trial performed from November 1, 2012, to October 23, 2015, and the follow-up study completed on July 23, 2016. All analyses were conducted using an intention-to-treat sample. INTERVENTIONS Extended-release naltrexone hydrochloride, 380 mg, administered as an injection every 4 weeks or flexible doses (4-24 mg; target dosage 16 mg/d) of daily oral combined BP-NLX. MAIN OUTCOMES AND MEASURES Every 4 weeks, symptoms of anxiety and depression were assessed using the 25-item Hopkins Symptom Checklist, and symptoms of insomnia were assessed using the Insomnia Severity Index. RESULTS In total, 159 participants were randomized to treatment with either XR-NTX (n = 80) or BP-NLX (n = 79), and 105 participants (66.0%) completed the trial. The treatment groups showed similar distributions of age (mean [SD], 36.4 [8.8] vs 35.7 [8.5] years), sex (61 [76.3%] women and 54 [68.4%] men), and duration of heroin use (mean [SD], 6.9 [5.8] vs 6.7 [5.2] years). For the clinical trial period, no overall differences were detected between treatment groups for anxiety (effect size [95% CI], -0.14 [-0.47 to 0.19]) or depression (effect size [95% CI], -0.12 [-0.45 to 0.21]) scores, but the insomnia score was significantly lower in the XR-NTX group (effect size [95% CI], -0.32 [-0.61 to -0.02]; P = .008). In the follow-up period, no overall differences could be detected in the effect size [95% CI] of scores for anxiety (0.04 [-0.34 to 0.42]), depression (-0.04 [-0.42 to 0.33]), or insomnia (0.04 [-0.33 to 0.42]) between participants continuing with and participants switching to XR-NTX. No significant sex differences between the 2 treatment groups were detected. CONCLUSIONS AND RELEVANCE Comorbid symptoms of anxiety, depression, or insomnia in abstinence-motivated persons with opioid dependence should not prevent switching from treatment with an opioid agonist to treatment with XR-NTX. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01717963.
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Affiliation(s)
- Zill-e-Huma Latif
- Department of Research and Development in Mental
Health, Akershus University Hospital, Lørenskog, Norway,Norwegian Center for Addiction Research, University of
Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus Ahus,
University of Oslo, Oslo, Norway,Health Services Research Unit, Akershus University
Hospital, Lørenskog, Norway
| | - Kristin Klemmetsby Solli
- Department of Research and Development in Mental
Health, Akershus University Hospital, Lørenskog, Norway,Norwegian Center for Addiction Research, University of
Oslo, Oslo, Norway
| | - Arild Opheim
- Department of Addiction Medicine, Haukeland University
Hospital, Bergen, Norway,Faculty of Medicine and Odonthology, The University of
Bergen, Bergen, Norway
| | - Nikolaj Kunoe
- Department of Research and Development in Mental
Health, Akershus University Hospital, Lørenskog, Norway
| | - Peter Krajci
- Department of Addiction Medicine, Oslo University
Hospital, Oslo, Norway,Vestfold Hospital Trust, Toensberg, Norway
| | - Kamni Sharma-Haase
- Norwegian Center for Addiction Research, University of
Oslo, Oslo, Norway
| | - Lars Tanum
- Department of Research and Development in Mental
Health, Akershus University Hospital, Lørenskog, Norway,Norwegian Center for Addiction Research, University of
Oslo, Oslo, Norway
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Wallen GR, Park J, Krumlauf M, Brooks AT. Identification of Distinct Latent Classes Related to Sleep, PTSD, Depression, and Anxiety in Individuals Diagnosed With Severe Alcohol Use Disorder. Behav Sleep Med 2019; 17:514-523. [PMID: 29377714 PMCID: PMC6289902 DOI: 10.1080/15402002.2018.1425867] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective/Background: Alcohol use disorders (AUDs) are often accompanied by comorbid physiologic and psychosocial conditions, including sleep disturbances. Sleep disturbances in these individuals may be associated with increased risk of relapse to drinking following detoxification and rehabilitation. Participants: The sample of inpatient treatment-seeking individuals with AUDs (N = 164) was 70.1% male and 47.6% African American with a mean age of 45.6 years (±9.5 years). Methods: Latent class analysis (LCA) was used to identify unmeasured class membership based on seven indicators: maximum Clinical Institute Withdrawal Assessment (CIWA) scores; sleep efficiency (actigraphy); sleep disturbances (Pittsburgh Sleep Quality Index-PSQI); anxiety or depression (Comprehensive Psychopathological Rating Scale [CPRS]); and current and lifetime posttraumatic stress disorder (PTSD). Results: The average number of drinking days in the 90 days preceding admission was 72.0 (±22.0 days), with an average of 13.16 drinks per day (±5.70 drinks). Nearly one quarter (24.4%) of respondents reported lifetime PTSD. Three latent classes were identified: Sleep Disturbance (SD); Sleep Disturbance, Anxiety and Depression (SD/AD); and Sleep Disturbance, Anxiety and Depression, and PTSD (SD/AD/PTSD). Members of the SD/AD/PTSD group were more likely to be female and had the highest withdrawal and sleep disturbance scores of all three groups. Conclusion: Findings support the use of LCA to identify subgroups of individuals with AUDs and accompanying sleep disturbances. Class identification may provide clinicians with insight into the integrative tailoring of interventions that meet the varied needs of individuals with AUDs, accompanying comorbidities, and sleep disturbances.
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Affiliation(s)
- Gwenyth R. Wallen
- Corresponding author. National Institutes of Health Clinical Center, 10 Center Drive Room 2B09, MSC-1151, Bethesda, MD 20892, USA. address:
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Abstract
The neuropeptides orexins are important in regulating the neurobiological systems that respond to stressful stimuli. Furthermore, orexins are known to play a role many of the phenotypes associated with stress-related mental illness such as changes in cognition, sleep-wake states, and appetite. Interestingly, orexins are altered in stress-related psychiatric disorders such as Major Depressive Disorder and Anxiety Disorders. Thus, orexins may be a potential target for treatment of these disorders. In this review, we will focus on what is known about the role of orexins in acute and repeated stress, in stress-induced phenotypes relevant to psychiatric illness in preclinical models, and in stress-related psychiatric illness in humans. We will also briefly discuss how orexins may contribute to sex differences in the stress response and subsequent phenotypes relevant to mental health, as many stress-related psychiatric disorders are twice as prevalent in women.
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16
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Sargin D. The role of the orexin system in stress response. Neuropharmacology 2018; 154:68-78. [PMID: 30266600 DOI: 10.1016/j.neuropharm.2018.09.034] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/18/2018] [Accepted: 09/21/2018] [Indexed: 11/30/2022]
Abstract
Orexins are neuropeptides that are exclusively produced by hypothalamic neurons, which project throughout the entire brain. Orexin, also known as hypocretins, were initially identified to play a fundamental role in food intake, arousal and the regulation of sleep and wakefulness. Recent studies identified orexins to be critical for diverse physiological processes including motivation, reward, attention, emotional regulation, stress and anxiety. Here, I review recent findings that indicate orexin has an important role in acute and chronic stress. I also summarize the recent optogenetic and chemogenetic studies that have advanced our understanding of the orexin system. I will conclude by discussing clinical studies that implicate orexins in mental health disorders. This article is part of the Special Issue entitled 'Hypothalamic Control of Homeostasis'.
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Affiliation(s)
- Derya Sargin
- Hotchkiss Brain Institute and the Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
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Grafe LA, Bhatnagar S. The contribution of orexins to sex differences in the stress response. Brain Res 2018; 1731:145893. [PMID: 30081036 DOI: 10.1016/j.brainres.2018.07.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/22/2018] [Accepted: 07/12/2018] [Indexed: 02/07/2023]
Abstract
Women are twice as likely as men to suffer from stress-related psychiatric disorders, such as post-traumatic stress disorder (PTSD) and Major Depressive Disorder (MDD), however, the biological basis of these sex differences is not fully understood. Interestingly, orexins are known to be dysregulated in these disorders. This review first discusses the important role of orexins regulating the response to stress. Next, we review the evidence for sex differences in the orexin system, in which the majority of both preclinical and clinical studies have reported higher orexin system expression in females. Finally, we discuss the functional consequences of these sex differences in orexin expression. Most importantly, the preclinical literature reveals that higher orexin system activity in females contributes to exaggerated neuroendocrine and behavioral responses to stress. In sum, the available data suggests that orexins may be important in the etiology of stress-related psychiatric disorders that present differently in men and women. Thus, targeting orexins could potentially ameliorate many phenotypes of stress-related illness in a sex-specific way.
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Affiliation(s)
- Laura A Grafe
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Seema Bhatnagar
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
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Brooks AT, Krumlauf M, Beck KH, Fryer CS, Yang L, Ramchandani VA, Wallen GR. A Mixed Methods Examination of Sleep Throughout the Alcohol Recovery Process Grounded in the Social Cognitive Theory: The Role of Self-Efficacy and Craving. HEALTH EDUCATION & BEHAVIOR 2018; 46:126-136. [DOI: 10.1177/1090198118757820] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sleep disturbances can accompany alcohol use disorders during various phases of the disease. This analysis utilized a mixed methods approach to assess whether sleep-related beliefs and/or behavior of individuals who are alcohol dependent were associated with sleep quality both pre- and postdischarge from a clinical research facility providing inpatient alcohol rehabilitation treatment. Individuals with higher self-efficacy for sleep (SE-S) reported better sleep quality at both time points. Individuals with fewer dysfunctional beliefs about sleep had poorer sleep quality at both time points. Individuals with higher unhealthy sleep-related safety behaviors had poorer sleep quality at both time points. In a linear regression model, only the difference in SE-S scores from pre- to postdischarge (β = −.396, p = .01) and the postdischarge Penn Alcohol Craving Score (β = .283, p = .019) significantly predicted the change in sleep quality. Thus, those whose SE-S scores increased and those with lower postdischarge craving scores were more likely to experience a decrease on Pittsburgh Sleep Quality Index scores from pre- to postdischarge even after controlling for covariates. References to behavior or personal factors were often discussed during the qualitative interviews in tandem with the environment. Participants reported both (1) self-medicating anxiety with alcohol and (2) self-medicating the inability to fall asleep with alcohol. Given the success of behavioral sleep interventions in various populations and the unique potential contributions of mixed methods approaches to examine sleep and alcohol use, assessing sleep-related cognitions and behaviors of individuals with severe alcohol use disorders may be important in understanding sleep quality and subsequent relapse.
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Affiliation(s)
- Alyssa T. Brooks
- National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Michael Krumlauf
- National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Kenneth H. Beck
- University of Maryland School of Public Health, College Park, MD, USA
| | - Craig S. Fryer
- University of Maryland School of Public Health, College Park, MD, USA
| | - Li Yang
- National Institutes of Health Clinical Center, Bethesda, MD, USA
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Ekholm O, Davidsen M, Larsen CVL, Juel K. A nationwide study of health-related quality of life, stress, pain or discomfort and the use of medicine among problem gamblers. Scand J Public Health 2017; 46:514-521. [PMID: 29143576 DOI: 10.1177/1403494817739501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM The aim of this study was to investigate the associations between problem gambling and health-related quality of life, stress, pain or discomfort and the use of analgesics and sleeping pills. METHODS Data derives from the Danish Health and Morbidity Survey 2010. The survey was based on a random sample of 25,000 adult Danes (response rate: 61%), and data were collected via a self-administered questionnaire. The Lie/Bet Questionnaire was used as the screening instrument for problem gambling. Respondents were categorised as current, previous or non-problem gamblers. The questionnaire also included topics such as health-related quality of life (Short Form-12), perceived stress, pain and discomforts within the past two weeks, as well as the use of medication within the past two weeks. RESULTS Current problem gambling was strongly associated with negative outcomes such as poor mental health, high perception of stress, headache, fatigue and sleeping problems. Furthermore, previous problem gambling was generally associated with poorer health outcomes. Thus, current and previous problem gamblers had 2.36 times (95% confidence interval [CI] 1.44-3.87) and 1.66 times (95% CI 1.07-2.55) higher odds than non-problem gamblers of reporting fair or poor health, respectively. The data revealed no clear association between problem gambling and the use of analgesics. CONCLUSIONS Both current and previous problem gambling were negatively associated with physical and mental-health problems. Health professionals should be alert to any signs of these complicating factors when planning the treatment of problem gamblers.
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Affiliation(s)
- Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Michael Davidsen
- National Institute of Public Health, University of Southern Denmark, Denmark
| | | | - Knud Juel
- National Institute of Public Health, University of Southern Denmark, Denmark
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20
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Abstract
How does a lack of sleep affect our brains? In contrast to the benefits of sleep, frameworks exploring the impact of sleep loss are relatively lacking. Importantly, the effects of sleep deprivation (SD) do not simply reflect the absence of sleep and the benefits attributed to it; rather, they reflect the consequences of several additional factors, including extended wakefulness. With a focus on neuroimaging studies, we review the consequences of SD on attention and working memory, positive and negative emotion, and hippocampal learning. We explore how this evidence informs our mechanistic understanding of the known changes in cognition and emotion associated with SD, and the insights it provides regarding clinical conditions associated with sleep disruption.
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21
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Brooks AT, Krumlauf M, Fryer CS, Beck KH, Yang L, Ramchandani VA, Wallen GR. Critical Transitions: A Mixed Methods Examination of Sleep from Inpatient Alcohol Rehabilitation Treatment to the Community. PLoS One 2016; 11:e0161725. [PMID: 27571353 PMCID: PMC5003361 DOI: 10.1371/journal.pone.0161725] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/10/2016] [Indexed: 12/02/2022] Open
Abstract
Aims This prospective, repeated measures study utilized a convergent parallel mixed methods approach to assess sleep experiences among individuals who were alcohol-dependent undergoing inpatient detoxification and treatment at a clinical research facility across the transition periods associated with the rehabilitation process: the initial adjustment to becoming an inpatient and the transition from inpatient to outpatient status. Methods This study included individual semi-structured interviews and quantitative measures relating to psychological distress, sleep quality, daytime sleepiness, and sleep-related beliefs and behavior (n = 33; 66.7% male). Interviews were conducted and questionnaires were administered within one week of participants’ scheduled discharge date and again four to six weeks post-discharge when they returned for a follow-up visit (or via phone). Results Participants self-reported significant sleep disturbances at both study time points. Of those participants with valid data at both time points (n = 28), there were no significant changes in mean scores from pre- to post-discharge with the exception of self-efficacy for sleep (SE-S) being significantly higher post-discharge. Preliminary qualitative findings suggested differences between those with ongoing sleep disturbances, those whose sleep disturbances had resolved, and those with no sleep disturbances at either time point. Conclusions This analysis highlights individual variation in sleep throughout the process of inpatient treatment and transition to outpatient aftercare in individuals with alcohol dependence. Collecting quantitative and qualitative data concurrently and combining emerging themes from qualitative data with quantitative analyses allowed for a more thorough examination of this relatively novel area of research and provided information that can be utilized to inform future behavioral sleep interventions.
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Affiliation(s)
- Alyssa Todaro Brooks
- National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, United States of America
- * E-mail:
| | - Michael Krumlauf
- National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America
| | - Craig S. Fryer
- University of Maryland School of Public Health, Department of Behavioral and Community Health, College Park, Maryland, United States of America
| | - Kenneth H. Beck
- University of Maryland School of Public Health, Department of Behavioral and Community Health, College Park, Maryland, United States of America
| | - Li Yang
- National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America
| | - Vijay A. Ramchandani
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, United States of America
| | - Gwenyth R. Wallen
- National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America
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Singh A, Ghazvini P, Robertson N, Massey AJ, Kirksey O, Honeywell MS. Sleep Disturbances in Patients With Psychiatric Illnesses. J Pharm Pract 2016. [DOI: 10.1177/0897190007300735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sleep is essential not only for our physical well-being but also for our mental well-being. Researchers, however, have determined that specific alterations in sleep patterns do exist among patients with psychiatric illnesses. The causes of these abnormalities include both direct and indirect mechanisms. These abnormalities lead to declines in both cognitive function and quality of life. Management should include both nonpharmacological and pharmacological methods. This article will review the types of sleep abnormalities associated with schizophrenia, depression, bipolar disorder, and anxiety disorders and will additionally review treatment options available for each illness.
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Affiliation(s)
- Angela Singh
- Florida A&M University College of Pharmacy and Pharmaceutical Sciences, Tallahassee,
| | - Patty Ghazvini
- Florida A&M University College of Pharmacy and Pharmaceutical Sciences, Tallahassee
| | | | - Angela J. Massey
- Florida A&M University College of Pharmacy and Pharmaceutical Sciences, Tallahassee
| | - Otis Kirksey
- Division of Pharmacy Practice at Florida A&M University College of Pharmacy and Pharmaceutical Sciences, Tallahassee
| | - Marlon S. Honeywell
- Florida A&M University College of Pharmacy and Pharmaceutical Sciences, Tallahassee
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Krakow BJ, Ulibarri VA, Moore BA, McIver ND. Posttraumatic stress disorder and sleep-disordered breathing: a review of comorbidity research. Sleep Med Rev 2015; 24:37-45. [DOI: 10.1016/j.smrv.2014.11.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 10/25/2014] [Accepted: 11/07/2014] [Indexed: 02/04/2023]
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Biard K, Douglass AB, De Koninck J. The effects of galantamine and buspirone on sleep structure: Implications for understanding sleep abnormalities in major depression. J Psychopharmacol 2015; 29:1106-11. [PMID: 26259773 DOI: 10.1177/0269881115598413] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
RATIONALE The serotonergic and cholinergic systems are jointly involved in regulating sleep, but this balance is theorized to be disturbed in depressed individuals. OBJECTIVE The goal of this study was to use biological probes in healthy participants, to model the serotonergic/cholinergic imbalance of depression and its associated abnormalities in sleep structure. METHODS We tested 20 healthy female participants 18-30 years of age on four non-consecutive nights. Participants were given galantamine (a cholinergic agent), buspirone (a serotonergic agonist), both drugs together, or placebo before sleeping. RESULTS Buspirone suppressed tonic rapid eye movement (REM): There was a significant increase in REM latency (p < 0.001). Galantamine increased tonic REM sleep, leading to more time spent in REM (p < 0.001) and shorter REM latency (p < 0.01). Galantamine and buspirone given together were not significantly different from the placebo night by REM sleep measures, but disrupted sleep more than either drug alone. CONCLUSIONS These findings are partially consistent with the cholinergic literature about sleep in depression, notably short REM latency, higher percentage of total sleep time spent in REM and increased sleep fragmentation. The prolonged REM latency and reduced percentage of REM with buspirone resembled the effect of selective serotonin reuptake inhibitor antidepressants on REM sleep.
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Affiliation(s)
- Kathleen Biard
- School of Psychology, University of Ottawa, ON, Canada University of Ottawa Institute for Mental Health Research, Ottawa, ON, Canada
| | - Alan B Douglass
- University of Ottawa Institute for Mental Health Research, Ottawa, ON, Canada Royal Ottawa Mental Health Center, Ottawa, ON, Canada
| | - Joseph De Koninck
- School of Psychology, University of Ottawa, ON, Canada University of Ottawa Institute for Mental Health Research, Ottawa, ON, Canada
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Norra C, Bremshey N. Die Bedeutung von Schlafstörungen für die Prävention von Suizidalität. SOMNOLOGIE 2015. [DOI: 10.1007/s11818-015-0009-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Poor sleep quality is associated with impaired glucose tolerance in women after gestational diabetes. J Psychiatr Res 2015; 65:166-71. [PMID: 25930074 DOI: 10.1016/j.jpsychires.2015.02.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 01/16/2015] [Accepted: 02/05/2015] [Indexed: 01/12/2023]
Abstract
We analyzed the association of sleep quality and glucose metabolism in women after gestational diabetes (pGDM) and in women after normoglycemic pregnancy (controls). Data during pregnancy and a visit within the first 15 months after delivery were collected from 61 pGDM and 30 controls in a prospective cohort study. This included a medical history, physical examination, questionnaires (Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS)), and 5-point oral glucose tolerance test with insulin measurements to determine indices of insulin sensitivity and insulin secretion. We used Spearman correlation coefficients and multivariate regression models for analysis.9.3 ± 3.2 months after delivery, pGDM had significantly higher fasting and 2 h glucose levels and lower insulin sensitivity than controls. There was no significant difference in age, BMI and sleep quality as assessed with the PSQI between the two groups. The PSQI score correlated with the ogtt-2 h plasma glucose in pGDM (δ = 0.41; p = 0.0012), but not in controls. This association was confirmed with a multivariate linear regression model with adjustment for age, BMI and months post-delivery. Perceived stress was an independent risk factor (OR 1.12; 95% CI 1.02-1.23) for impaired sleep. Our findings suggest that post-delivery sleep quality significantly influences glucose tolerance in women after GDM and that impaired sleep is associated with increased stress perception. Measures to improve of sleep quality and reduce perceived stress should therefore be tested as additional strategies to prevent progression to type 2 diabetes after GDM.
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Critical periods for the neurodevelopmental processes of externalizing and internalizing. Dev Psychopathol 2015; 27:321-46. [DOI: 10.1017/s0954579415000024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractResearch on neurobiological development is providing insight into the nature and mechanisms of human neural plasticity. These mechanisms appear to support two different forms of developmental learning. One form of learning could be described as externalizing, in which neural representations are highly responsive to environmental influences, as the child typically operates under a mode of hedonic approach. A second form of learning supports internalizing, in which motive control separates attention and self-regulation from the immediate influences of the context, particularly when the child faces conditions of avoidance and threat. The dorsal cortical networks of externalizing are organized around dorsal limbic (cingulate, septal, lateral hypothalamic, hippocampal, and ventral striatal) circuits. In contrast, the ventral cortical networks of internalizing are organized around ventral limbic (anterior temporal and orbital cortex, extended amygdala, dorsal striatal, and mediodorsal thalamic) circuits. These dual divisions of the limbic system in turn self-regulate their arousal levels through different brain stem and forebrain neuromodulator projection systems, with dorsal corticolimbic networks regulated strongly by locus coeruleus norepinephrine and brain stem raphe nucleus serotonin projection systems, and ventral corticolimbic networks regulated by ventral tegmental dopamine and forebrain acetylcholine projections. Because the arousal control systems appear to regulate specific properties of neural plasticity in development, an analysis of these systems explains differences between externalizing and internalizing at multiple levels of neural and psychological self-regulation. In neuroscience, the concept of critical periods has been applied to times when experience is essential for the maturation of sensory systems. In a more general neuropsychological analysis, certain periods of the child's development require successful self-regulation through the differential capacities for externalizing and internalizing.
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Black DS, O'Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med 2015; 175:494-501. [PMID: 25686304 PMCID: PMC4407465 DOI: 10.1001/jamainternmed.2014.8081] [Citation(s) in RCA: 234] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep. OBJECTIVE To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5). INTERVENTIONS A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework. MAIN OUTCOMES AND MEASURES The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)-κB. RESULTS Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05). CONCLUSIONS AND RELEVANCE The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01534338.
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Affiliation(s)
- David S Black
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Gillian A O'Reilly
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles
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Kalak N, Brand S, Beck J, Holsboer-Trachsler E, Wollmer MA. Association between subjective actual sleep duration, subjective sleep need, age, body mass index, and gender in a large sample of young adults. Neuropsychiatr Dis Treat 2015; 11:107-13. [PMID: 25657583 PMCID: PMC4295917 DOI: 10.2147/ndt.s74829] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Poor sleep is a major health concern, and there is evidence that young adults are at increased risk of suffering from poor sleep. There is also evidence that sleep duration can vary as a function of gender and body mass index (BMI). We sought to replicate these findings in a large sample of young adults, and also tested the hypothesis that a smaller gap between subjective sleep duration and subjective sleep need is associated with a greater feeling of being restored. METHODS A total of 2,929 university students (mean age 23.24±3.13 years, 69.1% female) took part in an Internet-based survey. They answered questions related to demographics and subjective sleep patterns. RESULTS We found no gender differences in subjective sleep duration, subjective sleep need, BMI, age, or feeling of being restored. Nonlinear associations were observed between subjective sleep duration, BMI, and feeling of being restored. Moreover, a larger discrepancy between subjective actual sleep duration and subjective sleep need was associated with a lower feeling of being restored. CONCLUSION The present pattern of results from a large sample of young adults suggests that males and females do not differ with respect to subjective sleep duration, BMI, or feeling of being restored. Moreover, nonlinear correlations seemed to provide a more accurate reflection of the relationship between subjective sleep and demographic variables.
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Affiliation(s)
- Nadeem Kalak
- Psychiatric Clinics of the University of Basel, University of Basel, Basel, Switzerland
| | - Serge Brand
- Psychiatric Clinics of the University of Basel, University of Basel, Basel, Switzerland ; Department of Sport and Health Science, Division of Sport Science, University of Basel, Basel, Switzerland
| | - Johannes Beck
- Psychiatric Clinics of the University of Basel, University of Basel, Basel, Switzerland
| | | | - M Axel Wollmer
- Psychiatric Clinics of the University of Basel, University of Basel, Basel, Switzerland ; Asklepios Clinic North Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Hamburg, Germany
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Farbod F, Farzaneh N, Bijan MD, Mehdi G, Nosratollah N. Psychological features in patients with and without irritable bowel syndrome: A case-control study using Symptom Checklist-90-Revised. Indian J Psychiatry 2015; 57:68-72. [PMID: 25657459 PMCID: PMC4314919 DOI: 10.4103/0019-5545.148526] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
CONTEXT Recent studies have demonstrated that a high proportion of irritable bowel syndrome (IBS) patients shows an association with psychological factors. A few studies were conducted on the investigation of psychological features of IBS patients in Iran. AIMS We aimed to evaluate the relationship of psychological distress with IBS in outpatient subjects. SETTINGS AND DESIGN A total of 153 consecutive outpatients met Rome III criteria, and 163 controls were interred to study and invited to complete the Symptom Checklist-90-Revised (SCL-90-R) instrument in order to assessment of psychological distress. STATISTICAL ANALYSIS Univariate (t-test and Chi-square) and multivariate (logistic regression) methods were used for data analysis. RESULTS A significant association of IBS with all nine subscale and three global indices including global severity index (GSI), positive symptom distress index (PSDI), and positive symptom total (PST) of the SCL-90-R were detected. Patients with IBS reported significantly higher levels of poor appetite, trouble falling asleep, thoughts of death or dying, early morning awakening, disturbed sleep, and feelings of guilt compared to the controls. Multivariate analysis indicated that interpersonal sensitivity, somatization, paranoid ideation, depression and phobic anxiety subscales, and PST, PSDI, and GSI global indices were significantly associated with IBS (age, gender, educational level, marital status, employment status, smoking, alcohol use, and body mass index). CONCLUSIONS Psychological features are strongly associated with IBS; notably, interpersonal sensitivity, somatization, paranoid ideation, depression, phobic anxiety, and all global indices including PST, PSDI, and GSI is significantly associated with. Hence, the appropriate psychological assessment in these patients is critically important.
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Affiliation(s)
- Fadai Farbod
- Department of Psychiatry, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Neda Farzaneh
- Department of Psychiatry, University of Social Welfare and Rehabilitation Science, Tehran, Iran
| | - Moghimi-Dehkordi Bijan
- Department of Health System Research, Research Institute for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghobakhlou Mehdi
- Department of Liver Disease, Research Institute for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naderi Nosratollah
- Department of Liver Disease, Research Institute for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Manoach DS, Demanuele C, Wamsley EJ, Vangel M, Montrose DM, Miewald J, Kupfer D, Buysse D, Stickgold R, Keshavan MS. Sleep spindle deficits in antipsychotic-naïve early course schizophrenia and in non-psychotic first-degree relatives. Front Hum Neurosci 2014; 8:762. [PMID: 25339881 PMCID: PMC4188028 DOI: 10.3389/fnhum.2014.00762] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 09/09/2014] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Chronic medicated patients with schizophrenia have marked reductions in sleep spindle activity and a correlated deficit in sleep-dependent memory consolidation. Using archival data, we investigated whether antipsychotic-naïve early course patients with schizophrenia and young non-psychotic first-degree relatives of patients with schizophrenia also show reduced sleep spindle activity and whether spindle activity correlates with cognitive function and symptoms. METHOD Sleep spindles during Stage 2 sleep were compared in antipsychotic-naïve adults newly diagnosed with psychosis, young non-psychotic first-degree relatives of schizophrenia patients and two samples of healthy controls matched to the patients and relatives. The relations of spindle parameters with cognitive measures and symptom ratings were examined. RESULTS Early course schizophrenia patients showed significantly reduced spindle activity relative to healthy controls and to early course patients with other psychotic disorders. Relatives of schizophrenia patients also showed reduced spindle activity compared with controls. Reduced spindle activity correlated with measures of executive function in early course patients, positive symptoms in schizophrenia and IQ estimates across groups. CONCLUSIONS Like chronic medicated schizophrenia patients, antipsychotic-naïve early course schizophrenia patients and young non-psychotic relatives of individuals with schizophrenia have reduced sleep spindle activity. These findings indicate that the spindle deficit is not an antipsychotic side-effect or a general feature of psychosis. Instead, the spindle deficit may predate the onset of schizophrenia, persist throughout its course and be an endophenotype that contributes to cognitive dysfunction.
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Affiliation(s)
- Dara S. Manoach
- Department of Psychiatry, Massachusetts General HospitalCharlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical ImagingCharlestown, MA, USA
- Harvard Medical SchoolBoston, MA, USA
| | - Charmaine Demanuele
- Department of Psychiatry, Massachusetts General HospitalCharlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical ImagingCharlestown, MA, USA
- Harvard Medical SchoolBoston, MA, USA
| | - Erin J. Wamsley
- Harvard Medical SchoolBoston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical CenterBoston, MA, USA
| | - Mark Vangel
- Athinoula A. Martinos Center for Biomedical ImagingCharlestown, MA, USA
- Harvard Medical SchoolBoston, MA, USA
| | - Debra M. Montrose
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
| | - Jean Miewald
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
| | - David Kupfer
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
| | - Daniel Buysse
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
| | - Robert Stickgold
- Harvard Medical SchoolBoston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical CenterBoston, MA, USA
| | - Matcheri S. Keshavan
- Harvard Medical SchoolBoston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical CenterBoston, MA, USA
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
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Soehner AM, Kaplan KA, Harvey AG. Prevalence and clinical correlates of co-occurring insomnia and hypersomnia symptoms in depression. J Affect Disord 2014; 167:93-7. [PMID: 24953480 PMCID: PMC4291280 DOI: 10.1016/j.jad.2014.05.060] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 05/29/2014] [Accepted: 05/29/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim was to examine the prevalence and consequences of co-occurring insomnia and hypersomnia symptoms in depressed adults drawn from a representative sample of the U.S. population. METHOD Data from 687 National Comorbidity Survey Replication (NCS-R) respondents meeting criteria for a major depressive episode (MDE) in the past year were included. Respondents completed clinical interviews that assessed 12-month DSM-IV disorders, impairment, mental health treatment, and depressive symptom severity. Outcomes were compared between respondents who experienced insomnia symptoms-only (N=404), hypersomnia symptoms-only (N=44), both insomnia and hypersomnia symptoms (N=184) and no sleep problems (N=55) during an MDE. RESULTS Insomnia and hypersomnia symptoms co-occurred in 27.7% of respondents with past-year MDEs, most frequently in bipolar spectrum disorders and major depressive disorder with dysthymia. Similar to the insomnia-only group, respondents with co-occurring sleep disturbances had more severe depression, and higher rates of past-year impulse control disorders and suicide planning. Similar to the hypersomnia-only group, respondents with co-occurring sleep disturbances had higher rates of past-year drug use disorders and suicide attempts. Compared to the insomnia-only and no sleep problem groups, respondents with both sleep disturbances were more frequently in mental health treatment, seeing a general practitioner, and taking antidepressants. LIMITATIONS The NCS-R is cross-sectional and did not evaluate sleep disorder diagnoses. CONCLUSIONS Co-occurring insomnia and hypersomnia symptoms were associated with a more severe MDE. Further research is warranted to more fully understand the joint presentation of insomnia and hypersomnia in depression.
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Affiliation(s)
- Adriane M. Soehner
- Department of Psychology, University of California, Berkeley,Department of Psychiatry, University of Pittsburgh Medical Center
| | - Katherine A. Kaplan
- Department of Psychiatry & Behavioral Science, Stanford University Medical Center
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Brooks AT, Wallen GR. Sleep Disturbances in Individuals with Alcohol-Related Disorders: A Review of Cognitive-Behavioral Therapy for Insomnia (CBT-I) and Associated Non-Pharmacological Therapies. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2014; 8:55-62. [PMID: 25288884 PMCID: PMC4179428 DOI: 10.4137/sart.s18446] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 08/14/2014] [Accepted: 08/19/2014] [Indexed: 12/11/2022]
Abstract
Sleep disturbances are common among alcohol-dependent individuals and are often associated with relapse. The utility of behavioral therapies for sleep disturbances, including cognitive-behavioral therapy for insomnia (CBT-I), among those with alcohol-related disorders is not well understood. This review systematically evaluates the evidence of CBT-I and related behavioral therapies applied to those with alcohol-related disorders and accompanying sleep disturbances. A search of four research databases (PubMed, PsycINFO, Embase, and CINAHL Plus) yielded six studies that met selection criteria. Articles were reviewed using Cochrane's Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) scoring system. A majority of the studies demonstrated significant improvements in sleep efficiency among behavioral therapy treatment group(s), including but not limited to CBT-I. While behavioral sleep interventions have been successful in varied populations, they may not be utilized to their full potential among those with alcohol-related disorders as evidenced by the low number of studies found. These findings suggest a need for mixed-methods research on individuals' sleep experience to inform interventions that are acceptable to the target population.
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Affiliation(s)
- Alyssa T Brooks
- National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Gwenyth R Wallen
- National Institutes of Health Clinical Center, Bethesda, Maryland, USA
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Afonso P, Figueira ML, Paiva T. Sleep-wake patterns in schizophrenia patients compared to healthy controls. World J Biol Psychiatry 2014; 15:517-24. [PMID: 23316764 DOI: 10.3109/15622975.2012.756987] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this study was to examine the differences between a sample of patients with schizophrenia and a sample of healthy controls in terms of sleep patterns and self-reported sleep quality and quality of life (QoL). METHODS Thirty-four schizophrenia outpatients (SP), 12 women and 22 men and 34 healthy subjects (HS), 15 women and 19 men, participated in this study. Wrist-actigraphy recordings and a sleep diary were used for sleep-wake cycle assessment. The quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI), the QoL was evaluated using the World Health Organization Quality of Life - Abbreviated version (WHOQOL-Bref). The Positive and Negative Syndrome Scale (PANSS) was used for psychopathology assessment. RESULTS Patients sleep more at night, but have poorer sleep efficiency, than HS. Sleep latency and nighttime awakenings were significantly higher in SP. Self-reported QoL scores were significantly higher, in all four domains, in HS. Scores on PSQI were significantly higher in SP, indicating a worse quality of sleep. Two disturbed patterns of sleep-wake phase were found in SP: advance sleep-phase syndrome (ASPS) (N = 3) and irregular sleep-wake rhythm (N = 3). CONCLUSION Schizophrenia patients have more disturbed sleep-wake patterns and poor sleep quality and quality of life compared with healthy controls.
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Affiliation(s)
- Pedro Afonso
- Psychiatric Hospital Centre of Lisbon , Lisbon , Portugal
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Vyazovskiy VV, Delogu A. NREM and REM Sleep: Complementary Roles in Recovery after Wakefulness. Neuroscientist 2014; 20:203-19. [PMID: 24598308 DOI: 10.1177/1073858413518152] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The overall function of sleep is hypothesized to provide "recovery" after preceding waking activities, thereby ensuring optimal functioning during subsequent wakefulness. However, the functional significance of the temporal dynamics of sleep, manifested in the slow homeostatic process and the alternation between non-rapid eye movement (NREM) and REM sleep remains unclear. We propose that NREM and REM sleep have distinct and complementary contributions to the overall function of sleep. Specifically, we suggest that cortical slow oscillations, occurring within specific functionally interconnected neuronal networks during NREM sleep, enable information processing, synaptic plasticity, and prophylactic cellular maintenance ("recovery process"). In turn, periodic excursions into an activated brain state-REM sleep-appear to be ideally placed to perform "selection" of brain networks, which have benefited from the process of "recovery," based on their offline performance. Such two-stage modus operandi of the sleep process would ensure that its functions are fulfilled according to the current need and in the shortest time possible. Our hypothesis accounts for the overall architecture of normal sleep and opens up new perspectives for understanding pathological conditions associated with abnormal sleep patterns.
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Affiliation(s)
| | - Alessio Delogu
- Department of Neuroscience, Institute of Psychiatry, King's College London, London, UK
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Saberi P, Comfort M, Sheon N, Johnson MO. Qualitative study of the quality of sleep in marginalized individuals living with HIV. Patient Prefer Adherence 2013; 7:499-507. [PMID: 23807839 PMCID: PMC3687846 DOI: 10.2147/ppa.s44595] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sleep disturbances have been reported to be higher in human immunodeficiency virus (HIV)-infected individuals compared to the general population. Despite the consequences of poor quality of sleep (QOS), research regarding sleep disturbances in HIV infection is lacking and many questions regarding correlates of poor QOS, especially in marginalized populations, remain unanswered. We conducted one-on-one qualitative interviews with 14 marginalized HIV-infected individuals who reported poor QOS to examine self-reported correlates of sleep quality and explore the relationship between QOS and antiretroviral adherence. Findings suggest a complex and multidimensional impact of mental health issues, structural factors, and physical conditions on QOS of these individuals. Those reporting poor QOS as a barrier to antiretroviral adherence reported lower adherence due to falling asleep or feeling too tired to take medications in comparison to those who did not express this adherence barrier. These interviews underscore the importance of inquiries into a patient's QOS as an opportunity to discuss topics such as adherence, depression, suicidal ideation, and substance use.
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Affiliation(s)
- Parya Saberi
- Department of Medicine, University of California, San Francisco, CA, USA
- Correspondence: Parya Saberi, University of California, Department of Medicine, UCSF Box 0886, San Francisco, CA, 94105, USA, Tel +1 415 597 8144, Email
| | | | - Nicolas Sheon
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Mallory O Johnson
- Department of Medicine, University of California, San Francisco, CA, USA
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DSM-IV psychiatric comorbidity according to symptoms of insomnia: a nationwide sample of Korean adults. Soc Psychiatry Psychiatr Epidemiol 2012; 47:2019-33. [PMID: 22526822 DOI: 10.1007/s00127-012-0502-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 03/24/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE The diagnosis of insomnia is based on the presence of four different symptoms: difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), early morning awakening (EMA), and non-restorative sleep (NRS). This study investigated the differences in sociodemographic correlates and psychiatric comorbidity between the four symptoms of insomnia in the general population of South Korea. METHODS A sample of the population aged 18-64 (N = 6,510) was questioned using a face-to-face interview. Insomnia was defined as having at least one of the four following symptoms three or more times per week: DIS, DMS, EMA, and NRS. Psychiatric disorders were evaluated using the Korean version of Composite International Diagnostic Interview. Logistic regression analysis was used to test each of the sleep outcomes (DIS, DMS, EMA, or NRS) for an association with sociodemographic and clinical variables. RESULTS The prevalence of DIS, DMS, EMA, and NRS were 7.9 % (95 % CI 6.6-9.5 %), 7.9 % (95 % CI 6.5-9.6 %), 4.9 % (95 % CI 3.9-6.0 %), and 14.8 % (95 % CI 12.6-17.4 %), respectively. The overall prevalence of insomnia was 19.0 % (95 % CI 16.1-22.2 %). Being separated, divorced, or widowed, being single, having a part-time job, having a psychiatric illness, and having a physical illness were all significantly related to insomnia. Older age also increased the risk of DMS and EMA, and younger age was a risk factor for NRS. The presence of most psychiatric disorders was significantly related to insomnia. However, the relationship between the psychiatric illness and each insomnia symptom varied and was dependent on the insomnia symptom. CONCLUSIONS Most psychiatric disorders were significantly associated with each insomnia symptom in different ways. Differences in sociodemographic and clinical correlates between the four insomnia symptoms implied the heterogeneous characteristics of insomnia as defined by the current diagnostic criteria.
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Abstract
The classification of sleep disorders is necessary to discriminate between disorders and to facilitate an understanding of symptoms, etiology, and pathophysiology that allows for appropriate treatment. The earliest classification systems, largely organized according to major symptoms (insomnia, excessive sleepiness, and abnormal events that occur during sleep), were unable to be based on pathophysiology because the cause of most sleep disorders was unknown. These 3 symptom-based categories are easily understood by physicians and are therefore useful for developing a differential diagnosis. The International Classification of Sleep Disorders, version 2, published in 2005 and currently undergoing revision, combines a symptomatic presentation (e.g., insomnia) with 1 organized in part on pathophysiology (e.g., circadian rhythms) and in part on body systems (e.g., breathing disorders). This organization of sleep disorders is necessary because of the varied nature and because the pathophysiology for many of the disorders is still unknown. The International Classification of Sleep Disorders, version 2 provides relevant diagnostic and epidemiological information on sleep disorders to more easily differentiate between the disorders.
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Affiliation(s)
- Michael J Thorpy
- Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York, NY, USA.
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Tribl GG, Wetter TC, Schredl M. Dreaming under antidepressants: a systematic review on evidence in depressive patients and healthy volunteers. Sleep Med Rev 2012; 17:133-42. [PMID: 22800769 DOI: 10.1016/j.smrv.2012.05.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 04/30/2012] [Accepted: 05/01/2012] [Indexed: 11/30/2022]
Abstract
Sleep related symptoms of depression include sleep fragmentation, early morning awakening, decreased rapid eye movement (REM) sleep latency, increased REM density, and more negative dream content. Most tricyclic antidepressants (ADs) increase total sleep time and decrease wake time after sleep onset, while many selective serotonin reuptake inhibitors (SSRIs) have an opposite effect. However, almost all ADs prolong REM sleep latency and reduce the amount of REM sleep. Case reports and research data indicate a strong effect of ADs on dream recall and dream content. We performed a systematic review (1950 to August 2010) about ADs impact on dreaming in depressive patients and healthy volunteers. Twenty-one clinical studies and 25 case reports were eligible for review and document a clear AD effect on dreaming. The major finding, both in depressed patients and in healthy volunteers, is a decrease of dream recall frequency (DRF) under ADs. This is a rather consistent effect in tricyclic ADs and phenelzine, less consistently documented also for SSRIs/serotonin norepinephrine reuptake inhibitors (SNRIs). Tricyclic ADs induce more positive dream emotions. Withdrawal from tricyclic ADs and from the monoamine oxidase inhibitors phenelzine and tranylcypromine may cause nightmares. Intake and even more withdrawal of SSRIs/SNRIs seem to intensify dreaming, which may be experienced in different ways; a potential to cause nightmares has to be taken into account. Though there are clear-cut pharmacological effects of ADs on DRF and dream content, publications have been surprisingly scarce during the past 60 years. There is evidence of a gap in neuropsychopharmacological research. AD effects on dreams should be recognized and may be used in treatment.
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Schlaf und seine Störungen im Alter. SOMNOLOGIE 2012. [DOI: 10.1007/s11818-012-0564-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Associations between psychiatric comorbidities and sleep disturbances in children with attention-deficit/hyperactivity disorder. J Dev Behav Pediatr 2012; 33:97-105. [PMID: 22261833 PMCID: PMC4078726 DOI: 10.1097/dbp.0b013e31823f6853] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Children with attention-deficit/hyperactivity disorder (ADHD) often have sleep complaints and also higher rates of psychiatric comorbidities such as mood and anxiety disorders that may affect sleep. The authors hypothesized that children with ADHD and psychiatric comorbidities would have higher overall sleep disturbance scores as measured by a sleep questionnaire than children with ADHD without comorbidities. METHODS This cross-sectional analysis in an academic center studied 317 children with ADHD; 195 subjects had no comorbid conditions, 60 were anxious and 62 were depressed. Participants completed the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present State, 4th Revised Edition and the Children's Sleep Habits Questionnaire. RESULTS Median age (range) was 8.9 (6-18.7) years; 78% were male. Median (interquartile range) Total Sleep Disturbance Score (TSDS) on Children's Sleep Habits Questionnaire for subjects with no comorbidities was 44 (40-49); anxiety, 48 (43-54); and depression, 46 (41-52). Compared with subjects without comorbidities, TSDS in anxious subjects was greater (p = .008). TSDS in depressed subjects was not significantly different. Compared with subjects without comorbidities, anxious subjects had higher Bedtime Resistance, Sleep Onset Delay, and Night Wakings subscales (p = .03, .007, and .007, respectively); depressed subjects had higher Sleep Onset Delay and Sleep Duration subscales (p = .003 and .01, respectively). CONCLUSIONS Anxiety in children with ADHD contributed to higher overall sleep disturbance scores, compared with children with ADHD alone. Both comorbidities were associated with higher Sleep Onset Latency subscale scores. Further study of the impact of psychiatric comorbidities on sleep in children with ADHD is warranted.
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Wegener G, Mathe AA, Neumann ID. Selectively bred rodents as models of depression and anxiety. Curr Top Behav Neurosci 2012; 12:139-187. [PMID: 22351423 DOI: 10.1007/7854_2011_192] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Stress related diseases such as depression and anxiety have a high degree of co morbidity, and represent one of the greatest therapeutic challenges for the twenty-first century. The present chapter will summarize existing rodent models for research in psychiatry, mimicking depression- and anxiety-related diseases. In particular we will highlight the use of selective breeding of rodents for extremes in stress-related behavior. We will summarize major behavioral, neuroendocrine and neuronal parameters, and pharmacological interventions, assessed in great detail in two rat model systems: The Flinders Sensitive and Flinders Resistant Line rats (FSL/FRL model), and rats selectively bred for high (HAB) or low (LAB) anxiety related behavior (HAB/LAB model). Selectively bred rodents also provide an excellent tool in order to study gene and environment interactions. Although it is generally accepted that genes and environmental factors determine the etiology of mental disorders, precise information is limited: How rigid is the genetic disposition? How do genetic, prenatal and postnatal influences interact to shape adult disease? Does the genetic predisposition determine the vulnerability to prenatal and postnatal or adult stressors? In combination with modern neurobiological methods, these models are important to elucidate the etiology and pathophysiology of anxiety and affective disorders, and to assist in the development of new treatment paradigms.
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Affiliation(s)
- Gregers Wegener
- Centre for Psychiatric Research, Aarhus University Hospital, 8240, Risskov, Denmark,
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43
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Schlaf und seine Störungen im Alter. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2011; 54:1311-8. [DOI: 10.1007/s00103-011-1371-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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44
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Bah TM, Benderdour M, Kaloustian S, Karam R, Rousseau G, Godbout R. Escitalopram reduces circulating pro-inflammatory cytokines and improves depressive behavior without affecting sleep in a rat model of post-cardiac infarct depression. Behav Brain Res 2011; 225:243-51. [DOI: 10.1016/j.bbr.2011.07.039] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 07/21/2011] [Accepted: 07/22/2011] [Indexed: 10/17/2022]
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45
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Norra C, Richter N, Juckel G. Sleep disturbances and suicidality: a common association to look for in clinical practise and preventive care. EPMA J 2011; 2:295-307. [PMID: 23199165 PMCID: PMC3405392 DOI: 10.1007/s13167-011-0101-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 07/01/2011] [Indexed: 01/10/2023]
Abstract
Suicidality and suicide has been associated with many risk factors, while recent clinical and epidemiological studies increasingly point to a potential link between sleep loss or sleep disturbances and suicidality. This review on studies of sleep disturbances associated with suicidality, i.e., suicidal ideation, suicide attempt and completed suicide suggests a frequent association especially with insomnia and nightmares but also hypersomnia and sleep panic attacks. In suicidal insomniacs with comorbid psychiatric disorders, there is some evidence for an even independent predictive nature of sleep problems for suicidality. Considerations on the shared neurobiology, risk assessment and treatment options complement the overview. Thus, sleep disturbances may qualify as an individual treatable target of personalised medicine in the clinical routine as well as in suicide prevention programmes. A more detailed assessment of sleep problems and identification of specific risk domains in primary or secondary prevention of suicidality seem to be a future area of high importance.
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Affiliation(s)
- Christine Norra
- Department of Psychiatry, Ruhr University Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
| | - Nadja Richter
- Department of Psychiatry, Ruhr University Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, Alexandrinenstrasse 1, 44791 Bochum, Germany
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Reigstad B, Jørgensen K, Sund AM, Wichstrøm L. Prevalences and correlates of sleep problems among adolescents in specialty mental health services and in the community: what differs? Nord J Psychiatry 2010; 64:172-80. [PMID: 19883190 DOI: 10.3109/08039480903282392] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS Knowledge of sleep problems and their relationships among adolescent psychiatric patients is limited. This study investigated whether adolescents in specialty mental health care differ in rate and correlates of sleep problems from adolescents in a community sample; 2465 adolescents from a community sample were compared with a representative clinical sample of 129 adolescent patients. METHODS Comparisons were made on frequent sleep problems according to scores on the Youth Self-Report, the Mood and Feelings Questionnaire, and instruments assessing coping styles, stresses and family functioning. RESULTS Sleep problems were more frequent in the clinical sample than the community sample (31.3% vs. 5%). Sleeping little and being overtired were the most common sleep problems. Sleep problems were multivariately associated with internalizing problems in both samples. Poor family functioning and distractive coping were multivariately associated with sleep problems among adolescent patients, whereas depressive symptoms were multivariately associated in community adolescents. CONCLUSIONS Prevalences of sleep problems were high among adolescent patients. However, sleep problems may be in danger of being unnoticed in clinical practice. Clinicians should ask about such problems and be aware of possible connections with family functioning, depression and suicidality. Therapeutic interventions directed towards sleep problems should be considered.
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Affiliation(s)
- Bjørn Reigstad
- Department of Child and Adolescent Psychiatry, Nordlandssykehuset, Bodø, Norway.
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Jaiswal MK, Dvela M, Lichtstein D, Mallick BN. Endogenous ouabain-like compounds in locus coeruleus modulate rapid eye movement sleep in rats. J Sleep Res 2010; 19:183-91. [PMID: 19878449 DOI: 10.1111/j.1365-2869.2009.00781.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although the detailed mechanism of spontaneous generation and regulation of rapid eye movement sleep (REMS) is yet unknown, it has been reported that noradrenergic REM-OFF neurons in the locus coeruleus (LC) cease firing during REMS and, if they are kept active, REMS is significantly reduced. On the other hand, the activity as well as expression of Na-K ATPase has been shown to increase in the LC following REMS deprivation. Ouabain is a specific inhibitor of Na-K ATPase, and endogenous ouabain-like compounds are present in the brain. These findings led us to propose that a decrease in the level of ouabain-like compounds spontaneously available in and around the LC would stimulate and increase the REM-OFF neuronal activities in this region and thus would reduce REMS. To test this hypothesis, we generated anti-ouabain antibodies and then microinjected it bilaterally into the LC in freely moving chronically prepared rats and recorded electrophysiological signals for evaluation of sleep-wakefulness states; suitable control experiments were also conducted. Injection of anti-ouabain antibodies into the LC, but not into adjacent brain areas, significantly reduced percent REMS (mean +/- SEM) from 7.12 (+/-0.74) to 3.63 (+/-0.65). The decrease in REMS was due to reduction in the mean frequency of REMS episode, which is likely due to increased excitation of the LC REM-OFF neurons. Control microinjections of normal IgG did not elicit this effect. These results support our hypothesis that interactions of naturally available endogenous ouabain-like compounds with the Na-K ATPase in the LC modulate spontaneous REMS.
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Affiliation(s)
- Manoj K Jaiswal
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
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Circadian phase and sex effects on depressive/anxiety-like behaviors and HPA axis responses to acute stress. Physiol Behav 2009; 99:276-85. [PMID: 19932127 DOI: 10.1016/j.physbeh.2009.11.002] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Revised: 11/03/2009] [Accepted: 11/09/2009] [Indexed: 01/21/2023]
Abstract
Circadian dysregulation in sleep pattern, mood, and hypothalamic-pituitary-adrenal (HPA) axis activity, often occurring in a sexually dimorphic manner, are characteristics of depression. However, the inter-relationships among circadian phase, HPA function, and depressive-like behaviors are not well understood. We investigated behavioral and neuroendocrine correlates of depressive/anxiety-like responses during diurnal ('light') and nocturnal ('dark') phases of the circadian rhythm in the open field (OF), elevated plus maze (EPM), forced swim (FST), and sucrose contrast (SC) tests. Plasma corticosterone (CORT) was measured after a) acute restraint and OF testing and b) FST. Both phase and sex significantly influenced behavioral responses to stress. Males were more anxious than females on the EPM in the light but not the dark phase. Further, the open:closed arm ratio was lower in the dark for females, but not males. By contrast, in the FST, females showed more "despair" (immobility) when tested in the dark, while phase did not affect males. Acute restraint stress increased OF activity in the light, but not the dark, phase. CORT levels were increased in both sexes following the FST, and in males and light phase females post-OF. As expected, females had higher CORT levels than males, even at rest, and this effect was more pronounced in the dark phase. Together, our data highlight the sexually dimorphic influences of circadian phase and stress on behavioral and hormonal responsiveness.
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Benca R, Duncan MJ, Frank E, McClung C, Nelson RJ, Vicentic A. Biological rhythms, higher brain function, and behavior: Gaps, opportunities, and challenges. ACTA ACUST UNITED AC 2009; 62:57-70. [PMID: 19766673 DOI: 10.1016/j.brainresrev.2009.09.005] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Revised: 09/14/2009] [Accepted: 09/15/2009] [Indexed: 10/20/2022]
Abstract
Increasing evidence suggests that disrupted temporal organization impairs behavior, cognition, and affect; further, disruption of circadian clock genes impairs sleep-wake cycle and social rhythms which may be implicated in mental disorders. Despite this strong evidence, a gap in understanding the neural mechanisms of this interaction obscures whether biological rhythms disturbances are the underlying causes or merely symptoms of mental disorder. Here, we review current understanding, emerging concepts, gaps, and opportunities pertinent to (1) the neurobiology of the interactions between circadian oscillators and the neural circuits subserving higher brain function and behaviors of relevance to mental health, (2) the most promising approaches to determine how biological rhythms regulate brain function and behavior under normal and pathological conditions, (3) the gaps and challenges to advancing knowledge on the link between disrupted circadian rhythms/sleep and psychiatric disorders, and (4) the novel strategies for translation of basic science discoveries in circadian biology to clinical settings to define risk, prevent or delay onset of mental illnesses, design diagnostic tools, and propose new therapeutic strategies. The review is organized around five themes pertinent to (1) the impact of molecular clocks on physiology and behavior, (2) the interactions between circadian signals and cognitive functions, (3) the interface of circadian rhythms with sleep, (4) a clinical perspective on the relationship between circadian rhythm abnormalities and affective disorders, and (5) the pre-clinical models of circadian rhythm abnormalities and mood disorders.
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Affiliation(s)
- Ruth Benca
- Department of Psychology and Psychiatry, University of Wisconsin-Madison, 53792, USA
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Manoach DS, Stickgold R. Does abnormal sleep impair memory consolidation in schizophrenia? Front Hum Neurosci 2009; 3:21. [PMID: 19750201 PMCID: PMC2741296 DOI: 10.3389/neuro.09.021.2009] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 08/12/2009] [Indexed: 11/13/2022] Open
Abstract
Although disturbed sleep is a prominent feature of schizophrenia, its relation to the pathophysiology, signs, and symptoms of schizophrenia remains poorly understood. Sleep disturbances are well known to impair cognition in healthy individuals. Yet, in spite of its ubiquity in schizophrenia, abnormal sleep has generally been overlooked as a potential contributor to cognitive deficits. Amelioration of cognitive deficits is a current priority of the schizophrenia research community, but most efforts to define, characterize, and quantify cognitive deficits focus on cross-sectional measures. While this approach provides a valid snapshot of function, there is now overwhelming evidence that critical aspects of learning and memory consolidation happen offline, both over time and with sleep. Initial memory encoding is followed by a prolonged period of consolidation, integration, and reorganization, that continues over days or even years. Much of this evolution of memories is mediated by sleep. This article briefly reviews (i) what is known about abnormal sleep in schizophrenia, (ii) sleep-dependent memory consolidation in healthy individuals, (iii) recent findings of impaired sleep-dependent memory consolidation in schizophrenia, and (iv) implications of impaired sleep-dependent memory consolidation in schizophrenia. This literature suggests that abnormal sleep in schizophrenia disrupts attention and impairs sleep-dependent memory consolidation and task automation. We conclude that these sleep-dependent impairments may contribute substantially to generalized cognitive deficits in schizophrenia. Understanding this contribution may open new avenues to ameliorating cognitive dysfunction and thereby improve outcome in schizophrenia.
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Affiliation(s)
- Dara S Manoach
- Department of Psychiatry, Massachusetts General Hospital Charlestown, MA 02129 , USA.
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