Chronotype is differentially associated with lifetime mood and panic-agoraphobic spectrum symptoms in patients with bipolar disorder and healthy controls

Chronotype and lifestyle in the transition to adulthood: Exploring the role of sleep health and circadian misalignment

OBJECTIVES

The present study aimed at exploring the association between eveningness and lifestyle-related variables, that is, body mass index, alcohol, and cigarette consumption, in adults (18-40years), focusing on the possible moderator effect of age and the role of sleep disturbances and circadian misalignment (social jetlag).

METHODS

A web-based survey was administered to 437 participants, covering demographics, lifestyle-related variables, chronotype, sleep quality, and daytime sleepiness. A subset of 206 participants wore a wrist actigraph for a week, allowing the creation of a sleep health index within the RU-SATED framework. Regression analysis was used to investigate the associations between chronotype and lifestyle-related outcomes, accounting for social jetlag and sleep health; and to explore the lifestyle trajectories over time.

RESULTS

Evening chronotypes showed higher body mass index levels, consumed more alcohol, and smoked more cigarettes than other circadian typologies, in particular after 25 years of age. Poor sleep health and social jetlag significantly contribute to explaining evening types smoking behavior, while not affecting body mass index levels. Social jetlag plays a more important role compared to sleep disturbances and eveningness in predicting more detrimental drinking and smoking behavior.

CONCLUSIONS

Participants who maintain the evening trait past the age of 25years are more prone to adopt an unhealthy lifestyle, especially if experiencing poor sleep health and circadian misalignment. Circadian preferences and sleep health should be considered when planning interventions aimed at promoting healthy lifestyles in adults aged 18-40years. Further investigations should explore the effect of modifications in lifestyle in the prevention of noncommunicable diseases.

Actigraphic and self-reported characterization of sleep in systemic lupus erythematosus patients

OBJECTIVES

In a cross-sectional study, we explored possible differences in sleep parameters between SLE patients and age- and gender-matched healthy controls through actigraphic and self-reported measures. Furthermore, we aimed to identify possible predictors of such disturbances in the patient cohort.

METHODS

Participants' sociodemographic data and sleep parameters were collected. Sleep parameters were evaluated through the Pittsburgh Sleep Quality Index, the Insomnia Severity Index and 7-day actigraphic monitoring. The 10-item Perceived Stress Scale was used to investigate stress. Disease activity and daily glucocorticoid dose were assessed in SLE patients. Possible predictors of the SLE group were explored through two binomial logistic models. Within the SLE group, possible predictors of sleep parameters were tested estimating multiple linear regression models.

RESULTS

A total of 40 SLE patients and 33 controls were included in the study. The SLE group showed worse sleep maintenance actigraphic parameters (i.e. sleep efficiency and wake after sleep onset), higher total sleep time and higher perceived stress. Within the SLE cohort, the daily glucocorticoids dose was associated with an impairment in sleep maintenance despite no reduction in sleep duration, typical of normal sleep duration insomnia, whereas perceived stress was associated with short sleep duration insomnia.

CONCLUSION

Compared with healthy controls, SLE patients showed worse sleep quality and greater perceived stress severity. As glucocorticoids and perceived stress are associated with different types of insomnia in these patients, a multidimensional approach to both sleep characterization and therapy might be preferred.

Effects of exogenous melatonin on sleep and circadian rhythm parameters in bipolar disorder with comorbid delayed sleep-wake phase disorder: An actigraphic study

The present study evaluates the effect of exogenous melatonin (exo-MEL) on sleep and circadian parameters in patients with bipolar disorder (BD) and delayed sleep-wake phase disorder (DSWPD). BD euthymic patients (n = 83, mean age = 45.13 ± 13.68, males 56%) were evaluated for chronotype (reduced Morningness-Eveningness Questionnaire [rMEQ]), sleep quality (Pittsburgh Sleep Quality Index), sleep and circadian parameters (actigraphic monitoring). Patients that fulfilled criteria for DSWPD (n = 25) were treated for three months with exo-MEL 2 mg administered approximately 4 h before the sleep onset time (SOT) actigraphically-determined at baseline. Sleep and circadian parameters at baseline (T0) and after the exo-MEL treatment (T1) were compared using paired Wilcoxon test. In patients that completed the treatment (n = 19), the rMEQ score increased between T0 (median = 8.0 [IQR = 7.0, 11.0]) and T1 (median = 13.5 [IQR = 9.3, 15.0], p-value = 0.006), the SOT was advanced between T0 (median = 00:55 [IQR = 00:25, 01:39] and T1 (median = 00:09 [IQR = 23:41, 01:04], p-value = 0.039), the sleep efficiency and total sleep time increased (T0: median = 84.4 [IQR = 81.3, 89.4]; T1 (median = 90.3 [IQR = 85.5, 92.9] %, p-value = 0.01, and T0: median = 7.20 [IQR = 6.15, 8.15]; T1: median = 7.7 [IQR = 7.0, 9.3] hours, p-value = 0.04, respectively). These results indicate that in BD with comorbid DSWPD, the self-reported chronotype, the sleep onset time, and sleep efficiency and duration were modified after a personalized treatment with exo-MEL, suggesting its potential efficacy in improving sleep patterns in BD. The absence of proper control groups and of treatment randomization constitute limitations of our study and further randomized controlled trials are required to confirm our results.