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Wallace DA, Johnson DA, Redline S, Sofer T, Kossowsky J. Rest-activity rhythms across the lifespan: cross-sectional findings from the US representative National Health and Nutrition Examination Survey. Sleep 2023; 46:zsad220. [PMID: 37610882 PMCID: PMC10636247 DOI: 10.1093/sleep/zsad220] [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: 03/27/2023] [Revised: 08/15/2023] [Indexed: 08/25/2023] Open
Abstract
STUDY OBJECTIVES Rest-activity rhythms (RAR) may mark development, aging, and physical and mental health. Understanding how they differ between people may inform intervention and health promotion efforts. However, RAR characteristics across the lifespan have not been well-studied. Therefore, we investigated the association between RAR measures with demographic and lifestyle factors in a US nationally representative study. METHODS RAR metrics of interdaily stability (IS), intradaily variability (IV), relative amplitude (RA), and mean amplitude and timing of high (M10) and low (L5) activity were derived from 2011 to 2012 and 2013 to 2014 National Health and Nutrition Examination Survey (NHANES) actigraphy data. Population-weighted linear and logistic regression models were fit to examine the associations of age, gender, smoking, alcohol, season, body mass index (BMI), income-to-poverty ratio, and race/ethnicity with RAR. Significance was based on a false-discovery rate-corrected P-value of <0.05. RESULTS Among n = 12 526 NHANES participants (3-≥80 years), IS (higher = greater day-to-day regularity) and RA (higher = greater rhythm strength) generally decreased with age and were lower among males, whereas IV (higher = greater rhythm fragmentation) increased with age (p < 0.05). Dynamic changes in RAR trajectories were observed during childhood and adolescence. Income, BMI, smoking, and alcohol use were associated with RAR metrics, as well as season among children and teenagers (p < 0.05). RAR also differed by race/ethnicity (p < 0.05), with trajectories initially diverging in childhood and continuing into adulthood. CONCLUSIONS RAR differed by demographic and health-related factors, representing possible windows for public health intervention and sleep health promotion. RAR differences by race/ethnicity begin in childhood, are evident in early adolescence, and persist throughout adulthood.
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Affiliation(s)
- Danielle A Wallace
- Division of Sleep Medicine, Harvard Medical School, Boston MA, USA
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston MA, USA
| | - Dayna A Johnson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Boston MA, USA
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tamar Sofer
- Division of Sleep Medicine, Harvard Medical School, Boston MA, USA
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joe Kossowsky
- Division of Sleep Medicine, Harvard Medical School, Boston MA, USA
- Department of Anesthesia, Harvard Medical School, Boston MA, USA
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston MA, USA
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Wang S, Wang H, Deng X, Lei X. Validation of the Munich Chronotype Questionnaire (MCTQ) in Chinese college freshmen based on questionnaires and actigraphy. Chronobiol Int 2023:1-12. [PMID: 37080772 DOI: 10.1080/07420528.2023.2202246] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
The Munich Chronotype Questionnaire (MCTQ) was developed to determine an individual's chronotype, and it provides information about sleep and wake times separately for work and free days. However, the MCTQ has not been effectively verified using a large sample based on multiple questionnaires and actigraphy measures. Three sequential studies were conducted. Study 1 used a large sample (n = 1066) to investigate the chronotype of Chinese college freshmen and assess the validity of the MCTQ compared with the reduced Morningness-Eveningness Questionnaire (rMEQ), actigraphy, and other related questionnaires. Study 2 verified the MCTQ compared with a sleep diary. Study 3 examined the test-retest reliability of the MCTQ at the 2-year follow-up. The results showed that MCTQ parameters were significantly associated with rMEQ scores, the actigraphy-based mid-point of sleep, sleep quality, depression, and trait anxiety. In addition, all MCTQ variables were significantly related to the diary-based sleep mid-point. The test-retest reliability of the mid-point of sleep adjusted for sleep debt (MSFsc) and mid-point of sleep on free days (MSF) was acceptable. These results indicate that the MCTQ is a practical and efficient tool with good reliability. Its further development is important for the accurate assessment of chronotypes and clinical diagnoses of sleep.
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Affiliation(s)
- Shuo Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Haien Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Xinyi Deng
- Department of Psychology, Cornell University, Ithaca, New York, USA
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
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Swanson GR, Kochman N, Amin J, Chouhan V, Yim W, Engen PA, Shaikh M, Naqib A, Tran L, Voigt RM, Forsyth CB, Green SJ, Keshavarzian A. Disrupted Circadian Rest-Activity Cycles in Inflammatory Bowel Disease Are Associated With Aggressive Disease Phenotype, Subclinical Inflammation, and Dysbiosis. Front Med (Lausanne) 2021; 8:770491. [PMID: 35265631 PMCID: PMC8900134 DOI: 10.3389/fmed.2021.770491] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/08/2021] [Indexed: 12/11/2022] Open
Abstract
Patients with inflammatory bowel disease (IBD)-Crohn's disease (CD), and ulcerative colitis (UC), have poor sleep quality. Sleep and multiple immunologic and gastrointestinal processes in the body are orchestrated by the circadian clock, and we recently reported that a later category or chronotype of the circadian clock was associated with worse IBD specific outcomes. The goal of this study was to determine if circadian misalignment by rest-activity cycles is associated with markers of aggressive disease, subclinical inflammation, and dysbiosis in IBD. A total of 42 patients with inactive but biopsy-proven CD or UC and 10 healthy controls participated in this prospective cohort study. Subjects were defined as having an aggressive IBD disease history (steroid dependence, use of biologic or immunomodulator, and/or surgery) or non-aggressive history. All participants did two weeks of wrist actigraphy, followed by measurement of intestinal permeability and stool microbiota. Wrist actigraphy was used to calculate circadian markers of rest-activity- interdaily stability (IS), intradaily variability (IV), and relative amplitude (RA). Aggressive IBD history was associated with decrease rest-activity stability (IS) and increased fragmentation compared to non-aggressive IBD and health controls at 0.39 ±.15 vs. 0.51 ± 0.10 vs. 0.55 ± 0.09 (P < 0.05) and 0.83 ± 0.20 vs. 0.72 ± 0.14 (P < 0.05) but not HC at 0.72 ± 0.14 (P = 0.08); respectively. There was not a significant difference in RA by IBD disease history. Increased intestinal permeability and increased TNF-α levels correlated with an increased rest activity fragmentation (IV) at R = 0.35, P < 0.05 and R = 0.37, P < 0.05, respectively; and decreased rest-activity amplitude (RA) was associated with increased stool calprotectin at R = 0.40, P < 0.05. Analysis of intestinal microbiota showed a significant decrease in commensal butyrate producing taxa and increased pro-inflammatory bacteria with disrupted rest-activity cycles. In this study, different components of circadian misalignment by rest-activity cycles were associated with a more aggressive IBD disease history, increased intestinal permeability, stool calprotectin, increased pro-inflammatory cytokines, and dysbiosis. Wrist activity allows for an easy non-invasive assessment of circadian activity which may be an important biomarker of inflammation in IB.
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Affiliation(s)
- Garth R. Swanson
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
- *Correspondence: Garth R. Swanson
| | - Nicole Kochman
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Jaimin Amin
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Vijit Chouhan
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Wesley Yim
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Phillip A. Engen
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
| | - Maliha Shaikh
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
| | - Ankur Naqib
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
| | - Laura Tran
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
| | - Robin M. Voigt
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
| | - Christopher B. Forsyth
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
| | - Stefan J. Green
- Genomics and Microbiome Core Facility, Rush University, Chicago, IL, United States
| | - Ali Keshavarzian
- Division of Digestive Diseases and Nutrition, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
- Rush Medical College, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL, United States
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Yavuz-Kodat E, Reynaud E, Geoffray MM, Limousin N, Franco P, Bonnet-Brilhault F, Bourgin P, Schroder CM. Disturbances of Continuous Sleep and Circadian Rhythms Account for Behavioral Difficulties in Children with Autism Spectrum Disorder. J Clin Med 2020; 9:jcm9061978. [PMID: 32599848 PMCID: PMC7356341 DOI: 10.3390/jcm9061978] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/20/2020] [Accepted: 06/21/2020] [Indexed: 12/27/2022] Open
Abstract
Sleep disorders are among the most common comorbidities in children with Autism Spectrum Disorder (ASD), and subjectively defined sleep disturbances have been related to ASD symptom severity. However, no study has investigated the differential impact of objectively measured sleep and circadian rhythm disturbances on behavioral difficulties in this population. Fifty-two children with ASD aged 3-10 years underwent assessments of sleep and circadian rest-activity rhythms objectively with actigraphy and subjectively with the Children's Sleep Habits Questionnaire. Behavioral difficulties were assessed using the ABC-C. Group comparison analyses were used to compare sleep and circadian rhythm parameters of children with higher and lower behavioral difficulties and dominance analysis to rank predictors and address multicollinearity. Children with high irritability had a shorter continuous sleep period compared to those with lower irritability (-60 min, p = 0.04), as well as those with high stereotypic behaviors compared to children with less stereotypies (-75 min, p = 0.006). Objective circadian and sleep disturbances accounted together for, respectively, 17%, 18% and 36% of the variance in social withdrawal, irritability and stereotypic behaviors. The identification of both sleep and circadian rhythm disturbances as explanatory factors for behavioral difficulties warrants their inclusion in the existing behavioral management strategies for children with ASD.
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Affiliation(s)
- Enise Yavuz-Kodat
- Centre National de la Recherche Scientifique CNRS UPR 3212, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, 8 allée du Général Rouvillois, 67000 Strasbourg, France; (E.Y.-K.); (P.B.); (C.M.S.)
| | - Eve Reynaud
- Centre National de la Recherche Scientifique CNRS UPR 3212, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, 8 allée du Général Rouvillois, 67000 Strasbourg, France; (E.Y.-K.); (P.B.); (C.M.S.)
- Correspondence:
| | - Marie-Maude Geoffray
- Department of Child and Adolescent Neurodevelopmental Psychiatry, Le Vinatier Hospital, 95 Boulevard Pinel, 69678 Bron CEDEX, France;
- Health Services and Performance Research (HESPER), Claude Bernard University Lyon 1, 43 Boulevard du 11 Novembre 1918, 69622 Villeurbane CEDEX, France
| | - Nadège Limousin
- Department of Neurology and Clinical Neurophysiology, University Hospital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France;
| | - Patricia Franco
- Pediatric Sleep, Hôpital Femme-Mère-Enfant, Hospices civils of Lyon, 59 Boulevard Pinel, 69500 Bron, France;
- Lyon Neuroscience Research Center U1028/UMR5292, Claude Bernard University Lyon 1, 43 Boulevard du 11 Novembre 1918, 69622 Villeurbane CEDEX, France
| | - Frédérique Bonnet-Brilhault
- UMR 1253, iBrain, Université de Tours, Inserm, CHRU de Tours, Centre Universitaire de Pédopsychiatrie, 2 Boulevard Tonnellé, 37044 Tours, France;
| | - Patrice Bourgin
- Centre National de la Recherche Scientifique CNRS UPR 3212, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, 8 allée du Général Rouvillois, 67000 Strasbourg, France; (E.Y.-K.); (P.B.); (C.M.S.)
- Sleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospitals, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Carmen M. Schroder
- Centre National de la Recherche Scientifique CNRS UPR 3212, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, 8 allée du Général Rouvillois, 67000 Strasbourg, France; (E.Y.-K.); (P.B.); (C.M.S.)
- Sleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospitals, 1 place de l’Hôpital, 67000 Strasbourg, France
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals & University of Strasbourg Medical School, 67000 Strasbourg, France
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