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El Rafihi-Ferreira R, Linares IMP, Paulos-Guarnieri L, Zakiei A. Psychological inflexibility as a predictor associated with insomnia. J Sleep Res 2024:e14232. [PMID: 38703025 DOI: 10.1111/jsr.14232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/23/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
Psychological flexibility has recently attracted the attention of researchers in the field of sleep disorders; therefore, in the study, psychological flexibility was evaluated as a predictor or factor related to the presence/severity of insomnia. We included 2218 individuals selected from the randomized-control trial for behavioural therapy for insomnia and cross-sectional studies, including 1797 individuals with insomnia and 421 controls without insomnia. All participants completed the DSM-5-based insomnia diagnosis interview, Insomnia Severity Index, Hospital Anxiety and Depression Scale, and Acceptance Action Questionnaire-II. Linear regression and multinomial logistic regression models were used. Sex, education, occupation, marital status, anxiety, depression and psychological inflexibility were possible predictors or factors associated with the severity of insomnia. Multivariate linear regression analysis demonstrated that sex (𝛽 = 0.88; t = 2.80; p = 0.005), depression (𝛽 = 0.41; t = 10.7; p < 0.001), anxiety (𝛽 = 0.58; t = 14.1; p < 0.001) and psychological inflexibility (𝛽 = 0.09; t = 5.07; p < 0.001) were predictors of insomnia. The results of the multinomial logistic regression demonstrate that, in comparison to the absence of insomnia, insomnia at all levels (mild, moderate and severe) was associated with sex, anxiety and depression. Psychological inflexibility was only associated with severe insomnia (odds ratio = 1.04). These findings are important from a public health perspective because behavioural strategies designed to treat insomnia with a focus on psychological flexibility are low-cost and may help improve sleep quality in adults with insomnia, which also influences mental health.
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Affiliation(s)
| | | | | | - Ali Zakiei
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Muhammad T, Srivastava S, Muneera K, Kumar M, Kelekar U. Treatment for Insomnia Symptoms is Associated with Reduced Depression Among Older Adults: A Propensity Score Matching Approach. Clin Gerontol 2024; 47:436-451. [PMID: 37153958 DOI: 10.1080/07317115.2023.2208582] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVES The study aimed to investigate the effect of utilization of treatment for insomnia symptoms on the prevalence of major depressive disorder among older adults in India. METHODS We used the data from the Longitudinal Ageing Study in India (LASI), 2017-18. The sample included 10,911 older individuals who reported insomnia symptoms. The propensity score matching (PSM) approach was used to compare the depressive disorder among those who received vs. not received treatment. RESULTS Only 5.7% of older adults reporting insomnia symptoms received treatment. On average, prevalence of depressive disorder among men and women who received treatment for insomnia symptoms was lesser by 0.79 and 0.33 points, respectively, than those who did not receive treatment. In the matched sample, treatment for insomnia symptoms was significantly associated with lesser prevalence of depression for both older men (β= -0.68, p < .001) and older women (β= -0.62, p < .001). CONCLUSIONS The current findings suggest that treatment for insomnia symptoms can reduce the risk of depressive disorder among older adults and the effects are higher among older men than women.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - K Muneera
- School of Management Studies, National Institute of Technology, Calicut, Kerala, India
| | - Manish Kumar
- Population Research Centre, Dharwad, Karnataka, India
| | - Uma Kelekar
- School of Business, College of Business, Innovation, Leadership and Technology
- Marymount Center for Optimal Aging, Marymount University, Arlington-VA, USA
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Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [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] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
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McCall WV, Looney SW, Zulfiqar M, Ketcham E, Jones M, Mixson C, McCloud L, Miller BJ, Rosenquist PB. Daytime autonomic nervous system functions differ among adults with and without insomnia symptoms. J Clin Sleep Med 2023; 19:1885-1893. [PMID: 37421322 PMCID: PMC10620659 DOI: 10.5664/jcsm.10704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
STUDY OBJECTIVES We gathered data to determine whether daytime assays of the autonomic nervous system would differ between persons with no vs modest insomnia symptoms and would correlate with the severity of insomnia symptoms in patients. METHODS This report is composed of 2 studies. Study 1 conducted pupillary light reflex (PLR) measurements in community volunteers who were not seeking medical care. Study 2 contrasted PLR and heart rate variability in a different sample of community volunteers and a comparison sample of adults seeking outpatient care for insomnia and psychiatric problems. All measurements were taken between 3 and 5 pm. RESULTS In Study 1, volunteers with modest insomnia symptom severity had a more rapid PLR average constriction velocity compared with those with no symptoms. In Study 2, lower heart rate variability, indicating higher levels of physiologic arousal, generally were in agreement with faster PLR average constriction velocity, both of which indicate higher levels of arousal. Insomnia symptom severity was highly correlated with faster average constriction velocity in the patient sample. CONCLUSIONS These studies suggest that (1) daytime measurements of the autonomic nervous system differ between persons with modest vs no insomnia symptoms and (2) insomnia symptom severity is highly correlated with PLR. Daytime measurement of autonomic nervous system activity might allow for daytime point-of-care measurement to characterize the level of physiologic arousal to define a hyperarousal subtype of insomnia disorder. CITATION McCall WV, Looney SW, Zulfiqar M, et al. Daytime autonomic nervous system functions differ among adults with and without insomnia symptoms. J Clin Sleep Med. 2023;19(11):1885-1893.
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Affiliation(s)
- William V. McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Stephen W. Looney
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Maria Zulfiqar
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Evan Ketcham
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Megan Jones
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Carter Mixson
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Laryssa McCloud
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Brian J. Miller
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Peter B. Rosenquist
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia
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Saitoh K, Yoshiike T, Kaneko Y, Utsumi T, Matsui K, Nagao K, Kawamura A, Otsuki R, Otsuka Y, Aritake-Okada S, Kaneita Y, Kadotani H, Kuriyama K, Suzuki M. The effect of nonrestorative sleep on incident hypertension 1-2 years later among middle-aged Hispanics/Latinos. BMC Public Health 2023; 23:1456. [PMID: 37525185 PMCID: PMC10388461 DOI: 10.1186/s12889-023-16368-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 07/24/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Insomnia is known to be a major risk factor for incident hypertension. Nonrestorative sleep (NRS), which refers to insufficiently rested sleep, has reported to associate with various diseases. This study aimed to investigate the longitudinal association between insomnia-related symptoms including NRS and incident hypertension 1-2 years later by age group (young, 18-39 years and middle-age, 40-64 years) using existing cohort data involving Hispanics/Latinos. METHODS This study included 1100 subjects who had participated in both the Hispanic Community Health Study/Study of Latinos and its follow-up study, the Sueño Ancillary Study, and met additional eligibility criteria. Incident hypertension was assessed by self-reported history and/or the use of antihypertensives. The Women's Health Initiative Insomnia Rating Scale (WHIIRS) was used to evaluate insomnia-related symptoms (difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, difficulty returning to sleep, and NRS). Logistic regression analyses were conducted to assess the degree to which insomnia-related symptoms at baseline predicted incident hypertension. RESULTS Among the participants (64% middle-aged, 36% young adults), 140 (12.7%) developed hypertension during the follow-up period. Among the sleep-related symptoms, only NRS predicted incident hypertension after adjusting for sociodemographic factors and physical condition (odds ratio: 1.88, 95% confidence interval: 1.10-3.21, p = 0.022) in middle-aged adults. None of the insomnia-related symptoms were associated with incident hypertension in the young adults. No association was found between WHIIRS-defined insomnia (total score ≥ 9) and incident hypertension in middle-aged adults or young adults. CONCLUSION The present findings suggest the importance of focusing on NRS to help prevent the development of hypertension in middle-aged adults.
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Affiliation(s)
- Kaori Saitoh
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Fondation FondaMental, Créteil, France
- Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, Créteil, France
| | - Takuya Yoshiike
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshiyuki Kaneko
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomohiro Utsumi
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Kentaro Matsui
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Clinical Laboratory, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
| | - Kentaro Nagao
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Aoi Kawamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Rei Otsuki
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Sayaka Aritake-Okada
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Health Sciences, Saitama Prefectural University, Saitama, Japan
| | - Yoshitaka Kaneita
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Kenichi Kuriyama
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masahiro Suzuki
- Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
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Carbone EA, Menculini G, de Filippis R, D’Angelo M, De Fazio P, Tortorella A, Steardo L. Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4431. [PMID: 36901441 PMCID: PMC10002427 DOI: 10.3390/ijerph20054431] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/16/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Patients with a generalized anxiety disorder (GAD) often report preeminent sleep disturbances. Recently, calcium homeostasis gained interest because of its role in the regulation of sleep-wake rhythms and anxiety symptoms. This cross-sectional study aimed at investigating the association between calcium homeostasis imbalance, anxiety, and quality of sleep in patients with GAD. A total of 211 patients were assessed using the Hamilton Rating Scale for Anxiety (HAM-A), Pittsburgh Sleep Quality Index questionnaire (PSQI) and Insomnia Severity Index (ISI) scales. Calcium, vitamin D, and parathyroid hormone (PTH) levels were evaluated in blood samples. A correlation and linear regression analysis were run to evaluate the association of HAM-A, PSQI, and ISI scores with peripheral markers of calcium homeostasis imbalance. Significant correlations emerged between HAM-A, PSQI, ISI, PTH, and vitamin D. The regression models showed that patients with GAD displaying low levels of vitamin D and higher levels of PTH exhibit a poor subjective quality of sleep and higher levels of anxiety, underpinning higher psychopathological burden. A strong relationship between peripheral biomarkers of calcium homeostasis imbalance, insomnia, poor sleep quality, and anxiety symptomatology was underlined. Future studies could shed light on the causal and temporal relationship between calcium metabolism imbalance, anxiety, and sleep.
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Affiliation(s)
- Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Graecia, 88100 Catanzaro, Italy
| | - Giulia Menculini
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy
| | - Renato de Filippis
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Martina D’Angelo
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy
| | - Luca Steardo
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
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Lucena L, Lavigne G, Fabbro CD, Andersen ML, Tufik S, Hachul H. Association between night pain and quality of life in women: A general population sleep study. Eur J Pain 2023; 27:401-412. [PMID: 36516369 DOI: 10.1002/ejp.2066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Women with pain present decreased sleep duration and quality of life, but little is known about the consequences of nighttime pain on overall health. Our goal was to compare levels of anxiety, depression and fatigue in women with pain during the night with those without pain. We hypothesized that pain perception is associated with the worsening of fatigue and mood. METHODS In total, 244 women aged 20-80 years who took part in the Epidemiologic Sleep Study (EPISONO) met the inclusion criteria, 85 in the self-reported pain group and 171 in the control group. Participants were assigned to the pain group if they both responded (i) they generally had pain, according to Pre-Sleep Questionnaire (PSQ) and (ii) their pain generally interfered with their sleep 3 or more times a week, according to Pittsburg Sleep Quality Index (PSQI). Those who answered negatively to both questions were allocated to the control group. All participants underwent a full night laboratory polysomnography, and completed questionnaires related to fatigue, depression, anxiety and quality of life. RESULTS Pain group participants had a significantly lower perception of quality of life, and significantly higher levels of fatigue (5.4 times), anxiety and depression. Pain perception was also correlated to levels of anxiety and depression in the psychological (rs = -0.463, -0.607, respectively) and social (rs = -0.423, -0.438, respectively) quality of life domains. CONCLUSIONS Nighttime pain in women was associated with decreased quality of life, worsening mood and fatigue. Our data shows the importance of investigating pain and its deleterious effects on women's health. SIGNIFICANCE Our study highlights that women experiencing nighttime pain also reported worse mood outcomes and decreased quality of life, regardless of the level and type of pain. Our data, based on association analysis and not investigating causality, suggest it is important to consider nighttime pain in clinical care to improve quality of life and general health.
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Affiliation(s)
- Leandro Lucena
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Gilles Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS Nord lle de Montréal and Stomatology, CHUM, Montréal, Canada
| | - Cibele Dal Fabbro
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
- Center for Advanced Research in Sleep Medicine, CIUSSS Nord lle de Montréal and Stomatology, CHUM, Montréal, Canada
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Helena Hachul
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
- Departamento de Ginecologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Papadopoulos D, Sosso FAE. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med 2023; 19:605-620. [PMID: 36239056 PMCID: PMC9978435 DOI: 10.5664/jcsm.10336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVES This review aims to assess the association between socioeconomic status (SES) and sleep health in the general population and the mediating effects of lifestyle and mental and physical health in this relationship. METHODS Observational studies testing the independent association between objective or subjective SES indicators and behavioral/physiological or clinical sleep health variables in the general population were included. PubMed/MEDLINE was searched for reports published from January 1990 to December 2019. The direction of effect was used as the primary effect measure, testing the hypothesis that low SES is associated with poor sleep health outcomes. Results are presented in the form of direction effect plots and synthesized as binomial proportions. RESULTS Overall, 336 studies were identified. A high proportion of effects at the expected direction was noted for measures of sleep continuity (100% for sleep latency, 50-100% for awakenings, 66.7-100% for sleep efficiency), symptoms of disturbed sleep (75-94.1% for insomnia, 66.7-100% for sleep-disordered breathing, 60-100% for hypersomnia), and general sleep satisfaction (62.5-100%), while the effect on sleep duration was inconsistent and depended on the specific SES variable (92.3% for subjective SES, 31.7% for employment status). Lifestyle habits, chronic illnesses, and psychological factors were identified as key mediators of the SES-sleep relationship. CONCLUSIONS Unhealthy behaviors, increased stress levels, and limited access to health care in low-SES individuals may explain the SES-sleep health gradient. However, the cross-sectional design of most studies and the high heterogeneity in employed measures of SES and sleep limit the quality of evidence. Further research is warranted due to important implications for health issues and policy changes. CITATION Papadopoulos D, Etindele Sosso FA. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med. 2023;19(3):605-620.
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Borges C, Ellis JG, Ruivo Marques D. The Role of Sleep Effort as a Mediator Between Anxiety and Depression. Psychol Rep 2023:332941221149181. [PMID: 36595381 DOI: 10.1177/00332941221149181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Depression, anxiety, and insomnia are all conditions that share a complex bidirectional relationship. Sleep effort is a construct with cognitive and behavioral components that perpetuates insomnia. Although many studies have examined the associations between these three variables, no studies have yet examined sleep effort as a mediating variable between anxiety and depression and vice versa. Online versions of the Hospital Anxiety and Depression Scale and the Glasgow Sleep Effort Scale were administered to a sample of 1927 higher education students aged 18-40 years (75.9% women and 76% from 18 to 23 years old). As part of the survey, participants also completed a sociodemographic questionnaire. Mediation analysis indicated that sleep effort mediates the relationship between depression and anxiety, when the former was the predictor and the latter was the criterion. Moreover, sleep effort also mediated the relationship between anxiety and depression when the former was the predictor and the latter was the criterion, albeit in a lesser extent. Sleep effort appears to play a bidirectional mediational role between depression and anxiety, being a potential target for intervention.
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Affiliation(s)
- Cristina Borges
- Department of Education and Psychology, 56062University of Aveiro, Aveiro, Portugal
| | - Jason G Ellis
- Northumbria Sleep Research Laboratory, Faculty of Health and Life Sciences, 5995Northumbria University, Newcastle, UK
| | - Daniel Ruivo Marques
- Department of Education and Psychology, 56062University of Aveiro, Aveiro, Portugal; CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
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10
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Speed TJ, Hanks L, Turner G, Gurule E, Kearson A, Buenaver L, Smith MT, Antoine D. A comparison of cognitive behavioral therapy for insomnia to standard of care in an outpatient substance use disorder clinic embedded within a therapeutic community: a RE-AIM framework evaluation. Trials 2022; 23:965. [DOI: 10.1186/s13063-022-06885-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 11/04/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Rates of substance use disorders (SUDs) continue to rise in the USA with parallel rises in admissions to outpatient SUD treatment programs. Insomnia symptoms reduce treatment adherence, trigger relapse, and generally undermine SUD recovery efforts. Cognitive-behavioral therapy for insomnia (CBT-I) is the first-line treatment recommended for chronic insomnia. No study has examined the effectiveness of CBT-I for individuals who recently entered an outpatient SUD treatment program embedded within a therapeutic community (i.e., long-term drug-free residential setting).
Methods
A randomized controlled trial conducted at a SUD program embedded in a therapeutic community aimed to compare group-based CBT-I (gCBT-I) (N = 10) with the standard of care (SOC) (N = 11) among individuals who have SUDs and comorbid insomnia. We present a RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework evaluation to provide empirical data on gCBT-I feasibility and facilitators and barriers of conducting an insomnia-focused clinical effectiveness study within a therapeutic community.
Results
Participants in both study arms reported moderately severe insomnia symptoms at admission and reductions in insomnia symptoms over time. Among participants who completed the Insomnia Severity Index (ISI) beyond admission, ISI decreased to ≤ 8 (the clinical cutoff for mild insomnia) in 80% of individuals in the gCBT-I group compared with 25% of individuals in the SOC group. A RE-AIM framework evaluation showed initial success with Reach and Adoption while Implementation, and Maintenance were limited. Effectiveness was inconclusive because of challenges with recruitment, intervention integrity, and missing data that precluded meeting the planned recruitment and study aims and led to study termination. Coordination and communication with staff and leadership facilitated gCBT-I implementation, yet well-known CBT-I barriers including time- and resource-intensive sleep medicine training for interventionalists and maintenance of treatment integrity during an 8-week intervention limited gCBT-I sustainability.
Conclusions
This analysis supports the feasibility of conducting behavioral sleep medicine research in outpatient SUD treatment programs embedded within therapeutic communities. Implementation of an insomnia-focused intervention was widely accepted by patients and providers and has potential to address insomnia symptoms in early SUD recovery. Addressing patient- and organizational-level implementation barriers may enhance the sustainability and scalability of sleep interventions and provide new hope to effectively treat insomnia among people living with SUDs.
Trial registration
Clinicaltrials.gov: NCT03208855. Registered July 6, 2017https://clinicaltrials.gov/ct2/show/NCT03208855?term=NCT03208855&draw=2&rank=1
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Yazıcı R, Güney İ. Prevalence and related factors of poor sleep quality in patients with pre-dialysis chronic kidney disease. Int J Artif Organs 2022; 45:905-910. [PMID: 35982585 DOI: 10.1177/03913988221118941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Sleep disturbances in patients with chronic kidney disease (CKD) are related to decreased quality of life and increased health-related risks. There is insufficient data about actual prevalence and related factors of poor sleepers in this group. In this study, we aimed to investigate prevalence and related risk factors of self-reported poor sleep quality in patients with pre-dialysis CKD. METHODS In this cross-sectional study, 259 pre-dialysis CKD patients (median age 56 years; range, 19-85) were included. Demographical, clinical and laboratory correlates were recorded. Body mass index (BMI) was calculated. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease (MDRD) formula. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), a self-rated questionnaire. Depression was evaluated using the Beck Depression Inventory (BDI). RESULTS Median eGFR was 27.6 ml/min/1.73 m2 (range, 9-56). Of the 259 patients, 110 (42.5%) were poor sleepers with global PSQI score >5. The univariate correlation analysis revealed that global PSQI score was positively correlated with age, BMI, waist circumferences (WC), hip circumferences (HC), serum phosphorus and triglyceride levels, systolic blood pressure (BP), pulse pressure and BDI score, and negatively correlated with male gender and hemoglobin level. Logistic regression analysis, showed that HC, systolic BP, and BDI scores were independently associated with poor sleep quality (p = 0.001, p = 0.020 and p < 0.001, respectively). CONCLUSION Prevalence of poor sleep quality in our pre-dialysis CKD patients was 42.5%. Systolic BP, depression and HC, all of these are potentially correctable factors, were associated with poor sleep quality independently.
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Affiliation(s)
- Raziye Yazıcı
- Department of Internal Medicine, Division of Nephrology, Konya Beyhekim Training and Research Hospital, Konya, Turkey
| | - İbrahim Güney
- Department of Internal Medicine, Division of Nephrology, University of Health Sciences, Konya City Hospital, Konya, Turkey
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Predicting Hypnotic Use among Insomnia Patients with the Theory of Planned Behavior and Craving. Behav Sci (Basel) 2022; 12:bs12070209. [PMID: 35877279 PMCID: PMC9312213 DOI: 10.3390/bs12070209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 12/12/2022] Open
Abstract
While long-term hypnotic use is very common in clinical practice, the associated factors have been understudied. This study aims to explore the cognitive factors that might influence the long-term use of hypnotics based on the theory of planned behavior (TPB), and examines the moderating effect of craving between cognitive intention and actual hypnotic-use behavior at follow-up. A total of 139 insomnia patients completed a self-constructed TPB questionnaire to measure their attitude, subjective norm, perceived behavioral control, and behavioral intention of hypnotic use, as well as the Hypnotic-Use Urge Scale (HUS) to measure their craving for hypnotics. They were then contacted through phone approximately three months later to assess their hypnotic use. Hierarchical regression showed that perceived behavioral control was the most significant determinant for behavioral intention of hypnotic use. Behavioral intention, in turn, can predict the frequency of hypnotic use after three months. However, this association was moderated by hypnotic craving. The association was lower among the participants with higher cravings for hypnotic use. The findings suggest that the patients’ beliefs about their control over sleep and daily life situations, and their craving for hypnotics should be taken into consideration in the management of hypnotic use.
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Park SH, Shin NR, Yang M, Bose S, Kwon O, Nam DH, Lee JH, Song EJ, Nam YD, Kim H. A Clinical Study on the Relationship Among Insomnia, Tongue Diagnosis, and Oral Microbiome. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2022; 50:773-797. [PMID: 35380093 DOI: 10.1142/s0192415x2250032x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Currently, there is a lack of adequate methods to assess insomnia objectively. This study addresses the usefulness of tongue features and oral microbial profile as a potential diagnostic biomarker of insomnia. One hundred insomniac patients and 20 healthy control subjects were selected. Their demographic and clinical characteristics, as well as the tongue diagnostic indices and oral microbial profile, were examined. Compared to the control group, insomniac patients showed a higher abnormal low-frequency/high-frequency (LF/HF) ratio. In tongue diagnosis, the indices related to lightness of tongue body and tongue coating were higher in the insomniac group vs. the control group. Furthermore, linear discriminant analysis (LDA) of oral microbial population revealed that the relative abundances of Clostridia, Veillonella, Bacillus and Lachnospiraceae were significantly higher in the insomniac patients than the control group. Additionally, the tongue features of the insomniac group exhibited that the non-coating group had a poor sleep condition compared to the thick-coating group, although the difference was insignificant. On the other hand, the oral microbial communities of the insomniac patients revealed greater alpha and beta diversities in the non-coating group vs. the thick-coating group. The alpha and beta diversities were higher in orotype1 than orotype2. Collectively, this study highlighted that the lightness of tongue body and tongue coating as well as oral microbial profiles of SR1, Actinobacteria, Clostridia and Lachnospiraceae_unclassified could be considered potential biomarkers of insomnia.
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Affiliation(s)
- Seo-Hyun Park
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University Goyang, Republic of Korea
| | - Na Rae Shin
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University Goyang, Republic of Korea
| | - Meng Yang
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University Goyang, Republic of Korea
| | - Shambhunath Bose
- Department of Life Science, Sri Sathya Sai University for Human Excellence Navanihal, Okali Post, Kamalapur, Kalaburagi, Karnataka 585313, India
| | - Ojin Kwon
- Division of Clinical Medicine, Korea Institute of Oriental Medicine, Republic of Korea
| | - Dong-Hyun Nam
- Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine Sangji University, Wonju 26382, Republic of Korea
| | - Jun-Hwan Lee
- Division of Clinical Medicine, Korea Institute of Oriental Medicine, Republic of Korea
| | - Eun-Ji Song
- Research Group of Healthcare, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon 34113, Republic of Korea
| | - Young-Do Nam
- Research Group of Healthcare, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea
- Department of Food Biotechnology, Korea University of Science and Technology, Daejeon 34113, Republic of Korea
| | - Hojun Kim
- Department of Rehabilitation Medicine of Korean Medicine, Dongguk University Goyang, Republic of Korea
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Rothe N, Vogel S, Schmelzer K, Kirschbaum C, Penz M, Wekenborg MK, Gao W, Walther A. The moderating effect of cortisol and dehydroepiandrosterone on the relation between sleep and depression or burnout. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 7:100051. [PMID: 35757064 PMCID: PMC9216258 DOI: 10.1016/j.cpnec.2021.100051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/02/2021] [Accepted: 03/22/2021] [Indexed: 11/30/2022] Open
Abstract
For poor sleep quality (SQ) as well as major depressive disorder (MDD) and burnout, a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been identified. Although poor SQ is often reported as an early symptom of MDD or burnout, it is not clear whether HPA axis-related hormones can influence the association between SQ and MDD or burnout. This manuscript addresses this question by examining HPA axis-related hormones as potential moderators influencing the association between SQ and MDD or burnout. In the fourth annual examination wave of the Dresden Burnout Study, we measured general SQ (including sleep duration and efficiency), depressive and burnout symptoms, and obtained hair samples for quantification of long-term integrated steroid concentrations (cortisol [hC], cortisone [hCn], dehydroepiandrosterone [hDHEA]) from 462 participants (67% female). Data on SQ, depressive and burnout symptoms were available from 342 participants from the preceding examination wave (average time span between examinations 13.2 months). Cross-sectional analyses showed that the negative association between sleep duration and depressive symptoms was buffered by higher levels of hC, and hCn, whereas the negative association between sleep duration and burnout symptoms was buffered by higher levels of hDHEA. The negative association between sleep efficiency and burnout symptoms was intensified by higher levels of hC and hC/hCn ratio and the negative association between general SQ and burnout symptoms was intensified by higher levels of hC/hCn ratio. With regard to longitudinal data, a significant interaction effect between sleep duration and hC/hCn ratio could be detected for burnout symptoms. Our results suggest opposed moderation effects of hair glucocorticoids on the association between SQ and depressive or burnout symptoms. This points toward opposed glucocorticoid receptor functioning in depression and burnout. To fully elucidate the negative consequences of poor SQ on MDD and burnout, the complex underlying mechanisms of action including HPA axis-related hormones need to be investigated in MDD and burnout separately. hC and hDHEA are not directly related to depression, burnout, or sleep symptoms. Higher hC levels buffer the relation between poor sleep quality (SQ) and depression. Higher hC levels intensify the relation between poor SQ and burnout. Higher hDHEA levels buffer the relation between poor SQ and burnout. hC and hDHEA exhibit contrary effects on the relation between SQ and burnout.
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Abstract
Insomnia is an important but widely ignored health problem in modern society. Despite unequivocal evidence on its large prevalence, health and social impacts, comorbidities, and various pharmacologic and nonpharmacologic (behavioral and device-based) approaches, its effective management is still difficult and often incomplete. This article discusses the role of insomnia in modern societies, newer complicating factors, and its overall social and public health burden. Acute insomnia and sleep difficulties during pandemic and confinement are reviewed. The article also focuses on newer developments accumulating in the field of insomnia and possible future trends.
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Affiliation(s)
- Samson G Khachatryan
- Department of Neurology and Neurosurgery, National Institute of Health, Ministry of Health, Titogradyan 14, Yerevan 0087, Armenia; Sleep and Movement Disorders Center, Somnus Neurology Clinic, Titogradyan 14, Yerevan 0087, Armenia.
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16
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Osiogo F, Shalaby R, Adegboyega S, Hrabok M, Gusnowski A, Vuong W, Surood S, Greenshaw AJ, Agyapong VIO. COVID-19 pandemic: demographic and clinical correlates of disturbed sleep among 6,041 Canadians. Int J Psychiatry Clin Pract 2021; 25:164-171. [PMID: 33606597 DOI: 10.1080/13651501.2021.1881127] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Psychological burdens of the COVID-19 pandemic are likely to impact sleep negatively. We investigate prevalence and correlates of disturbed sleep among subscribers to Text4Hope a daily supportive text message program launched in Alberta to support residents to deal with stress, anxiety, and depression. METHODS A survey link was sent to Text4Hope subscribers to assess demographic and clinical variables, including disturbed sleep, stress, anxiety, and depression using the third question on the Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale, Generalised Anxiety Disorder 7-item scale, and PHQ-9, respectively. Data were analysed using univariate and logistic regression analyses. RESULTS Overall, 6041 out of 32,805 Text4Hope subscribers completed the survey (18.4% response rate). Prevalence of disturbed sleep was 77.8%. Subscribers aged 41-60 years were twice as likely to present with sleep disturbance compared to individuals ≤25 years (OR 1.89, 95% CI: 1.27-2.81). Individuals with moderate/high anxiety and stress symptoms and those with passive death wish/suicidal ideation had higher probability for sleep disturbance [(OR 4.05, 95% CI: 3.33-4.93), (OR 2.42, 95% CI: 1.99-2.94), and (OR 2.39, 95% CI: 1.69-3.38)], respectively. CONCLUSION As the pandemic continues, more Canadians are likely to develop sleep problems, an important consideration for planning mental health services.KEY POINTSThis is the first study to examine the prevalence rates and demographic and clinical correlates of disturbed sleep in a large sample (n = 6041) of Canadians during the COVID-19 pandemic.Prevalence of disturbed sleep was high at 77.8%.Individuals aged 41-60 years were twice as likely to present with sleep disturbance compared to individuals ≤25 years (OR 1.89, 95% CI: 1.27-2.81).Individuals with moderate/high anxiety symptoms, moderate/high stress symptoms, and suicidal ideation/thoughts of self-harm had higher likelihood of developing sleep disturbance, compared to individuals lacking these symptoms [(OR 4.05, 95% CI: 3.33-4.93) and (OR 2.42, 95% CI: 1.98-2.94)], respectively.As the pandemic continues, with fear of multiple waves, more Canadians are likely to develop sleep problems, an important consideration for planning the provision of mental health services.
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Affiliation(s)
- Felix Osiogo
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Addiction and Mental Health, Alberta Health Services, Edmonton, Canada
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Sapara Adegboyega
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Addiction and Mental Health, Alberta Health Services, Edmonton, Canada
| | - Marianne Hrabok
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - April Gusnowski
- Addiction and Mental Health, Alberta Health Services, Edmonton, Canada
| | - Wesley Vuong
- Addiction and Mental Health, Alberta Health Services, Edmonton, Canada
| | - Shireen Surood
- Addiction and Mental Health, Alberta Health Services, Edmonton, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Vincent I O Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Addiction and Mental Health, Alberta Health Services, Edmonton, Canada
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Braçe O, Duncan DT, Correa-Fernández J, Garrido-Cumbrera M. Association of sleep duration with mental health: results from a Spanish general population survey. Sleep Breath 2021; 26:389-396. [PMID: 34003436 DOI: 10.1007/s11325-021-02332-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/09/2021] [Accepted: 02/19/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of the present study was to evaluate the association of sleep duration and mental health among the general population. METHODS A cross-sectional study was carried out with an adult Spanish population sample between 16 and 64 years old. The information was obtained from data provided by a randomly selected representative sample of 505 adults stratified by age, sex, and geographic area. Participants were interviewed face-to-face in their respective households with questions including sociodemographic characteristics, lifestyle, sleep duration, and the 12-item General Health Questionnaire to screen risk for poor mental health. The duration of sleep hours were grouped into the following categories: < 6 h, 6-7 h, and, > 7 h. Regression analysis was used to assess associations between sleep duration and risk of poor mental health. RESULTS A percentage of respondents 13.1% reported sleeping less than 6 h. The analysis demonstrated a significant (p = 0.001) negative (B = - 0.512) relationship between hours of sleep and risk of poor mental health (GHQ-12), demonstrating that reduced sleep duration increases the risk of poor mental health. CONCLUSIONS Sleep duration lower than 6 h is prevalent among the general population in Spain, especially among women and people who frequently use electronic devices. The results show that people who experience shorter sleep duration face a greater risk of poor mental health. These findings suggest that it is important to raise awareness of healthy sleeping habits, with emphasis on adequate sleep duration.
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Affiliation(s)
- Olta Braçe
- Health & Territory Research, Centro Internacional de la Universidad de Sevilla, Av. Ciudad Jardín, 20-22, 41005, Seville, Spain.
| | - Dustin T Duncan
- Spatial Epidemiology Lab, Columbia University Mailman School of Public Health, New York, NY, USA
| | - José Correa-Fernández
- Health & Territory Research, Centro Internacional de la Universidad de Sevilla, Av. Ciudad Jardín, 20-22, 41005, Seville, Spain
| | - Marco Garrido-Cumbrera
- Health & Territory Research, Centro Internacional de la Universidad de Sevilla, Av. Ciudad Jardín, 20-22, 41005, Seville, Spain
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18
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Age and gender differences in objective sleep properties using large-scale body acceleration data in a Japanese population. Sci Rep 2021; 11:9970. [PMID: 33976280 PMCID: PMC8113448 DOI: 10.1038/s41598-021-89341-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/26/2021] [Indexed: 11/11/2022] Open
Abstract
Using large-scale objective sleep data derived from body acceleration signals of 68,604 Japanese residents ranging from adolescents to the elderly (10–89 years old), we found significant age- and gender-related differences in sleep properties (timing, duration, and quality) in real-life settings. Time-in-bed and total sleep time (TST) showed a U-shaped association with age, indicating their decrease in adulthood following their increase in the elderly. There was a remarkable shift in sleep phase toward earlier bedtime and earlier wake time with increasing age (> 20 years), together with worsening of sleep quality, which is estimated by sleep efficiency (SE) and wake time after sleep onset. Gender comparisons showed that TST was shorter in women than in similarly aged men, which is much evident after the age of 30 years. This was associated with later bedtimes and greater age-related deterioration of sleep quality in women. Compared to men in the same age group, women over age 50 demonstrated a greater reduction in SE with aging, due mainly to increasing durations of nighttime awakening. These differences can be attributed to several intricately intertwined causes, including biological aging as well as socio-cultural and socio-familial factors in Japan. In conclusion, our findings provide valuable insights on the characteristics of Japanese sleep habits.
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Leeds R, Shechter A, Alcantara C, Aggarwal B, Usseglio J, Abdalla M, Moise N. Elucidating the Relationship Between Insomnia, Sex, and Cardiovascular Disease. GENDER AND THE GENOME 2020. [DOI: 10.1177/2470289720980018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sex differences in cardiovascular disease (CVD) mortality have been attributed to differences in pathophysiology between men and women and to disparities in CVD management that disproportionately affect women compared to men. Similarly, there has been investigation of differences in the prevalence and presentation of insomnia attributable to sex. Few studies have examined how sex and insomnia interact to influence CVD outcomes, however. In this review, we summarize the literature on sex-specific differences in the prevalence and presentation of insomnia as well as existing research regarding the relationship between insomnia and CVD outcomes as it pertains to sex. Research to date indicate that women are more likely to have insomnia than men, and there appear to be differential associations in the relation between insomnia and CVD by sex. We posit potential mechanisms of the relationship between sex, insomnia and CVD, discuss gaps in the existing literature, and provide commentary on future research needed in this area. Unraveling the complex relations between sex, insomnia, and CVD may help to explain sex-specific differences in CVD, and identify sex-specific strategies for promotion of cardiovascular health. Throughout this review, terms “men” and “women” are used as they are in the source literature, which does not differentiate between sex and gender. The implications of this are also discussed.
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Affiliation(s)
- Rebecca Leeds
- Center for Family and Community Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Ari Shechter
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Brooke Aggarwal
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, New York, NY, USA
| | - Marwah Abdalla
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Nathalie Moise
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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Tiseo C, Vacca A, Felbush A, Filimonova T, Gai A, Glazyrina T, Hubalek IA, Marchenko Y, Overeem LH, Piroso S, Tkachev A, Martelletti P, Sacco S. Migraine and sleep disorders: a systematic review. J Headache Pain 2020; 21:126. [PMID: 33109076 PMCID: PMC7590682 DOI: 10.1186/s10194-020-01192-5] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 10/14/2020] [Indexed: 12/14/2022] Open
Abstract
Migraine and sleep disorders are common and often burdensome chronic conditions with a high prevalence in the general population, and with considerable socio-economic impact and costs.The existence of a relationship between migraine and sleep disorders has been recognized from centuries by clinicians and epidemiological studies. Nevertheless, the exact nature of this association, the underlying mechanisms and interactions are complex and not completely understood. Recent biochemical and functional imaging studies identified central nervous system structures and neurotransmitters involved in the pathophysiology of migraine and also important for the regulation of normal sleep architecture, suggesting a possible causative role, in the pathogenesis of both disorders, of a dysregulation in these common nervous system pathways.This systematic review summarizes the existing data on migraine and sleep disorders with the aim to evaluate the existence of a causal relationship and to assess the presence of influencing factors. The identification of specific sleep disorders associated with migraine should induce clinicians to systematically assess their presence in migraine patients and to adopt combined treatment strategies.
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Affiliation(s)
- Cindy Tiseo
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
- Regional Referral Headache Centre, S.S. Filippo e Nicola Hospital, Avezzano, L'Aquila, Italy
| | - Alessandro Vacca
- Headache Center, Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Anton Felbush
- Pain Treatment Center, OOO "Vertebra", Samara City, Russia
| | - Tamara Filimonova
- Federal State Budget Educational Institution of Higher Education "Academician Ye. A. Vagner Perm State Medical University" of the Ministry of Healthcare of the Russian Federation, Perm, Russia
| | - Annalisa Gai
- Headache Center, Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | | | - Irina Anna Hubalek
- Department of Neurology, Headache Center, Charité University Medicine Berlin, Berlin, Germany
| | - Yelena Marchenko
- V. A. Almazov National Medical Research Centre, Saint-Petersburg, Russia
| | - Lucas Hendrik Overeem
- Charité - Universitätsmedizin Berlin Charité Centrum Neurologie, Neurochirurgie und Psychiatrie CC, Berlin, Germany
| | - Serena Piroso
- Department of Human Neurosciences, Sapienza University of Rome, Roma, Italy
| | - Alexander Tkachev
- Department of Neurology, Neurosurgery, medical genetics, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Roma, Italy
- Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | - Simona Sacco
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
- Regional Referral Headache Centre, S.S. Filippo e Nicola Hospital, Avezzano, L'Aquila, Italy.
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Sleep dissatisfaction and insufficient sleep duration in the Italian population. Sci Rep 2020; 10:17943. [PMID: 33087728 PMCID: PMC7578786 DOI: 10.1038/s41598-020-72612-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/31/2020] [Indexed: 12/13/2022] Open
Abstract
To investigate the prevalence and possible determinants of sleep quality and quantity, we used data from a cross-sectional study conducted in 2019 on a sample of 3120 subjects, representative of the general Italian adult population. Sleep dissatisfaction was reported by 14.2% and insufficient sleep (duration) by 29.5% of adults. Sleep dissatisfaction and insufficient sleep were directly related with age (p for trend < 0.001), and inversely related with socioeconomic class (p for trend < 0.001) and income (p for trend < 0.001). Sleep dissatisfaction was higher among women (odds ratio, OR 1.30; 95% confidence interval, CI 1.05–1.60). Insufficient sleep was inversely related to education (p for trend < 0.001) and more frequent in current compared to never smokers (OR 1.32; 95% CI 1.08–1.61). Sleep dissatisfaction was higher among divorced/separated compared with married subjects (OR 1.75; 95% CI 1.20–2.58) and lower among subjects living with children aged 0–14 years (OR 0.48, 95% CI 0.33–0.70). Pet owners more frequently had sleep dissatisfaction (OR 1.35, 95% CI 1.08–1.68) and insufficient sleep (OR 1.46, 95% CI 1.23–1.73). In Italy, self-perceived sleep problems appear to be increasing. Sleep problems can contribute to aggravating health disparities in the society. The unfavourable relationship with pets (and the favourable ones with children) should be confirmed by longitudinal studies.
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RELATED FACTORS OF POOR SLEEP QUALITY IN CHRONIC KIDNEY PATIENTS AND ITS EFFECT ON KIDNEY PROGRESS. JOURNAL OF CONTEMPORARY MEDICINE 2020. [DOI: 10.16899/jcm.788100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Prevalence of Sleep Disturbance and Potential Associated Factors among Medical Students from Mashhad, Iran. SLEEP DISORDERS 2020; 2020:4603830. [PMID: 32695519 PMCID: PMC7362288 DOI: 10.1155/2020/4603830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/31/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022]
Abstract
Methods In this cross-sectional study, 315 medical students chosen by stratified random sampling participated in the academic year 2018-2019. The Pittsburgh Instrument and DASS-21 questionnaire were used to evaluate sleep quality and anxiety, depression, and stress, respectively. Also, demographic, educational, and socioeconomic information was collected. SPSS 16 software was used for data analysis. Results Out of 300 students who completed the questionnaires, 165 (55%) were male, with a mean age of 21.94 ± 2.28 years old. The prevalence of poor sleep quality was 51.3%. We did not find significant associations among age, sex, and poor sleep quality. Concurrent psychological symptoms such as stress, depression, and anxiety were significantly associated with sleep disorders. After adjusting variables in the multivariable regression model, depression (OR = 2.81, 95% CI: 1.35-5.87; p = 0.006) and the number of hours spent on using smartphones in 24 hours (OR = 1.13, 95% CI: 1.02-1.25; p = 0.01) were significantly associated with poor sleep quality among medical students. Conclusion The prevalence of poor sleep quality among medical students was high, and we found that increased use of smartphones during the day and depression were associated with sleep disorders.
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Begum A, Biswas P, Shahed-Al-Mahmud M. Methanol extract of Spathodea campanulata P. (Beauv.) leaves demonstrate sedative and anxiolytic like actions on swiss albino mice. CLINICAL PHYTOSCIENCE 2020. [DOI: 10.1186/s40816-020-00182-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Spathodea campanulata P. Beauv. (Bignoniaceae) is a very common plant in Bangladesh which is locally called “Rudrapalash”. In Nigeria leaves extract of S. campanulata has a reputation of being used as an anticonvulsant. In this connection, the aim of this study was to investigate other neuropharmacological effects like sedative and anxiolytic activities of methanol extract of S. campanulata (MESC) leaves in different mice tests.
Methods
To assay sedative activity mice were subjected to open field and hole-cross test, whereas anxiolytic activity was checked by the elevated-plus maze, light-dark box, and hole-board test. For each test, mice were divided into control group (deionized water, 0.1 ml/mouse, p.o.), standard group (diazepam, 1 mg/kg, i.p) and three test groups (200, 400 and 600 mg/kg MESC, p.o.). The acute toxicity test and phytochemical screening of MESC were performed before the pharmacological study.
Results
The result demonstrated strong sedative and anxiolytic activity of MESC in a dose-dependent manner. All doses of MESC (200, 400 & 600 mg/kg) reduced the number of (square & hole) crossed by mice in both open field and hole cross tests (p < 0.001). On the other hand, in elevated plus-maze and light-dark box test mice opted to stay more in open arms and light box instead of close arms and dark box (p < 0.001). In hole-board test MESC (200, 400 & 600 mg/kg) elevated the number of head dipping (p < 0.001) dose-dependently. Phytochemical investigation indicated the presence of alkaloid, saponin, glycoside, carbohydrate, flavonoid, and tannin in MESC.
Conclusion
The experimental results explicit that S. campanulata leaves possess sedative and anxiolytic activities, hence suggest further chemical investigation to identify specific phytoconstituents responsible for sedative and anxiolytic effects.
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Abstract
AbstractRecent studies by Cloninger suggest that the temperament dimension of harm avoidance might be related to serotonergic activity. Since serotonergic mechanisms equally play a major role in sleep regulation, we decided to use Cloninger’s psychobiological model of temperament and character to assess whether there is a link between psychophysiologic insomnia and specific personality traits. Chronic insomnia is a common complaint in modern society, and it is still controversial whether insomniacs share specific personality traits. Thirty-two chronic insomniacs (<50 years) were studied. They underwent polysomnography for two consecutive nights and filled out the 226-item self-questionnaire of Temperament and Character Inventory as well as the Hospital Anxiety and Depression scale. (1) Harm avoidance for all subscores was significantly higher in insomniac patients when compared with controls; (2) self-directedness scores were lower in insomniacs; (3) sleep latency was positively correlated to harm avoidance; (4) HA1 (anticipatory worry) was negatively correlated to REM latency. Temperament and Character Inventory is a useful tool in the investigation of chronic insomnia. Serotonergic mechanisms might explain the high incidence of harm avoidance as personality trait in psychophysiologic insomniac patients. Further studies are needed to see whether harm avoidance could be a psychological vulnerability marker for primary insomnia and be used as predictor of SSRI treatment responders.
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Affiliation(s)
- Zara de Saint Hilaire
- Sleep Laboratory, University Hospital of Geneva, Belle-idée, 2 chemin Petit Bel-Air, 1225, Chêne-Bourg, Switzerland.
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Shayesteh M, Vaez-Mahdavi MR, Shams J, Kamalinejad M, Faghihzadeh S, Gholami-Fesharaki M, Gharebaghi R, Heidary F. Effects of Viola odorata as an Add-On Therapy on Insomnia in Patients with Obsession or Depression: A Pilot Randomized Double-Blind Placebo-Controlled Trial. J Altern Complement Med 2020; 26:398-408. [PMID: 32073874 DOI: 10.1089/acm.2019.0254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The present study was conducted to investigate the effect of Viola odorata extracted syrup on the quality and patterns of sleep in patients with depression or obsessive-compulsive disorder (OCD) as add-on therapy. Design: A pilot double-blind randomized placebo-controlled trial. Settings/Location: Psychiatric Clinic of Imam Hossein Hospital, Tehran, Iran. Subjects: Participants were 16-15 years of age with mild and moderate depression or OCD having insomnia. Interventions: This pilot study was conducted on patients with insomnia divided into two groups with depression (40 patients) or OCD (43 patients). Each group randomly assigned into two arms with the same conditions at baseline. The intervention arm daily received 5 mL V. odorata syrup every 12 h for 4 weeks, and the control arm received 5 mL placebo syrup every 12 h for 4 weeks. None of the participants was deprived of their routine treatment for depression or OCD. Outcome measures: The scores of insomnia symptoms were evaluated using total score of the Pittsburgh Sleep Quality Index (PSQI) and the scores of its components, the depression score using the final Beck depression inventory-II (BDI-II) score, and OCD score using the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Results: The total PSQI score was found to be improved significantly in the intervention arms with depression or OCD (p < 0.001) compared with the corresponding control arms. Significant improvements were also observed in the final mean difference of BDI-II (p = 0.009) and YBOCS (p = 0.001) scores in the intervention arms. Conclusions: V. odorata syrup significantly improved insomnia symptoms and the scores of depression and OCD.
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Affiliation(s)
- Maryam Shayesteh
- Department of Traditional Medicine, Faculty of Medicine, Shahed University, Tehran, Iran
| | | | - Jamal Shams
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Kamalinejad
- School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soghrat Faghihzadeh
- Department of Biostatistics and Epidemiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Reza Gharebaghi
- International Virtual Ophthalmic Research Center, Tehran, Iran
| | - Fatemeh Heidary
- Immunoregulation Research Center, Shahed University, Tehran, Iran
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Rothe N, Schulze J, Kirschbaum C, Buske-Kirschbaum A, Penz M, Wekenborg MK, Walther A. Sleep disturbances in major depressive and burnout syndrome: A longitudinal analysis. Psychiatry Res 2020; 286:112868. [PMID: 32163819 DOI: 10.1016/j.psychres.2020.112868] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 12/13/2022]
Abstract
Sleep quality (SQ) is considered to be a critical variable in major depressive syndrome (MD) as well as in burnout syndrome (B). Thus far, no study examined the differential influence of these syndromes on SQ. MD and B have been assessed in 4,415 participants at baseline and in 1,396 participants at follow-up based on the Patient Health Questionnaire-9 (PHQ-9) and the Maslach Burnout Inventory-General Survey (MBI-GS). The Pittsburgh Sleep Quality Index was used to measure SQ. Based on the PHQ-9 and MBI-GS at baseline assessment, participants were divided into four groups: a control group, a MD group, a B group, and a comorbid group suffering from MD and B. Multiple regression analyses showed that all groups demonstrate significantly worse SQ than the control group, while individuals with MD showed a lower SQ compared to individuals with B. The comorbid group showed the lowest SQ. Longitudinal analyses showed a significant bidirectional association between major depressive symptoms and SQ, whereas burnout symptoms were predictive for SQ but not vice versa. The study indicates differences between MD and B with regard to SQ, suggesting worse SQ in more severely burdened groups. Major depressive symptoms are bidirectionally linked to SQ, whereas burnout symptoms are only suggested a risk factor for impaired SQ.
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Affiliation(s)
- Nicole Rothe
- Department of Biopsychology, Technische Universität Dresden, 01069 Dresden, Germany.
| | - Jara Schulze
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, 01069 Dresden, Germany
| | | | - Marlene Penz
- Department of Biopsychology, Technische Universität Dresden, 01069 Dresden, Germany; University Hospital Dresden Clinic and Polyclinic for Psychotherapy and Psychosomatics, 01307 Dresden, Germany
| | | | - Andreas Walther
- Department of Biopsychology, Technische Universität Dresden, 01069 Dresden, Germany; Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
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Mangrio E, Zdravkovic S, Sjögren Forss K. The Association Between Self-perceived Health and Sleep-Quality and Anxiety Among Newly Arrived Refugees in Sweden: A Quantitative Study. J Immigr Minor Health 2020; 22:82-86. [PMID: 30788680 PMCID: PMC6952325 DOI: 10.1007/s10903-019-00871-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Previous research findings suggest that insomnia could be related to decreased health status and that it could also be affected by traumatic life experiences, such as war. Good health is important for newly arrived refugees for an effective integration process. The aim of the present study is, therefore, to investigate the association between self-perceived health and sleep quality among newly arrived refugees in Sweden. The results are based on 681 migrants who participated in a survey between 2015 and 2016. There was a significant odds ratio (OR) after adjustment for confounders for newly arrived refugees that were experiencing bad self-perceived health to also experience bad sleep: OR 8.07 (4.34-15.00). Furthermore, the OR remained significant but lower after adjustments for confounders for newly arrived refugees that had bad self-perceived health to be suffering from anxiety during sleep, with OR 3.83 (2.11-6.94).
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Affiliation(s)
- Elisabeth Mangrio
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Malmö Institute for Studies of Migration, Diversity and Welfare (MIM), Malmö University, Malmö, Sweden
| | - Slobodan Zdravkovic
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Malmö Institute for Studies of Migration, Diversity and Welfare (MIM), Malmö University, Malmö, Sweden
| | - Katarina Sjögren Forss
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Malmö Institute for Studies of Migration, Diversity and Welfare (MIM), Malmö University, Malmö, Sweden
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Abstract
Insomnia is a state defined as trouble with sleep; it is a chronically disabling condition and is now significantly prevalent, imposing enormous health and economic burdens both on individuals and on society. This state includes trouble in falling asleep, problems staying asleep, fragmented sleep (repeatedly awakening at night), and/or awakening before time in the morning. This difficulty in sleeping causes feeling exhausted during the day and trouble with daytime activities including driving, family responsibilities, and completion of valued daily routines. Different types of synthetic sedative drugs are used to handle nervous system changes, but repeated use of sedatives caused tolerance in the human body. After a while, people had to take a heavy dose of sedative to make them feel sleepy, which imposes extra toxic effects on vital organs of the body. Medicinal plants are gaining more and more attention as sedative agents because herbs contained different types of natural bioactive metabolites with not well reported side effects. In addition, medicinal plants have economic, high efficacy and are easy available. So in current review plants possessing sedative activities have been compiled with their constituents responsible to manage insomnia. Review of the literature indicated that medicinal plants from various systems of medicine have been reported to possess sedative activity. This review suggests that medicinal plants are efficacious for insomnia; further laboratory and clinical studies are required.
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Zhang Z, Cheng J, Yang W, Zou H, Su C, Miao J. Gender differences in clinical manifestations and polysomnographic findings in Chinese patients with obstructive sleep apnea. Sleep Breath 2019; 24:1019-1026. [DOI: 10.1007/s11325-019-01943-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/10/2019] [Accepted: 09/12/2019] [Indexed: 11/29/2022]
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Gender Differences With Regard to Perceived Job Insecurity and Insomnia in a Working Population. J Occup Environ Med 2019; 61:e474-e479. [PMID: 31626065 DOI: 10.1097/jom.0000000000001729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Insomnia is one of the most prevalent disorders, and it is associated with various factors. Therefore, this study aimed to examine the association between perceived job insecurity and insomnia. METHODS Multiple logistic regression analysis was used to examine the association between three levels of perceived job insecurity and insomnia using the 2017 Korean Working Conditions Survey. RESULTS Approximately 10.2% of the total study population has insomnia. The higher the perception of job insecurity, the greater the chance for insomnia in both men (odds ratio = 4.03, 95% confidence interval [CI] = 3.18 to 5.11) and women (odds ratio = 4.44, 95% CI = 3.41 to 5.77). CONCLUSION These findings reveal the sex differences in insomnia, thus suggesting the need to implement different approaches to deal with perceived job insecurity based on sex.
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Abstract
Insomnia poses significant challenges to public health. It is a common condition associated with marked impairment in function and quality of life, psychiatric and physical morbidity, and accidents. As such, it is important that effective treatment is provided in clinical practice. To this end, this paper reviews critical aspects of the assessment of insomnia and the available treatment options. These options include both non-medication treatments, most notably cognitive behavioral therapy for insomnia, and a variety of pharmacologic therapies such as benzodiazepines, "z-drugs", melatonin receptor agonists, selective histamine H1 antagonists, orexin antagonists, antidepressants, antipsychotics, anticonvulsants, and non-selective antihistamines. A review of the available research indicates that rigorous double-blind, randomized, controlled trials are lacking for some of the most commonly administered insomnia therapies. However, there are an array of interventions which have been demonstrated to have therapeutic effects in insomnia in trials with the above features, and whose risk/benefit profiles have been well characterized. These interventions can form the basis for systematic, evidence-based treatment of insomnia in clinical practice. We review this evidence base and highlight areas where more studies are needed, with the aim of providing a resource for improving the clinical management of the many patients with insomnia.
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Affiliation(s)
- Andrew D. Krystal
- Department of PsychiatryUniversity of California San Francisco School of MedicineSan FranciscoCAUSA,Department of NeurologyUniversity of California San Francisco School of MedicineSan FranciscoCAUSA
| | - Aric A. Prather
- Department of PsychiatryUniversity of California San Francisco School of MedicineSan FranciscoCAUSA
| | - Liza H. Ashbrook
- Department of NeurologyUniversity of California San Francisco School of MedicineSan FranciscoCAUSA
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Do individual differences in state and trait anxiety predict sleep difficulties in healthy older adults? PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2019.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Pop P, Bronskill SE, Piggott KL, Stall NM, Savage RD, Visentin JD, McCarthy LM, Giannakes V, Wu W, Gruneir A, Gatley JM, Rochon PA. Management of Sleep Disorders in Community-Dwelling Older Women and Men at the Time of Diagnosis. J Am Geriatr Soc 2019; 67:2094-2101. [PMID: 31225914 DOI: 10.1111/jgs.16038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/10/2019] [Accepted: 05/21/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Sedative and hypnotic medications are associated with harm, and guidelines suggest limiting their use. Only limited evidence has described how older adults are managed following an initial sleep disorder diagnosis. We aimed to describe clinical management patterns of sleep disorders in older women and men at the time of initial diagnosis. DESIGN Population-based retrospective cohort study using linked administrative databases. SETTING Ontario, Canada. PARTICIPANTS Community-dwelling adults aged 66 and older, diagnosed with a new sleep disorder by a primary care provider (n = 30 729; 56% women and 44% men). We compared women and men for each outcome. MEASUREMENTS The primary outcome was prescription of a medication used for sleep within 30 days of a new sleep disorder diagnosis. Additional analysis included medical investigations such as sleep studies and visits to specialists who manage obstructive sleep disorders within 90 days of diagnosis. RESULTS Among the 30 729 older adults with a new sleep disorder diagnosis, 5512 (17.9% total; 18.8% of women and 16.9% of men) were prescribed a medication used for sleep. Compared with men, women were somewhat more likely to be prescribed at least one sedative medication (adjusted odds ratio = 1.09; 95% confidence interval = 1.03-1.16). A total of 2573 (8.4%) older adults underwent a sleep study, and 3743 (12.2%) were evaluated by a specialist; both occurred more commonly in men. CONCLUSION In our cohort, almost 1 in 5 older adults with a new sleep disorder diagnosis were prescribed a medication used for sleep; of these, a higher proportion were women. Comparatively few older adults were further evaluated; of these, a higher proportion were men. Our study highlights the high rates at which medications are prescribed to older adults with a new sleep disorder diagnosis and identifies potential sex differences in the management of such diagnoses. J Am Geriatr Soc 1-8, 2019. J Am Geriatr Soc 67:2094-2101, 2019.
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Affiliation(s)
- Paula Pop
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Susan E Bronskill
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,ICES, Toronto, Ontario, Canada
| | - Katrina L Piggott
- Department of Medicine, Division of Geriatric Medicine, University of Toronto, Toronto, Canada
| | - Nathan M Stall
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Medicine, Division of Geriatric Medicine, University of Toronto, Toronto, Canada
| | - Rachel D Savage
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Jessica D Visentin
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Lisa M McCarthy
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Vasily Giannakes
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.,ICES, Toronto, Ontario, Canada
| | - Wei Wu
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Andrea Gruneir
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.,ICES, Toronto, Ontario, Canada.,Department of Family Medicine, University of Alberta, Edmonton, Canada
| | | | - Paula A Rochon
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,ICES, Toronto, Ontario, Canada.,Department of Medicine, Division of Geriatric Medicine, University of Toronto, Toronto, Canada
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Pallesen S, Jacobsen DP, Nielsen MB, Gjerstad J. The 5-HTTLPR rs25531 L AL A-genotype increases the risk of insomnia symptoms among shift workers. Sleep Med 2019; 60:224-229. [PMID: 31213395 DOI: 10.1016/j.sleep.2019.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Previous studies indicate that shift work tolerance may be associated with individual factors including genetic variability in the gene encoding the serotonin transporter 5-HTT (SLC6A4). The present study aimed to explore the interaction between work schedule (shift work versus non-shift work), genetic variability in SLC6A4 and insomnia symptoms. METHODS The study was based on a national probability sample survey of 987 Norwegian employees drawn from The Norwegian Central Employee Register by Statistics Norway. Insomnia symptoms were assessed by three items reflecting problems with sleep onset, sleep maintenance, and early morning awakenings. Genotyping concerning SLC6A4 (the 5-HTTLPR S versus L and the SNP rs25531 A versus G) was carried out using a combination of gel-electrophoresis and TaqMan assay. RESULTS Using the LALA genotype as a reference a main effect of the SS genotype (B = 0.179; 95% CI = 0.027-0.330) was found. In addition, a main effect of work schedule (0 = non shift, 1 = shift work) was found (B = 0.504; 95% CI = 0.185-0.823). The genotype x work schedule interaction was significant for all genotypes; SLA (B = -0.590; 95% CI = -0.954-0.216), LALG (B = -0.879; 95% CI = -1.342-0.415), SLG (B = -0.705; 95% CI = -1.293-0.117) and SS (B = -0.773; 95% CI = -1.177-0.369) indicating higher insomnia symptom scores among LALA-participants compared to participants with other genotypes when working shifts. CONCLUSIONS The ability to cope with shift work is associated with the combination of the SLC6A4 variants 5-HTTLPR and SNP rs25531. Our findings demonstrated that the LALA-genotype increases the risk of insomnia symptoms among shift workers.
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Affiliation(s)
- Ståle Pallesen
- Department for Psychosocial Science, University of Bergen, Norway; Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Norway.
| | | | - Morten B Nielsen
- Department for Psychosocial Science, University of Bergen, Norway; National Institute of Occupational Health, Oslo, Norway
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Chami HA, Bechnak A, Isma'eel H, Talih F, Nasreddine L, Nasrallah M, Tamim H. Sleepless in Beirut: Sleep Difficulties in an Urban Environment With Chronic Psychosocial Stress. J Clin Sleep Med 2019; 15:603-614. [PMID: 30952222 DOI: 10.5664/jcsm.7724] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 01/09/2019] [Indexed: 12/22/2022]
Abstract
STUDY OBJECTIVES The prevalence of sleep disorders in the Lebanese population is unknown. We assessed the prevalence of insomnia and sleep apnea risk and examined their relationship with sociodemographic, lifestyle, and health characteristics in a sample from Greater Beirut. METHODS This cross-sectional pilot survey included 501 adults from the community (age 45.2 ± 15.2 years, 64% females). Insomnia symptoms, insomnia disorder, and sleep apnea risk were assessed using the Sleep Heart Health Study and Berlin Questionnaire. Characteristics were compared between individuals with and without insomnia symptoms, insomnia disorder, and sleep apnea. Correlates were assessed using multivariate regression. RESULTS A total of 44.5% of participants reported insomnia symptoms > 15 nights/mo and 34.5% reported insomnia. Predictors of insomnia symptoms and disorder included female sex (odds ratio [OR] 1.51, 95% confidence interval [CI] 1.01-2.27 and OR 1.76, 95% CI 1.13-2.75, respectively), education level below high school (OR 1.96, 95% CI 1.31-2.95 and OR 2.40, 95% CI 1.52-3.77, respectively) and medical comorbidities (OR 2.27, 95% CI 1.30-3.95 and OR 3.02, 95% CI 1.3-5.27, respectively). Although 31% of participants were at high risk for sleep apnea, only 5% received the diagnosis from a physician. Increased sleep apnea risk was associated with unemployment (OR 1.96, 95% CI 1.11-3.49), high body mass index (OR 1.17, 95% CI 1.11-1.24), snoring (OR 16.7, 95% CI 9.0-31.0), hypertension (OR 4.33, 95% CI 2.28-8.22), arthritis (OR 2.00, 95% CI 1.01-4.01), and other medical comorbidities (OR 2.65, 95% CI 1.24-5.68). CONCLUSIONS Insomnia and sleep apnea are highly prevalent and likely underdiagnosed in this cohort from Lebanon and are associated with disadvantaged socioeconomic status and medical comorbidities. This alarming prevalence of sleep difficulties and disorders calls for future research exploring the causes including the potential effect of social, economic, and political instability, mental and psychological stress, local customs, and environmental factors.
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Affiliation(s)
- Hassan A Chami
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amer Bechnak
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hussain Isma'eel
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Farid Talih
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Mona Nasrallah
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Nédélec M, Dawson B, Dupont G. Influence of Night Soccer Matches on Sleep in Elite Players. J Strength Cond Res 2019; 33:174-179. [DOI: 10.1519/jsc.0000000000002906] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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38
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Trauma-Related Dissociation Is No Fantasy: Addressing the Errors of Omission and Commission in Merckelbach and Patihis (2018). PSYCHOLOGICAL INJURY & LAW 2018. [DOI: 10.1007/s12207-018-9336-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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40
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Évaluation de l’insomnie chez les patients tunisiens atteints de cancers bronchopulmonaires primitifs. Rev Mal Respir 2018; 35:716-722. [DOI: 10.1016/j.rmr.2017.10.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/23/2017] [Indexed: 11/19/2022]
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Hao G, Lu W, Huang J, Ding W, Wang P, Wang L, Ding F, Hu M, Hou L. Predialysis fluid overload linked with quality of sleep in patients undergoing hemodialysis. Sleep Med 2018; 51:140-147. [PMID: 30165338 DOI: 10.1016/j.sleep.2018.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/04/2018] [Accepted: 07/23/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Hemodialysis (HD) patients are exposed to dysregulated fluid balance which can lead to overhydration. Poor sleep quality and excessive daytime sleepiness are particularly common in these patients, however the relationship between fluid status and sleep quality and daytime sleepiness has not yet been studied. Therefore, the aim of this study is to evaluate the correlations between fluid status and sleep quality and daytime sleepiness in HD patients. METHOD This cross-sectional study included 115 HD patients and 30 healthy control subjects from the HD center of Shanghai Ninth People's Hospital. Fluid compartments [total body water (TBW)], extracellular water (ECW)] and overhydration index (OH) were analyzed by multifrequency bio-impedance (BCM). Overhydration was defined as OH/ECW≥7%. HD patients were divided into an overhydration group and non overhydration group according to OH/ECW. Sleep quality was assessed by the Chinese version of the Pittsburgh Sleep Quality Index (PSQI), and excessive daytime sleepiness was evaluated by the Epworth Sleepiness Scale (ESS). RESULTS The prevalence rate of fluid overload in HD patients was 65.2%. Poor sleep quality (PSQI≥5) and excessive daytime sleepiness (ESS≥11) were significantly higher in HD patients compared with the healthy controls [6 (3, 10) vs.2.11 ± 1.59, p = 0.000; 3 (0, 6) vs.1.68 ± 1.07, p = 0.045]. Furthermore, the PSQI scores were higher in HD patients with overhydration (7.8 ± 4.5 vs. 4.8 ± 3.2, p = 0.000). The component scores 1, 2, 3 and 5 of the PSQI showed significant differences between the overhydration and non overhydration groups. The ESS scores did not show differences between the two groups (3.9 ± 4.1 vs. 3.3 ± 3.5, p = 0.508). OH was correlated with Systolic BP and Diastolic BP, and additionally was an independent predictor of poor sleep quality. CONCLUSION Fluid overload is significantly linked with poor quality of sleep in HD patients, however there is no association with excessive daytime sleepiness. Our study provides new insight into possible treatment strategies. Future studies should examine the effects of optimizing fluid status on quality of sleep.
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Affiliation(s)
- Guihua Hao
- Division of Surgical Intensive Care Unit, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Wei Lu
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Jie Huang
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Wei Ding
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Pengfei Wang
- Division of Surgical Intensive Care Unit, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Lili Wang
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Feng Ding
- Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China
| | - Min Hu
- Division of Surgical Intensive Care Unit, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, China.
| | - Lili Hou
- Department of Nursing, Shanghai Ninth People's Hospital, School of Medicine, Shanghai jiaotong University, Shanghai 200011, China.
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42
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Poor sleep quality and influencing factors among rural adults in Deqing, China. Sleep Breath 2018; 22:1213-1220. [PMID: 29936592 DOI: 10.1007/s11325-018-1685-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Poor sleep quality is prevalent and is associated with cognitive decline, impaired health, and reduced quality of life. There is a lack of studies about sleep quality and its potential risk factors among rural adults aged 45 years or above under rapid urbanization in China. METHODS In a cross-sectional survey conducted in Deqing County, China in 2015, we included 1584 adults 45+ years of age. Sleep quality was measured by using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Poor sleep quality was defined by a CPSQI global score > 5. Other data collected included sociodemographic and lifestyle factors as well as physical health. Logistic regression model was applied to assess factors influencing sleep quality by calculating crude odds ratio (cOR), adjusted OR (aOR), and their 95% confident intervals (CI). RESULTS Of 1584 subjects, more than half were female with an average age of 58.9 ± 8.1 years. Their night sleep duration was 7.7 ± 1.2 h, sleep latency was 31.9 ± 32.0 min, and 17% of them could not fall asleep within half hour, averagely. The mean score of CPSQI was 4.4 ± 2.7. The prevalence of poor sleep quality was 27.7% (95% CI = 25.4-29.7%) overall, and there existed a significant sex difference-30.6% (95% CI = 27.7-33.7%) for women and 24.0% (95% CI = 20.9-27.2%) for men. Five domains of the CPSQI except for sleep efficiency and use of sleeping medication also showed a sex difference (p < 0.05). Logistic regression analysis indicated that unmarried status (aOR = 1.51, 95% CI = 1.03-2.22), lower monthly individual income (aOR = 2.09, 95% CI = 1.49-2.94), and chronic diseases (aOR = 1.95, 95% CI = 1.51-2.51) were significantly related to poor sleep quality. CONCLUSIONS Sleep problems were prevalent among the rural Chinese adults aged 45+ years. People who were unmarried or had low personal income or any chronic diseases were more likely to have poor sleep quality.
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43
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Bezerra AG, Andersen ML, Pires GN, Tufik S, Hachul H. Effects of hormonal contraceptives on sleep - A possible treatment for insomnia in premenopausal women. Sleep Sci 2018; 11:129-136. [PMID: 30455843 PMCID: PMC6201525 DOI: 10.5935/1984-0063.20180025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 06/28/2018] [Indexed: 12/20/2022] Open
Abstract
Due to the changes that took place since the 1970s, women have achieved important socioeconomic positions. Many tasks, including domestic and familiar ones, continue to be under women's responsibility, which leads to an overload work. Additionally, the female organism has its peculiarities due to hormonal changes. Adding all these factors up, women seem to be more vulnerable to stressing factors and consequently, might be prone to present several health problems. Within this scenario, one can point out insomnia as a highly prevalent disease among women, directly affecting performance and quality of life. Progesterone has an important effect over sleep, acting both as a hypnogenic and as a respiratory stimulant. Hormonal contraceptives are largely recognized among the modern society women; however, little is known about the effects of these drugs on sleep. This proposal hypothesizes that the use of hormonal contraceptives, mainly those based on progestagens could be a new therapeutic element for the treatment of insomnia and one more tool to be used to improve women´s sleep pattern and quality of life.
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Affiliation(s)
| | | | - Gabriel Natan Pires
- UNIFESP, Departamento de Psicobiologia - São Paulo - SP -
Brasil
- Santa Casa de São Paulo School of Medical Sciences,
Departamento de Ciências Fisiológicas - São Paulo - SP -
Brasil
| | - Sergio Tufik
- UNIFESP, Departamento de Psicobiologia - São Paulo - SP -
Brasil
| | - Helena Hachul
- UNIFESP, Departamento de Psicobiologia - São Paulo - SP -
Brasil
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44
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Gulia KK, Kumar VM. Sleep disorders in the elderly: a growing challenge. Psychogeriatrics 2018; 18:155-165. [PMID: 29878472 DOI: 10.1111/psyg.12319] [Citation(s) in RCA: 221] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/27/2017] [Accepted: 01/15/2018] [Indexed: 12/24/2022]
Abstract
In contrast to newborns, who spend 16-20 h in sleep each day, adults need only about sleep daily. However, many elderly may struggle to obtain those 8 h in one block. In addition to changes in sleep duration, sleep patterns change as age progresses. Like the physical changes that occur during old age, an alteration in sleep pattern is also a part of the normal ageing process. As people age, they tend to have a harder time falling asleep and more trouble staying asleep. Older people spend more time in the lighter stages of sleep than in deep sleep. As the circadian mechanism in older people becomes less efficient, their sleep schedule is shifted forward. Even when they manage to obtain 7 or 8 h sleep, they wake up early, as they have gone to sleep quite early. The prevalence of sleep disorders is higher among older adults. Loud snoring, which is more common in the elderly, can be a symptom of obstructive sleep apnoea, which puts a person at risk for cardiovascular diseases, headaches, memory loss, and depression. Restless legs syndrome and periodic limb movement disorder that disrupt sleep are more prevalent in older persons. Other common medical problems of old age such as hypertension diabetes mellitus, renal failure, respiratory diseases such as asthma, immune disorders, gastroesophageal reflux disease, physical disability, dementia, pain, depression, and anxiety are all associated with sleep disturbances.
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Affiliation(s)
- Kamalesh K Gulia
- Division of Sleep Research, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Velayudhan Mohan Kumar
- Division of Sleep Research, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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45
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Li L, Wang YY, Wang SB, Zhang L, Li L, Xu DD, Ng CH, Ungvari GS, Cui X, Liu ZM, De Li S, Jia FJ, Xiang YT. Prevalence of sleep disturbances in Chinese university students: a comprehensive meta-analysis. J Sleep Res 2018; 27:e12648. [DOI: 10.1111/jsr.12648] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 11/06/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Lu Li
- Unit of Psychiatry; Faculty of Health Sciences; University of Macau; Macao China
| | - Yuan-Yuan Wang
- Unit of Psychiatry; Faculty of Health Sciences; University of Macau; Macao China
| | - Shi-Bin Wang
- Guangdong Mental Health Center; Guangdong General Hospital & Guangdong Academy of Medical Sciences; Guangzhou Guangdong Province China
| | - Ling Zhang
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders; Beijing Anding Hospital; Capital Medical University; Beijing China
| | - Lin Li
- Faculty of Life Sciences and Biopharmaceutics; University of Shenyang Pharmaceutical; Shenyang China
- Liaoning Medical Device Test Institute; Shenyang China
| | - Dan-Dan Xu
- Unit of Psychiatry; Faculty of Health Sciences; University of Macau; Macao China
| | - Chee H. Ng
- Department of Psychiatry; University of Melbourne; Melbourne Vic. Australia
| | - Gabor S. Ungvari
- University of Notre Dame Australia/Marian Centre; Perth Australia
- School of Psychiatry & Clinical Neurosciences; University of Western Australia; Perth Australia
| | - Xiling Cui
- Department of Business Administration; Hong Kong Shue Yan University; Hong Kong China
| | - Zhao-Min Liu
- School of Public Health; Sun Yat-Sen University; Guangzhou China
| | - Spencer De Li
- Department of Sociology; University of Macau; Macao China
| | - Fu-Jun Jia
- Guangdong Mental Health Center; Guangdong General Hospital & Guangdong Academy of Medical Sciences; Guangzhou Guangdong Province China
| | - Yu-Tao Xiang
- Unit of Psychiatry; Faculty of Health Sciences; University of Macau; Macao China
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46
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Zheng W, Luo XN, Li HY, Ke XY, Dai Q, Zhang CJ, Zhang XY, Ning YP. Regional differences in the risk of insomnia symptoms among patients from general hospital outpatient clinics. Neuropsychiatr Dis Treat 2018; 14:3307-3315. [PMID: 30555236 PMCID: PMC6280893 DOI: 10.2147/ndt.s184216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Region-specific differences in the prevalence of insomnia symptoms in outpatient clinics in China have received little systematic study. This study was conducted preliminarily to examine region-specific differences in the risk of insomnia symptoms in Chinese outpatients. METHOD In total, 4,399 adult outpatients (urban vs rural residents: 1,768 vs 2,631) who completed three questions focusing on insomnia symptoms were included. Their sociodemographic and clinical information were collected with standardized questionnaires. RESULTS The prevalence of self-reported insomnia symptoms in urban residents (23.4%) was more frequent than the prevalence in rural residents (21.2%). The estimated prevalence of insomnia symptoms was significantly lower in rural than urban residents after adjusting for the potential confounders (P=0.015). Similarly, more urban (22.9%) than rural (13.4%) residents with insomnia symptoms had significantly higher treatment rates (χ 2=14.9, P<0.001). Multiple regression analyses showed that depressive symptoms, old age, and low education level were the most common risk factors for insomnia symptoms in both urban and rural residents. CONCLUSION Our findings show that the prevalence of insomnia symptoms was relatively lower in rural than urban residents. Longitudinal studies are warranted to confirm the current findings.
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Affiliation(s)
- Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
| | - Xin-Ni Luo
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
| | - Hai-Yan Li
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
| | - Xiao-Yin Ke
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
| | - Qing Dai
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
| | - Chan-Juan Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
| | - Xiang-Yang Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China, .,Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Yu-Ping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,
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47
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Nazaripanah NS, Momtaz YA, Mokhtari F, Sahaf R. Urinary incontinence and sleep complaints in community dwelling older adults. ACTA ACUST UNITED AC 2018; 11:106-111. [PMID: 30083298 PMCID: PMC6056063 DOI: 10.5935/1984-0063.20180020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sleep disorder is associated with poor quality of life in old age. Therefore, it
is imperative to identify contributing factors leading to sleep disorder. The
current study aimed to examine the impact of urinary incontinence on sleep
complaint after controlling for potential sociodemographic and health
covariates. Materials and Methods: A cross-sectional study was
conducted on a sample of 184 community dwelling older adults 60 years and older
in Yazd, Iran, 2016. In order to obtain the sample a multistage proportional
random sampling technique was employed. Sociodemographic characteristics, sleep
complaint, and urinary incontinence were collected from medical records.
Statistical analyses were performed using SPSS version 24. A multiple logistic
regression analysis was used to examine the impact of urinary incontinence on
sleep complaint after controlling for potential covariates.
Findings: A total of 184 respondents with a mean age of
68.48±6.65 years (age range, 60-87 years) were included in the study.
About 70% of the respondents were women, 72.8% were married, 68.5% were not
formally educated, and 21.7% were living alone. The prevalence of sleep
complaint and urinary incontinence were 27.2% (95% CI: 21-34) and 22.3% (95% CI:
17-29), respectively. The results of the multiple logistic regression analysis
revealed respondents with urinary incontinence were four times more likely to
suffer from sleep complaint than those without urinary incontinence after
adjusting for potential covariates (AOR=4.04, 95% CI: 1.74-9.35,
p<0.001). Conclusion: Based on the results
of this present study, which showed that urinary incontinence independently
contributed to sleep complaint among older adults, it is necessary to employ
effective interventions for controlling urinary incontinence to reduce sleep
complaints.
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Affiliation(s)
- Neda Sadat Nazaripanah
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran, Gerontology - Tehran - Tehran - Iran.,Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran, Gerontology - Tehran - Tehran - Iran
| | - Yadollah Abolfathi Momtaz
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran, Gerontology - Tehran - Tehran - Iran.,Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Gerontology - Serdang - Selangor - Malaysia
| | - Farideh Mokhtari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran, Gerontology - Tehran - Tehran - Iran.,Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran, Gerontology - Tehran - Tehran - Iran
| | - Robab Sahaf
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran, Gerontology - Tehran - Tehran - Iran
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48
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Dean LE, Arnold L, Crofford L, Bennett R, Goldenberg D, Fitzcharles MA, Paiva ES, Staud R, Clauw D, Sarzi-Puttini P, Jones GT, Ayorinde A, Flüß E, Beasley M, Macfarlane GJ. Impact of Moving From a Widespread to Multisite Pain Definition on Other Fibromyalgia Symptoms. Arthritis Care Res (Hoboken) 2017; 69:1878-1886. [DOI: 10.1002/acr.23214] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/31/2017] [Indexed: 11/10/2022]
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49
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Gahr M. [Diagnosis and therapy of insomnia and basic aspects of other sleep disorders]. MMW Fortschr Med 2017; 159:32-36. [PMID: 28905313 DOI: 10.1007/s15006-017-9946-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Maximilian Gahr
- Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm, Leimgrubenweg 12-14, D-89075, Ulm, Deutschland.
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50
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Cho HJ, Savitz J, Dantzer R, Teague TK, Drevets WC, Irwin MR. Sleep disturbance and kynurenine metabolism in depression. J Psychosom Res 2017; 99:1-7. [PMID: 28712413 PMCID: PMC5526094 DOI: 10.1016/j.jpsychores.2017.05.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/19/2017] [Accepted: 05/21/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Although the interrelationships between sleep disturbance, inflammation, and depression have been found, molecular mechanisms that link these conditions are largely unknown. Kynurenine metabolism is hypothesized to be a key mechanism that links inflammation and depression. Inflammation activates the kynurenine pathway, leading to increases in 3-hydroxykynurenine (3HK) and quinolinic acid (QA), potentially neurotoxic metabolites, and decreases in kynurenic acid (KynA), a potentially neuroprotective compound. This relative neurotoxic shift in the balance of kynurenine metabolites has been associated with depression, but never been examined regarding sleep disturbance. We tested the association between sleep disturbance and this relative neurotoxic shift in 68 currently depressed, 26 previously depressed, and 66 never depressed subjects. METHODS Sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. Serum concentrations of kynurenine metabolites were measured using high performance liquid chromatography. Putative neuroprotective indices reflecting the relative activity of neuroprotective and neurotoxic kynurenine metabolites were calculated as KynA/QA and KynA/3HK (primary outcomes). RESULTS Sleep disturbance was associated with reduced KynA/QA in the currently depressed group only (unadjusted beta -0.43, p<0.001). This association remained significant even after controlling for age, sex, analysis batch, body-mass index, and depressive symptoms in currently depressed subjects (adjusted beta -0.30, p=0.02). There was no significant association between sleep disturbance and KynA/3HK in any of the groups. Sleep disturbance was associated with increased C-reactive protein in currently depressed subjects only (unadjusted beta 0.38, p=0.007; adjusted beta 0.33, p=0.02). CONCLUSION These data support the hypothesis that altered kynurenine metabolism may molecularly link sleep disturbance and depression.
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Affiliation(s)
- Hyong Jin Cho
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
| | - Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK,Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK
| | - Robert Dantzer
- Department of Symptom Research, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - T. Kent Teague
- Department of Surgery, University of Oklahoma College of Medicine, Tulsa OK
| | | | - Michael R. Irwin
- Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
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