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Li J, Wang X, Liu M, Yin Y, Wu Y, Xu G, Ma X. Sex-specific grey matter abnormalities in individuals with chronic insomnia. Neurol Sci 2024; 45:2301-2310. [PMID: 38063921 DOI: 10.1007/s10072-023-07224-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/23/2023] [Indexed: 04/17/2024]
Abstract
Previous studies have reported sex differences in altered brain function in patients with chronic insomnia (CI). However, sex-related alterations in brain morphology have rarely been investigated. This study aimed to investigate sex-specific grey matter (GM) alterations in patients with CI and to examine the relationship between GM alterations and neuropsychological assessments. Ninety-three (65 females and 28 males) patients and 78 healthy (50 females and 28 males) controls were recruited. Structural magnetic resonance imaging data were analysed using voxel-based morphometry to test for interactions between sex and diagnosis. Spearman's correlation was used to assess the associations among structure, disease duration, and sleep-, mood-, and cognition-related assessments. Males with CI showed reduced GM volume in the left inferior parietal lobe, left middle cingulate cortex, and right supramarginal gyrus. Females with CI showed increased GM volume in the right Rolandic operculum. Moreover, mood-related assessments were negatively correlated with GM volumes in the right supramarginal gyrus and left inferior parietal lobe in the male patients, and cognitive-related assessments were positively correlated with GM volumes in the Rolandic operculum in the female patients. Our findings indicate sex-specific alterations in brain morphology in CI, thereby broadening our understanding of sex differences in CI and potentially providing complementary evidence for the development of more effective therapies and individual treatments.
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Affiliation(s)
- Jingwen Li
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
- The Second School of Clinical Medicine, Southern Medial University, No. 253 Industrial Avenue Central, Guangzhou, 510260, P. R. China
| | - Xinzhi Wang
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Mengchen Liu
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Yi Yin
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Yunfan Wu
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Guang Xu
- Department of Neurology, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China
| | - Xiaofen Ma
- Department of Nuclear medicine, Guangdong Second Provincial General Hospital, No.466 Road XinGang, Guangzhou, 510317, P. R. China.
- The Second School of Clinical Medicine, Southern Medial University, No. 253 Industrial Avenue Central, Guangzhou, 510260, P. R. China.
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Yang H, Luan L, Xu J, Xu X, Tang X, Zhang X. Prevalence and correlates of sleep disturbance among adolescents in the eastern seaboard of China. BMC Public Health 2024; 24:1003. [PMID: 38600538 PMCID: PMC11008010 DOI: 10.1186/s12889-024-18564-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 04/10/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Sleep disturbances are serious public health issues that warrant increased attention, especially in adolescents. The aim of this study was to investigate the prevalence and factors associated with sleep disorders among urban adolescents in China. METHODS This study utilized an online survey to assess the demographic characteristics and mental health status of secondary school students in Lianyungang City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate sleep disturbances in adolescents. The seven-item Generalized Anxiety Disorder (GAD-7) assessed anxiety symptoms, and the Perceived Social Support Scale (PSSS) was used to measure perceived social support. RESULTS Among 3443 adolescents, the prevalence of sleep disorders were 10.8%, with significantly higher proportions of sleep disorders (13.7% VS 8.3%, P < 0.001) among female adolescents when compared to males. Binary regression analysis revealed that anxiety symptoms (OR = 1.305, 95% CI: 1.269-1.342, P < 0.001) was risk factor for sleep disturbances, and significant other support (OR = 0.944, 95% CI: 0.896-0.994, P = 0.028) and good annual household income (OR = 0.616, 95% CI: 0.394-0.963, P = 0.034) were protective factors. Furthermore, multinomial logistic regression analysis showed that age, sex, and anxiety symptoms were associated with an elevated risk of experiencing more frequent sleep disturbances (all P < 0.05). CONCLUSIONS We have found that 10.8% of adolescents experience sleep disorders, and it is evident that various factors can influence healthy sleeping. These results underscore the significance of addressing these factors to enhance sleep health among this population.
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Affiliation(s)
- Haidong Yang
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, 222003, Lianyungang, P.R. China
- Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, P.R. China
| | - Lingshu Luan
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, 222003, Lianyungang, P.R. China
- Xuzhou Medical University, 221004, Xuzhou, P.R. China
| | - Jiuli Xu
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, 222003, Lianyungang, P.R. China
- Xuzhou Medical University, 221004, Xuzhou, P.R. China
| | - Xingran Xu
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, 222003, Lianyungang, P.R. China
- Xuzhou Medical University, 221004, Xuzhou, P.R. China
| | - Xiaowei Tang
- Department of Psychiatry, Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, 225003, Yangzhou, P. R. China.
| | - Xiaobin Zhang
- Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, P.R. China.
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Chen P, Lam MI, Si TL, Zhang L, Balbuena L, Su Z, Cheung T, Ungvari GS, Sha S, Xiang YT. The prevalence of poor sleep quality in the general population in China: a meta-analysis of epidemiological studies. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01764-5. [PMID: 38429554 DOI: 10.1007/s00406-024-01764-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/13/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND The high prevalence of poor sleep quality (PSQ) in the general population leads to negative health outcomes. Since estimates of PSQ prevalence in the Chinese general population vary widely, this meta-analysis aimed to refine these estimates and to identify moderating factors. METHODS A comprehensive literature search was undertaken in both international (PubMed, PsycINFO, Web of Science, and EMBASE) and Chinese (Wanfang, and the China National Knowledge Infrastructure databases) databases from inception to 23 November 2023. Studies were required to have used standard scales such as the Chinese version of the Pittsburgh Sleep Quality Index (PSQI). The pooled prevalence of PSQ and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup and meta-regression analyses were performed to identify sources of heterogeneity. RESULTS In 32 studies with a combined 376,824 participants, the pooled prevalence of PSQ was 19.0% (95% CI 15.8-22.8%; range 6.6-43.6%). Across 22 studies that reported PSQI data, the pooled mean score was 4.32 (95%CI 3.82-4.81; SD = 0.502). The pooled mean sleep duration across 8 studies was 7.62 (95% CI 7.23-8.00; SD = 0.194) hours. Subgroup analyses showed that lower education (Q = 4.12, P = 0.042), living in less developed regions (Q = 60.28, P < 0.001), and lower PSQI cutoff values (Q = 9.80, P = 0.007) were significantly associated with PSQ. Meta-regression analyses showed that study quality was inversely associated with estimated PSQ prevalence (β = - 0.442, P = 0.004). LIMITATIONS Although measures such as subgroup and meta-regression analyses were performed, substantial heterogeneity remained. Information related to sleep quality, such as comorbid physical diseases or psychiatric disorders, substance use, occupational types, and employment status, were not reported in most studies. CONCLUSION One in five people in the general population of China may have PSQ and people with lower education or living in western regions may be more susceptible.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- Psychiatry Section, University of Notre Dame Australia, Fremantle, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 1/F, Building E12, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Liao DD, Hu JH, Ding KR, Hou CL, Tan WY, Ke YF, Jia FJ, Wang SB. Prevalence and Patterns of Insomnia Symptoms Among People Aged 65 and Above in Guangdong Province, China. ALPHA PSYCHIATRY 2024; 25:233-242. [PMID: 38798807 PMCID: PMC11117421 DOI: 10.5152/alphapsychiatry.2024.231458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/28/2024] [Indexed: 05/29/2024]
Abstract
Objective This survey investigated the prevalence, distribution, and correlative factors of insomnia symptoms among people aged 65 and above in Guangdong Province, China. Methods The Guangdong Mental Health Survey was conducted on the elderly in all 21 cities of Guangdong Province from September to December 2021. Multistage stratified cluster sampling was adopted, and 16 377 adult residents were interviewed face-to-face, from which 4001 elderly participants aged 65 and above were included for this study. Complex weighted adjustment methods were applied to weight the data. Multinomial logistic regression was applied to test the independent associations of clinical insomnia symptoms (CIS) and subthreshold insomnia symptoms (SIS) with the factors. Results The pooled estimate of insomnia symptoms was 13.44% [95% confidence interval (CI): 12.2 %-14.7%]. The 1-month weighted prevalence of SIS and CIS were 11.15% (95% CI: 10.05%-12.37%) and 2.28% (95%CI: 1.77%-2.94%), respectively. Multinomial logistic regression analysis revealed that urban residence, irregular diet, low body mass index, chronic disease, napping 3-4/week, early changes in dementia, symptoms of subthreshold depression, subthreshold generalized anxiety, and generalized anxiety disorder were positively associated with SIS. Additionally, living in urban areas, having chronic diseases, symptoms of subthreshold depression, major depressive disorder, subthreshold generalized anxiety, generalized anxiety disorder were positively associated with CIS. Conclusion Insomnia symptoms, including CIS and SIS, were prevalent among the elderly in Guangdong Province. Given the high burden of CIS and SIS, policymakers and healthcare professionals must explore and treat the related factors accordingly.
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Affiliation(s)
- Dan-Dan Liao
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
- Southern Medical University, Second School of Clinical Medicine, Guangdong, China
| | - Jia-Hui Hu
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
- Department of Psychology, Southern Medical University, School of Public Health, Guangdong, China
| | - Kai-Rong Ding
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
- Department of Psychology, Southern Medical University, School of Public Health, Guangdong, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
- Southern Medical University, Second School of Clinical Medicine, Guangdong, China
- Department of Psychology, Southern Medical University, School of Public Health, Guangdong, China
| | - Wen-Yan Tan
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
| | - Yun-Fei Ke
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
- Southern Medical University, Second School of Clinical Medicine, Guangdong, China
- Department of Psychology, Southern Medical University, School of Public Health, Guangdong, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, China
- Zhuhai College of Science and Technology, School of Health, Guangdong, China
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López-Bueno R, Núñez-Cortés R, Calatayud J, Salazar-Méndez J, Petermann-Rocha F, López-Gil JF, Del Pozo Cruz B. Global prevalence of cardiovascular risk factors based on the Life's Essential 8 score: an overview of systematic reviews and meta-analysis. Cardiovasc Res 2024; 120:13-33. [PMID: 38033266 DOI: 10.1093/cvr/cvad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/25/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023] Open
Abstract
Cardiovascular health (CVH) is a critical issue for global health. However, no previous study has determined the prevalence of cardiovascular risk factors based on the American Heart Association's (AHA) Life's Essential 8 (LE8). Therefore, we aimed to estimate the global prevalence of the eight cardiovascular risk factors identified in the LE8. A systematic search of systematic reviews with meta-analysis on cardiovascular risk factors covering data reported between 2000 and 2019 was conducted on PubMed, Epistemonikos, and the Cochrane Library until 1 May 2023. After applying exclusion criteria, 79 studies remained in the final selection for the narrative synthesis in the systematic review, of which 33 of them were used in the meta-analysis which included 2 555 639 participants from 104 countries. The overall pooled prevalence of cardiovascular risk factors was as follows: insufficient physical activity, 26.3% (95% CI 2.3%-63.4%), no adherence to a healthy diet, 34.1% (95% CI 5.8%-71.2%), nicotine exposure, 15.4% (95% CI 10.4%-21.2%), insufficient sleep quality, 38.5% (95% CI 14.0%-66.7%), obesity, 17.3% (95% CI 6.1%-32.6%), dyslipidemia, 34.1% (95% CI 33.8%-34.4%), diabetes, 12.0% (95% CI 7.0%-18.2%), and hypertension, 29.4% (95% CI 23.3%-35.8%). These results warrant prevention strategies aimed at reducing insufficient sleep quality, and no adherence to a healthy diet as leading cardiovascular risk factors worldwide. The high prevalence of hypertension among children and adults is concerning and should also be adequately addressed through global policies.
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Affiliation(s)
- Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Rodrigo Núñez-Cortés
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Fanny Petermann-Rocha
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
| | | | - Borja Del Pozo Cruz
- Faculty of Education, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Lu ML, Zhu JW, Wu JL, Lv LY, Liu L, Kong GQ, Ding CL, Yu Y, Pan L. Insomnia among coronavirus disease 2019 survivors: A single-center cross-sectional study. Medicine (Baltimore) 2024; 103:e37311. [PMID: 38363887 PMCID: PMC10869043 DOI: 10.1097/md.0000000000037311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/29/2024] [Indexed: 02/18/2024] Open
Abstract
Since the coronavirus disease 2019 (COVID-19) epidemic, insomnia has become one of the longer COVID-19 symptoms. This study aimed to investigate insomnia among COVID-19 survivors and explore the occurrence and influencing factors of insomnia. A cross-sectional study was performed from December 2022 to February 2023 through an online questionnaire star survey with 8 questions. The insomnia severity index scale (ISI) was used to assess the severity of insomnia. Univariate analysis was used to analyze the factors related to COVID-19 infection. A total of 564 participants (183 males and 381 females) were surveyed in the present study. The prevalence of insomnia was 63.12%. Among these insomnia patients, there were 202 (35.82%) with sub-threshold symptoms, 116 (20.57%) with moderate symptoms, and 38 (6.74%) with severe symptoms. Univariate analysis indicated that there were statistically significant differences in the prevalence of insomnia among COVID-19 survivors of different ages, occupations, and educational levels (P < .05). Of the 356 insomnia patients, 185 (51.97%) did not take any measures against insomnia, while those who took drugs only, physical exercise only, drugs and physical exercise, and other measures were 90 (25.28%), 42 (11.80%), 17 (4.78%), and 22 (6.18%), respectively. Additionally, of the 107 insomnia patients with drug therapy, 17 (15.89%) took estazolam, 16 (14.95%) took alprazolam, 39 (36.45%) took zopiclone, and 35 (32.71%) took other drugs to improve insomnia symptoms. The prevalence of insomnia symptoms remains high among COVID-19 survivors in China. Education level and occupation may be the influencing factors. Unfortunately, most patients with insomnia do not take corresponding treatment measures.
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Affiliation(s)
- Man-Lu Lu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Ji-Wei Zhu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Jing-Lin Wu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Liang-Yan Lv
- Institute of Clinical Drug Trials, Binzhou Medical University Hospital, Binzhou, China
| | - Lu Liu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Gui-Qing Kong
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Chang-Ling Ding
- Institute of Clinical Drug Trials, Binzhou Medical University Hospital, Binzhou, China
| | - Yan Yu
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
| | - Lei Pan
- Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China
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Liao J, Rosenheck R, Sun B, Liu J, Shen Y, Yuan S, Ma Y, Zhang J, Zhang R, Zheng L, Chen H, Feng H, He H. Prevalence and correlates of suicide risk among non-psychiatric inpatients in a general hospital in China. J Affect Disord 2024; 347:509-514. [PMID: 38036048 DOI: 10.1016/j.jad.2023.11.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/25/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE This study aims to investigate the suicide risk and mental health status of non-psychiatric inpatients in general hospital and explore the risk factors of suicide. METHODS A prospective study was conducted at a tertiary general hospital in Guangzhou, Guangdong Province, China. On-line assessment of mental health status and suicide was completed at admission and discharge. We assessed depression, anxiety, insomnia and suicide of inpatients and binary logistics regression was used to examine the risk factors of suicide. RESULTS From April 1, 2021 and January 31, 2022, 3685 inpatients were included. The detection rates of depression, anxiety and insomnia were 14.6 %, 9.0 % and 17.8 %, respectively. There were 2.7 % of inpatients at suicide risk. Binary logistics regression demonstrated that the inpatients with anxiety were at higher risk of suicide. LIMITATIONS (1) Single-center study limits the generalization of conclusion, (2) low response rate at discharge. CONCLUSIONS The comorbidity of physical illnesses and mental health problems, including depression, anxiety, insomnia, and suicide among non-psychiatric patients in general hospital was common. An assessment of anxiety may help identify individuals at high suicide risk. Medical staff in general hospitals should be trained to improve their ability to identify mental disorders and high-risk individuals for suicide, provide timely interventions and effectively reduce the suicide risk of patients.
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Affiliation(s)
- Jiayi Liao
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Robert Rosenheck
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Bin Sun
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Jingwen Liu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Yizhong Shen
- The Third People's Hospital of Zhuhai, Zhuhai, China
| | - Shuai Yuan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Yarong Ma
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Jie Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Rong Zhang
- Guangdong Second Rongjun Hospital, Foshan, China
| | - Lijiao Zheng
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Hanwei Chen
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Huiqiang Feng
- Health Commission of Guangdong Province, Guangzhou, China
| | - Hongbo He
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
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8
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WANG Y, WU S, WANG Z, CHANG W, XIE Z, TANG X, ZHAO S, ZHOU J, CHEN Z, WANG C, YANG C. Efficacy of Zhumian Tang formula granules combined with eszopiclone for the treatment of poor sleep quality: a multi-center, randomized controlled, superiority trial. J TRADIT CHIN MED 2024; 44:163-171. [PMID: 38213251 PMCID: PMC10774717 DOI: 10.19852/j.cnki.jtcm.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE To evaluate the efficacy and safety of Zhumian Tang formula granules combined with eszopiclone for treating poor sleep quality. METHODS This multi-center, dynamic block-randomized, parallel-group superiority clinical trial included 130 patients. The combined treatment group received Zhumian Tang formula granules combined with eszopiclone treatment, and the control group received eszopiclone treatment only. The group allocation ratio was 1∶1. The duration of treatment was 2 weeks. Participants were asked to complete questionnaires before treatment, after 1 week of the intervention, after 2 weeks of the intervention, and at the follow-up on week 3. The primary outcomes were the Pittsburgh Sleep Quality Index (PSQI) score and the total effective rate of treatment. The secondary outcome was the rate of adverse effects. RESULTS Compared with the eszopiclone treatment group, the PSQI score of the combined treatment group was significantly lower after 2 weeks of the intervention (6.98 vs 8.26, P < 0.05). However, there was no significant difference in the mean PSQI score after 1 week of the intervention (9.89 vs 9.15, P = 0.124). After the follow-up on week 3, the PSQI score of the combined treatment group remained significantly lower than that of the eszopiclone treatment group (6.12 vs 8.31, P < 0.001). The total effective rates of treatment of the combined group and the eszopiclone group were 36.92% vs 35.38% (Z = 0.033, P = 0.855) after 1 week of the intervention, 83.08% vs 58.46% (Z = 9.519, P < 0.05) after 2 weeks of the intervention, and 83.08% vs 61.54% (Z = 7.530, P < 0.05) and after the follow-up on week 3, respectively. There was no significant difference in the overall rate of adverse reactions between the combined and eszopiclone treatment groups (21.53% vs 31.8%, P = 0.318). CONCLUSION The combination of Zhumian Tang formula granules with eszopiclone was found to be safe and more effective in improving sleep quality than eszopiclone alone. Traditional Chinese medicine can enhance the effectiveness of Western medicine in the treatment of insomnia.
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Affiliation(s)
- Yichen WANG
- 1 Orthopedic geriatrics department, Sichuan Province Orthopedic Hospital, Chengdu 610093, China
| | - Shiyi WU
- 2 Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Zhengyan WANG
- 3 Sub-health department, Sichuan Integrative Medicine Hospital, Chengdu 610041, China
| | - Wenling CHANG
- 2 Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Zhihao XIE
- 2 Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Xing TANG
- 4 College of Acupuncture and Massage, Chengdu University of Traditional Chinese Medicine, Chengdu 610041, China
| | - Songmei ZHAO
- 5 Internal Medicine Department, Ya'an Hospital of Traditional Chinese Medicine, Ya’an 625000, China
| | - Jing ZHOU
- 6 Preventive Treatment of Disease Center, Dazhou Integrated TCM and Western Medicine Hospital, Dazhou Second People’s Hospital, Dazhou 635000, China
| | - Zehong CHEN
- 7 Geriatrics Department, Dayi Wang Country Hospital of Traditional Chinese Medicine, Chengdu 611330, China
| | - Chao WANG
- 3 Sub-health department, Sichuan Integrative Medicine Hospital, Chengdu 610041, China
| | - Chunxia YANG
- 2 Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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9
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Yan X, Li Y, Li S, Liang C, Wang L, Kong J, Zhao Y, Chen Q, Xu H. Validation of the Chinese version of the Sleep Regularity Questionnaire (SRQ) and analysis of influencing factors. Sleep Med 2024; 114:73-81. [PMID: 38157623 DOI: 10.1016/j.sleep.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/03/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Currently, there is no instrument to measure sleep regularity in China. In this study, the Sleep Regularity Questionnaire(SRQ) was translated into Chinese, tested for reliability and validity, and analyzed for factors affecting sleep regularity. METHODS The English version of the SRQ was translated into Chinese, and a total of 3642 individuals were included in this research. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying factor structure of the Chinese version of the SRQ and to measure its reliability and validity. In addition, the correlations between sleep regularity and general information, personal habits, self-control, stress, anxiety, and depression were explored. RESULTS The Cronbach's α of the Chinese SRQ was 0.858, supporting the two-factor structure. Sleep regularity was statistically different between gender and ethnicity (p < 0.05), and personal habits (exercise, continued eating after dinner, smoking and drinking) had an effect on sleep regularity. Sleep regularity was positively associated with individual self-control and negatively associated with stress, anxiety, and depression. CONCLUSIONS The Chinese version of the SRQ has excellent reliability and validity. There are two dimensions, namely circadian regularity and sleep continuity regularity, which can be used to assess the sleep regularity of Chinese adults. The results of this study showed that males and Han Chinese having better sleep regularity. And people with good lifestyle habits and greater self-control sleep more regularly, while stress, anxiety and depression can affect individuals' sleep regularity.
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Affiliation(s)
- Xiangru Yan
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China; Jining No.1 People's Hospital, 272000, Jining, China.
| | - Yanhui Li
- Department of Stomatology, Shandong Medical College, 276000, Linyi, China.
| | - Sisi Li
- Department of Nursing, Panjin Vocational and Technical College, 124000, Panjin, China.
| | - Chunguang Liang
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Liying Wang
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Jie Kong
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Ying Zhao
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Qing Chen
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Huameng Xu
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
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10
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Li X, He C, Shen M, Wang M, Zhou J, Chen D, Zhang T, Pu Y. Effects of aqueous extracts and volatile oils prepared from Huaxiang Anshen decoction on p-chlorophenylalanine-induced insomnia mice. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117331. [PMID: 37858748 DOI: 10.1016/j.jep.2023.117331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Insomnia occurs frequently in modern society, and its common symptoms include difficulty in falling asleep and decreased sleep quality and time, memory, and attention. With the advantages of having few side-effects and reduced drug-dependence, a compound traditional Chinese medicine (TCM) prescription called Huaxiang Anshen Decoction (HAD) has been widely used in clinical practice in China mainly for primary insomnia treatment. Although the effects of volatile oils from TCM herbs have been increasingly reported, volatile oils in HAD are conventionally neglected because of its preparation process and clinical usage. Therefore, exploring the anti-insomnia effects of volatile oils from HAD is of great importance. AIM OF THE STUDY The sedative and hypnotic effects of the conventional aqueous extracts, the volatile oils from HAD, and their combinations were investigated. METHODS The main components in HAD volatile oils (HAD-Oils), were analyzed through gas chromatography-mass spectrometry (GC-MS). The HAD volatile oil inclusion complex (HAD-OIC) was prepared with β-cyclodextrin, and characterized. P-chlorophenylalanine (PCPA) was used to induce insomnia mice model and the test groups of HAD aqueous extract (HAD-AE), HAD-OIC and their combination (AE-OIC). An open field test was used in evaluating the mice's activities, and the levels of 5-hydroxytryptamine (5-HT) in mice sera, glutamate (Glu) in the hypothalamus, and γ-aminobutyric acid (γ-GABA) and dopamine (DA) in the brain tissues were assayed by enzyme-linked immunosorbent assay (ELISA). RESULTS A total 74 components in HAD-Oil were determined by GC/MS, and cyperenone (20.46%) and α-cyperone (10.39%) had the highest relative content. The characterization results of the physical phase showed that volatile oils were successfully encapsulated by β-cyclodextrin and HAD-OIC was produced. The average encapsulation rates of cyperenone and α-cyperone were 79.93% and 71.96%, respectively. The results of pharmacology study showed that all the test groups increased the body weight and decreased voluntary activity when compared with the model group (P < 0.05). The HAD-AE, HAD-OIC, and AE-OIC groups increased the levels of 5-HT in the sera and DA and Glu/γ-GABA in the brains, and AE-OIC groups showed better performance than the other test groups. CONCLUSIONS HAD-Oil exerts sedative and hypnotic effects, which are increased when it is used with HAD-AEs. This result provides a favorable experimental evidence that volatile oils should be retained for the further development of HAD.
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Affiliation(s)
- Xinye Li
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Chao He
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Min Shen
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Mingyun Wang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jingwen Zhou
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Dongying Chen
- Laboratory of Pharmaceutical Analysis, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Tong Zhang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Yiqiong Pu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
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11
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Cai H, Chen P, Jin Y, Zhang Q, Cheung T, Ng CH, Xiang YT, Feng Y. Prevalence of sleep disturbances in children and adolescents during COVID-19 pandemic: a meta-analysis and systematic review of epidemiological surveys. Transl Psychiatry 2024; 14:12. [PMID: 38191533 PMCID: PMC10774396 DOI: 10.1038/s41398-023-02654-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 10/19/2023] [Accepted: 11/06/2023] [Indexed: 01/10/2024] Open
Abstract
The COVID-19 pandemic and the ensuing widespread lockdown measures have had a negative impact on the mental health of children and adolescents. We thus conducted a meta-analysis of the worldwide prevalence of sleep disturbances in children and adolescents during the COVID-19 pandemic. We performed a systematic literature search of the major international (PubMed, PsycINFO, Web of Science) and Chinese (Chinese Nation Knowledge Infrastructure (CNKI) and WANFANG) databases from their commencement dates to 27 December 2022. Altogether, 57 articles covering 206,601 participants were included in the meta-analysis. The overall prevalence of sleep disturbances was 34.0% (95% confidence interval (CI): 28-41%). The prevalence of parent-reported sleep disturbances during the COVID-19 pandemic was significantly higher than that of self-reported (p = 0.005) sleep disturbances. Epidemiological studies jointly conducted across Asia and Europe had a higher prevalence of sleep disturbances compared to those conducted in Asia, Europe, America, Oceania, or South America alone (p < 0.001). Children had a significantly higher prevalence of sleep disturbances compared to adolescents alone or a mixed cohort of children and adolescents (p = 0.022). Meta-regression analyses revealed that mean age (p < 0.001), quality evaluation score (p < 0.001), and percentage of men (p < 0.001) showed negative associations, while time of survey (B = 1.82, z = 34.02, p < 0.001) showed a positive association with the prevalence of sleep disturbances. Sleep disturbances were common in children and adolescents during the COVID-19 pandemic.
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Affiliation(s)
- Hong Cai
- Unit of Medical Psychology and Behavior Medicine, School of public health, Guangxi Medical University, Nanning, Guangxi, China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
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12
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Türkarslan KK, Canel Çınarbaş D, Nicassio PM. The psychometric properties of the Turkish version of the Pre-sleep Arousal Scale. Sleep Biol Rhythms 2024; 22:75-84. [PMID: 38476852 PMCID: PMC10899935 DOI: 10.1007/s41105-023-00483-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/01/2023] [Indexed: 03/14/2024]
Abstract
Purpose The aim of the present study was to examine the psychometric properties of the Turkish version of the Pre-sleep Arousal Scale (PSAS), which measures pre-sleep arousal, a significant predictor of insomnia symptoms. Methods 651 participants were recruited via social media and the Internet. Confirmatory factor analysis was conducted in the total sample (65.28% females; Mage1 = 28.09 ± 14.00). Convergent, divergent, incremental, and known-groups validity and internal consistency coefficients were assessed in a subsample of 556 participants (62.77% females; Mage2 = 29.25 ± 14.81). A second separate sample of 88 participants (80.68% females; Mage3 = 22.19 ± 4.98) was used to evaluate three-week test-retest reliability. Results The results of factor analysis confirmed the two-factor structure of the Turkish PSAS with cognitive (PSAS-C) and somatic (PSAS-S), similar to the original scale. The correlations of the PSAS with convergent and divergent measures showed that the Turkish form had good convergent and acceptable divergent validity. PSAS-C and PSAS-S were able to explain an 18% additional variance in insomnia severity beyond depression and anxiety, an 18% additional variance in depression beyond insomnia severity, and a 35% additional variance in anxiety beyond insomnia severity. Moreover, insomnia patients had significantly higher PSAS-C and PSAS-S scores than good sleepers. Finally, the PSAS, PSAS-C, and PSAS-S had satisfactory internal consistency coefficients (α = 0.92, 0.91, and 0.86, respectively) and three-week test-retest correlations (ICC = 0.82, 0.82, and 0.71, respectively). Conclusion The Turkish form of the PSAS was a valid and reliable measure of pre-sleep arousal and can be utilized in sleep studies. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-023-00483-z.
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Affiliation(s)
| | | | - Perry M. Nicassio
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute, Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, USA
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13
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Zhao W, Van Someren EJW, Xu Z, Ren Z, Tang L, Li C, Lei X. Identifying the insomnia-related psychological issues associated with hyperarousal: A network perspective. Int J Psychophysiol 2024; 195:112276. [PMID: 38056632 DOI: 10.1016/j.ijpsycho.2023.112276] [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: 06/08/2023] [Revised: 10/30/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023]
Abstract
Hyperarousal, recognized as a fundamental characteristic of insomnia for decades, has yielded limited evidence concerning its direct psychological associations. This study aimed to explore the psychological factors linked to hyperarousal within the framework of interrelated variables. Two independent samples, comprising n = 917 and n = 652 young adults, were included in the study. Employing the first dataset as a discovery sample and the second dataset as a replication sample, network analyses were conducted using 26 variables derived from 17 scales. The objective was to estimate the direct and indirect associations between psychological issues, including hyperarousal and insomnia. Additionally, linear regression analysis was employed to assess the convergence of findings obtained from the network analysis. Network analyses in both samples converged to reveal direct associations between insomnia severity and several psychological factors, including negative sleep beliefs, physical fatigue, insomnia response to stress, hyperarousal, self-reported depression, and mental fatigue. Notably, the nodes with relative importance within the network include trait anxiety, depressive rumination, hyperarousal, perfectionism sub-dimension of concern over mistakes, and private self-consciousness. Hyperarousal is one of the key factors linking insomnia with a variety of psychological issues, including emotion-related factors (rumination, perveived stress), sleep-related factors (dysfunctional sleep beliefs and attitudes, insomnia response to stress, fatigue, chronotype), and self-related factors (self-consciousness, perfectionism). The results suggest that forthcoming strategies for enhancing the treatment efficacy of insomnia could consider supplementary interventions that specifically address hyperarousal, other factors directly linked to insomnia, or the hub nodes within the network.
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Affiliation(s)
- Wenrui Zhao
- Sleep Center, Department of Neurology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam UMC, Vrije Universiteit, the Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, the Netherlands
| | - Ziye Xu
- Sleep and Neuroimaging Center, Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Zhiting Ren
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Ling Tang
- Sleep Center, Department of Neurology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China
| | - Chenyu Li
- Sleep Center, Department of Neurology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400021, China.
| | - Xu Lei
- Sleep and Neuroimaging Center, Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing 400715, China.
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14
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Zhang W, Yu M, Xu Y, Li X, Zuo H, Huang Z, Gao X. Self-reported sleep status and influencing factors: a web-based national cross-sectional survey in China. Ann Med 2023; 55:2287706. [PMID: 38048387 PMCID: PMC10836258 DOI: 10.1080/07853890.2023.2287706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVES To investigate self-reported sleep duration, sleep timing, sleep status and influencing factors in the Chinese population. METHODS This web-based cross-sectional survey was conducted in 2022, covering 31 provinces (91%) in China. 11,000 questionnaires were collected, of which 8970 were valid for analysis. Self-reported sleep habits, problems and quality were investigated. Good or fair sleep ratings, enough duration, regular, with no sleep disturbances and <30 min sleep latency was defined as a composite variable: 'Good sleep'. Factors influencing sleep patterns and 'Good sleep' were analyzed by multivariate logistic regression. RESULTS Most participants sleep less than 7 h per night (55.13%), usually go to bed at 10-12 pm (47.99%), wake up at 6-8 am (49.86%), and take less than 30 min to fall asleep (66.30%) with regular sleep schedule (76.01%). Only 12.36% have 'Good sleep'. In the past 3 months, 46.80% of the participants reported symptoms of insomnia, and 21.54% had snoring problems. Among the adults, the young, males, college students, freelancers, and those who resided in urban areas and pandemic-free areas slept later, and the northerners woke up earlier. The adults with low-moderate and moderate income and the minors at elementary and middle school slept earlier and woke up earlier. Mid-aged adults who often napped at noon were more likely to have 'Good sleep' than any other age group, and urban dwellers with the same habit were more likely to have 'Good sleep' than people dwelled in other regions. While people who slept late, woke up too early or too late, slept too little or too much, resided at GMT 7-8 area or pandemic area, had high income, or took up some occupations (entrepreneurs/individuals, professionals, manual and non-manual workers, housewives) were less likely to get a 'Good sleep'. CONCLUSIONS The national survey provided a sleep profile of the Chinese population. Both socio-economic status and personal sleep hygiene habits had an impact on 'Good sleep'.
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Affiliation(s)
- Wanxin Zhang
- Oral Center of Sleep Disordered Breathing, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Min Yu
- Oral Center of Sleep Disordered Breathing, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Ying Xu
- Oral Center of Sleep Disordered Breathing, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Xiaoqing Li
- Oral Center of Sleep Disordered Breathing, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Heming Zuo
- Chinese Sleep Research Society, Beijing, PR China
- China-Japan Friendship Hospital, Beijng, PR China
| | - Zhili Huang
- Chinese Sleep Research Society, Beijing, PR China
- School of Basic Medical Sciences, Fudan University, Shanghai, PR China
| | - Xuemei Gao
- Oral Center of Sleep Disordered Breathing, Peking University School and Hospital of Stomatology, Beijing, PR China
- Chinese Sleep Research Society, Beijing, PR China
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15
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Xu S, Li Y, Ye J, Han D. Sleep medicine in China: current clinical practice. J Clin Sleep Med 2023; 19:2125-2131. [PMID: 37602465 PMCID: PMC10692925 DOI: 10.5664/jcsm.10784] [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: 06/18/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
The modern practice of sleep medicine in China was introduced in the 1980s and has undergone significant development over the past few decades. The field has witnessed an increase in sleep laboratories, the publication of guidelines for the diagnosis and treatment of sleep disorders, and the establishment of several sleep medicine associations. Despite these achievements, there is still much to be done in this field. By utilizing original national survey data, this study comprehensively discusses the current practice of sleep medicine in China, including sleep medicine training, diagnostic capacity, multidisciplinary care, clinical competence and standardization, sleep telemedicine, barriers to the practice of sleep medicine, and costs of sleep medicine. It is imperative for the Chinese health care authorities to enhance their attention and investment in the field of sleep medicine. Urgent implementation of standardized training programs and accreditation systems is necessary to promote the diagnosis and treatment of sleep disorders in China. CITATION Xu S, Li Y, Ye J, Han D. Sleep medicine in China: current clinical practice. J Clin Sleep Med. 2023;19(12):2125-2131.
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Affiliation(s)
- Shenglong Xu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China
| | - Yanru Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China
| | - Jingying Ye
- Sleep Center, Department of Otorhinolaryngology—Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
- Institute of Precision Medicine, Tsinghua University, Beijing, China
| | - Demin Han
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China
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16
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Endomba FT, Tchebegna PY, Chiabi E, Angong Wouna DL, Guillet C, Chauvet-Gélinier JC. Epidemiology of insomnia disorder in older persons according to the Diagnostic and Statistical Manual of Mental Disorders: a systematic review and meta-analysis. Eur Geriatr Med 2023; 14:1261-1272. [PMID: 37725311 DOI: 10.1007/s41999-023-00862-2] [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: 05/09/2023] [Accepted: 08/30/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE There is a scarcity of summarizing data on the epidemiology of insomnia in older persons, especially when diagnosed with international criteria. This study aimed to estimate the prevalence and correlates of insomnia disorder in older persons, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). METHODS Through PubMed/MEDLINE, EMBASE, and Web of Science (WoS), we searched for relevant articles published before June 28, 2023. The risk of bias was weighed using the Joanna Briggs Institute's (JBI's) critical appraisal checklist for studies reporting prevalence data. For our analyses, we used a random-effect model, with subgroup analyses, meta-regression, and sensitivity analyses to explore potential sources of heterogeneity. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. RESULTS We included 18,270 participants across 16 studies. The male/female ratio was 0.89 (12 studies), and the mean age varied from 65.9 to 83.1 years (8 studies). The pooled prevalence of insomnia was 19.6% (95% CI = [12.3%; 28.3%]), with substantial heterogeneity. This prevalence fluctuated according to the sample size, the minimal age for inclusion, and the study quality, considering that the risk of bias was moderate for most of studies. There was a publication bias, with a very low level of certainty. Insomnia disorder was associated with the female gender, depression, anxiety, and somatic illnesses notably cardiovascular, respiratory, and painful ones. CONCLUSION Nearly one in every five old individuals was considered to have insomnia disorder, which was associated with the gender and the existence of mental health and/or somatic conditions. REGISTRATION We registered the protocol in the International Prospective Register of Systematic Reviews (PROSPERO) with registration number: CRD42022344675.
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Affiliation(s)
- Francky Teddy Endomba
- Research department, Medical Mind Association, Yaoundé, Cameroon.
- Sleep Specialized Transversal Training, Psychiatry Internship Program, University of Burgundy, Dijon, France.
| | | | - Edmond Chiabi
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Clément Guillet
- Centre d'Exploration du Sommeil, Centre Hospitaliser Spécialisé La Chartreuse, Dijon, France
| | - Jean Christophe Chauvet-Gélinier
- Service de Psychiatrie Adultes, Centre Hospitalier Universitaire, Dijon, France
- INSERM LNC UMR1231, University of Burgundy, Dijon, France
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17
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Wu J, Liu X, Ye C, Hu J, Ma D, Wang E. Intranasal dexmedetomidine improves postoperative sleep quality in older patients with chronic insomnia: a randomized double-blind controlled trial. Front Pharmacol 2023; 14:1223746. [PMID: 38034987 PMCID: PMC10687473 DOI: 10.3389/fphar.2023.1223746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023] Open
Abstract
Objective: This study was determined to investigate the impact of intranasal dexmedetomidine (DEX) on postoperative sleep quality in older patients (age over 65) with chronic insomnia during their hospitalization after surgery. Design: A randomized double-blind controlled trial was conducted to compare the effects of intranasal dexmedetomidine spray with a placebo group. Setting and Participants: The study was carried out at Xiangya Hospital, Central South University. 110 participants with chronic insomnia were analyzed. Methods: This trial enrolled older patients who underwent total hip/knee arthroplasty and randomized them to receive intranasal dexmedetomidine (2.0 μg/kg) or saline daily at around 9 p.m. after surgery until discharge. The primary outcomes were subjective sleep quality assessed with the Leeds Sleep Evaluation Questionnaire (LSEQ). The secondary outcomes included the objective sleep quality measured with the Acti-graph, the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI). The other outcomes included the incidence of delirium, levels of inflammatory factors, visual analog scale (VAS) pain scores, postoperative opioid consumption, and treatment-related adverse events. Results: 174 patients were screened for eligibility, and 110 were recruited and analyzed. The DEX group had significantly higher scores on both the LSEQ-Getting to sleep and LSEQ-Quality of Sleep at each time point compared to the placebo (p < 0.0001), The least squares (LS) mean difference in LSEQ-GTS score at T0 between placebo group and DEX group was 2 (95% CI, -1-6), p = 0.4071 and at T5 was -14 (95% CI, -17 to -10), p < 0.0001; The LS mean difference in the LSEQ-QOS score at T0 was -1 (95% CI, -4 to 1), p = 0.4821 and at T5 was -16 (95% CI, -21 to -10), p < 0.0001. The DEX group exhibited significant improvement in Total Sleep Time (TST), Sleep Onset Latency (SOL), and Sleep Efficiency (SE), at each time point after treatment compared to the placebo group (p < 0.0001). The PSQI and ISI scores in the DEX group were reduced after treatment (p < 0.001). No significant adverse events were reported with the use of dexmedetomidine. Conclusion and Implications: This study demonstrates that intranasal administration of dexmedetomidine improves postoperative sleep quality in older patients with chronic insomnia who undergo surgery, without increasing the incidence of adverse effects. Clinical Trial Registration: http://www.chictr.org.cn/, identifier ChiCTR2200057133.
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Affiliation(s)
- Jinghan Wu
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, China
| | - Xingyang Liu
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
| | - Chunyan Ye
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
| | - Jiajia Hu
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
| | - Daqing Ma
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London and Chelsea and Westminster Hospital, London, United Kingdom
| | - E. Wang
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, China
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Chen P, Zhao YJ, An FR, Li XH, Lam MI, Lok KI, Wang YY, Li JX, Su Z, Cheung T, Ungvari GS, Ng CH, Zhang Q, Xiang YT. Prevalence of insomnia and its association with quality of life in caregivers of psychiatric inpatients during the COVID-19 pandemic: a network analysis. BMC Psychiatry 2023; 23:837. [PMID: 37964197 PMCID: PMC10644468 DOI: 10.1186/s12888-023-05194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/14/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Studies on sleep problems among caregivers of psychiatric patients, especially during the COVID-19 pandemic, are limited. This study examined the prevalence and correlates of insomnia symptoms (insomnia hereafter) among caregivers of psychiatric inpatients during the COVID-19 pandemic as well as the association with quality of life (QoL) from a network analysis perspective. METHODS A multi-center cross-sectional study was conducted on caregivers of inpatients across seven tertiary psychiatric hospitals and psychiatric units of general hospitals. Network analysis explored the structure of insomnia using the R program. The centrality index of "Expected influence" was used to identify central symptoms in the network, and the "flow" function was adopted to identify specific symptoms that were directly associated with QoL. RESULTS A total of 1,101 caregivers were included. The overall prevalence of insomnia was 18.9% (n = 208; 95% CI = 16.7-21.3%). Severe depressive (OR = 1.185; P < 0.001) and anxiety symptoms (OR = 1.099; P = 0.003), and severe fatigue (OR = 1.320; P < 0.001) were associated with more severe insomnia. The most central nodes included ISI2 ("Sleep maintenance"), ISI7 ("Distress caused by the sleep difficulties") and ISI1 ("Severity of sleep onset"), while "Sleep dissatisfaction" (ISI4), "Distress caused by the sleep difficulties" (ISI7) and "Interference with daytime functioning" (ISI5) had the strongest negative associations with QoL. CONCLUSION The insomnia prevalence was high among caregivers of psychiatric inpatients during the COVID-19 pandemic, particularly in those with depression, anxiety and fatigue. Considering the negative impact of insomnia on QoL, effective interventions that address insomnia and alteration of sleep dissatisfaction should be developed.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Yan-Jie Zhao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Kiang Wu Nursing College of Macau, Macao SAR, China
| | - Ka-In Lok
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao SAR, China
| | - Yue-Ying Wang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Jia-Xin Li
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia.
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
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Hasan F, Lee HC, Chen PY, Wang YH, Yuliana LT, Romadlon DS, Tu YK, Chiu HY. Comparative efficacy of hypnotics in young and middle-aged adults with insomnia: a systematic review and network meta-analysis. Sleep Breath 2023; 27:2021-2030. [PMID: 36928548 DOI: 10.1007/s11325-023-02812-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/04/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE/BACKGROUND Insomnia is highly prevalent in modern society. However, the hierarchical selection of hypnotics in young and middle-aged adults with insomnia remains unclear. We aimed to compare the efficacy and daytime drowsiness associated with different hypnotics for treating insomnia in young and middle-aged adults. METHODS We searched Embase, PubMed, Cochrane Library, and ProQuest Dissertations and Theses A&I databases from inception until December 15, 2021. We also manually searched reference lists and relevant publications. The literature search, data collection, and risk of bias evaluation were all carried out separately by pairs of reviewers. We included randomized control trials (RCTs) that compared hypnotics approved by the Food and Drug Administration. The R and Stata software were both used to perform the meta-analysis. RESULTS In total, 117 RCTs comprising 22,508 participants with the age of 18 to 65 years were included. Assessment of the efficacy of the hypnotics and adverse events (drowsiness) revealed that zolpidem improved all objective sleep parameters (oTST, oSOL, oWASO, and oSE), zopiclone increased oTST and oSE and reduced oSOL, and daridorexant increased oTST and reduced oWASO. Regarding subjective sleep outcomes, zolpidem exhibited beneficial effects on sTST, sSOL, and sWASO. Zaleplon reduced sSOL, and zopiclone was the recommended hypnotic for improving SQ. Zolpidem was associated with drowsiness effect (odds ratio = 1.82; 95% confidence interval = 1.25 to 2.65). The results of sensitivity analysis remained unchanged after the exclusion of studies reporting long-term effects. CONCLUSION Zolpidem is recommended for managing sleep-onset insomnia and sleep maintenance insomnia but should be used with caution because of daytime drowsiness effects. Daridorexant is recommended as a promising agent for managing sleep maintenance insomnia.
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Affiliation(s)
- Faizul Hasan
- School of Nursing, College of Nursing, Taipei Medical University, Xinyi Dist, Taipei, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry & Sleep Center, Taipei Medical University Hospital, Taipei, Taiwan
- Research Center of Sleep Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Pin-Yuan Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Han Wang
- School of Nursing, College of Nursing, Taipei Medical University, Xinyi Dist, Taipei, Taiwan
- Department of Nursing, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Lia Taurussia Yuliana
- School of Nursing, College of Nursing, Taipei Medical University, Xinyi Dist, Taipei, Taiwan
| | - Debby Syahru Romadlon
- School of Nursing, College of Nursing, Taipei Medical University, Xinyi Dist, Taipei, Taiwan
| | - Yu-Kang Tu
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Xinyi Dist, Taipei, Taiwan.
- Research Center of Sleep Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.
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20
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Zhu R, Zhou Y, Wei S, Wang W, Wang D, Wang L, Zhang XY. Insomnia in Chinese patients with chronic schizophrenia: prevalence, clinical correlates and relationship with cognitive impairment. Sleep Breath 2023; 27:1977-1983. [PMID: 36522602 DOI: 10.1007/s11325-022-02762-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Insomnia is a major public health concern that often occurs in patients with schizophrenia, complicating the treatment and prognosis of patients. This study aimed to investigate the prevalence of insomnia and its relationship with cognitive function in Chinese patients with chronic schizophrenia. METHODS We recruited patients with schizophrenia and collected their clinical and demographic data. Insomnia data were collected through a self-reported questionnaire consisting of three questions. The positive and negative syndrome scale (PANSS) was used to measure psychopathological symptoms, while the repeatable battery for the assessment of neuropsychological status (RBANS) was used to measure cognitive performance. RESULTS Of 957 Chinese patients with chronic schizophrenia 20.2% reported having insomnia (193/957). Male patients (107/630, 17.0%) had a lower rate of insomnia than female patients (86/327, 26.3%) (x2 = 11.60, p = 0.001). Patients with insomnia exhibited significantly higher PANSS total score and positive symptom, negative symptom, and general psychopathology scores, but significantly lower RBANS total score, language, attention and delayed memory scores compared to patients without insomnia (all p < 0.05). Logistic regression analysis showed that female sex, high PANSS total score and the use of diazepam were independently associated with insomnia (all p < 0.05). CONCLUSIONS Insomnia is relatively common in Chinese patients with chronic schizophrenia. Some demographic data and clinical symptoms are associated with insomnia. Patients with schizophrenia and insomnia perform poorly on cognition tests suggesting that insomnia and cognitive function are closely related in patients with schizophrenia.
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Affiliation(s)
- Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China
| | - Shuochi Wei
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wenjia Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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21
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Bai W, Gui Z, Chen MY, Zhang Q, Lam MI, Si TL, Zheng WY, Liu YF, Su Z, Cheung T, Jackson T, Li XH, Xiang YT. Global prevalence of poor sleep quality in military personnel and veterans: A systematic review and meta-analysis of epidemiological studies. Sleep Med Rev 2023; 71:101840. [PMID: 37647751 DOI: 10.1016/j.smrv.2023.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
Poor sleep quality is prevalent among members of the military but rates of poor sleep quality vary between studies. This study examined the global prevalence of poor sleep quality in military personnel and veterans as well as possible moderators of prevalence differences between studies. PubMed, EMBASE, Web of Science, and PsycINFO were systematically searched from their inception dates to September 1, 2022. Studies were included if they were conducted on military personnel and/or veterans and prevalence estimates of poor sleep quality could be generated from assessments with standardized tools. A random-effects model was used to calculate the pooled prevalence and its 95% confidence intervals (CIs). Fifty-nine studies (N = 28,100) were included for analysis with sample sizes ranging from 14 to 8481. Two studies were rated as "high quality" (3.39%), while 57 were rated as "moderate quality" (96.61%). The overall pooled prevalence of poor sleep quality in military personnel and veterans was 69.00% (95% CI: 62.33-75.30%); pooled rates were 57.79% (95% CI: 49.88-65.50%) and 82.88% (95% CI: 74.08-90.21%) for active duty personnel and veterans, respectively. Subgroup analyses indicated study region, study design, sampling method, Pittsburg Sleep Quality Index cut-off values, and service type moderated prevalence of poor sleep quality. Meta-regression analyses indicated sample size, mean age, depression and posttraumatic stress disorder (PTSD) were associated with prevalence differences between studies. Poor sleep quality was more common in both active duty military personnel and veterans who were older and those who reported PTSD or depression. Regular monitoring of sleep quality and sleep hygiene should be promoted in this population. More relevant studies in middle- and low-income countries should also be conducted.
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Affiliation(s)
- Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Zhen Gui
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Meng-Yi Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Wan-Ying Zheng
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yu-Fei Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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22
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Wang P, Wang Z, Li ZX, Ma SH, Li Y, Li H, Yang C, Yu M, Wang J, An YC, Li M. Efficacy and safety of Tongdutiaoshen acupuncture on insomnia in maintenance hemodialysis patients: A randomized clinical trial protocol. Contemp Clin Trials Commun 2023; 35:101196. [PMID: 37583470 PMCID: PMC10423895 DOI: 10.1016/j.conctc.2023.101196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/23/2023] [Accepted: 07/30/2023] [Indexed: 08/17/2023] Open
Abstract
Background Patients undergoing maintenance hemodialysis (MHD) experience insomnia frequently. Poor sleep quality impairs the quality of life and adversely affects long-term outcomes. Currently, the treatment of insomnia in patients undergoing MHD is mainly based on medication, although it has severe side effects and poor compliance in patients. Therefore, developing complementary and alternative therapies with higher efficacies is important. This study explores the clinical efficacy and safety of Tongdutiaoshen acupuncture in treating insomnia in patients with MHD. Methods This randomized controlled trial (RCT) will be performed at Beijing Luhe Hospital, affiliated with Capital Medical University in China. We will strictly adhere to the Standards for Reporting Interventions in Clinical Trials of Acupuncture (2010). A total of 110 MHD patients with insomnia will be randomly allocated in a 1:1 ratio to the drug control (DC) or Tongdutiaoshen acupuncture (TA) group. Patients in the control group will be administered estazolam tablets (1 mg/day) for four weeks, followed by a 4-week follow-up period. Based on the background therapy provided for the DC group, the TA group will be administered the interventional cohort three times a week for four weeks in a row, followed by a 4-week follow-up period. The primary endpoints will include the Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAM-A), TCM Insomnia Syndrome Score, and clinical response rate, which will be evaluated on days 0, 14, 28, and 56. Secondary endpoints will include sleep data monitoring and related laboratory indices, which will be evaluated on days 0, 28, and 56, respectively. Discussion This study is designed based on a rigorous methodology to evaluate the efficacy and safety of Tongdutiaoshen acupuncture for insomnia in patients undergoing hemodialysis. The findings of this trial will be published in peer-reviewed journals as reliable evidence. Trial registration Chinese Clinical Trial Registry ChiCTR2200061967. Registered on July 07, 2022.
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Affiliation(s)
- Pei Wang
- Center of Traditional Chinese Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Zheng Wang
- Center of Traditional Chinese Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Zhong-xin Li
- Kidney Center, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Si-hui Ma
- Kidney Center, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Yan Li
- Kidney Center, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Huan Li
- Department of Psychiatry, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Chao Yang
- Department of Psychiatry, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Man Yu
- Center of Traditional Chinese Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Jiao Wang
- Center of Traditional Chinese Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Yan-chen An
- Center of Traditional Chinese Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
| | - Min Li
- Center of Traditional Chinese Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University, No.82, Xinhua South Street, Tongzhou Distract, Beijing, 101149, China
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23
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Santos M, Gabani FL, de Andrade SM, Bizzozero-Peroni B, Martínez-Vizcaíno V, González AD, Mesas AE. The bidirectional association between chronic musculoskeletal pain and sleep-related problems: a systematic review and meta-analysis. Rheumatology (Oxford) 2023; 62:2951-2962. [PMID: 37104741 DOI: 10.1093/rheumatology/kead190] [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: 12/23/2022] [Revised: 04/08/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVES This systematic review and meta-analysis synthesizes the evidence on prospective bidirectional associations between sleep-related problems (SRP) and chronic musculoskeletal pain (CMP). METHODS A literature search for cohort studies available in the PubMed, Scopus, Web of Science, PsycINFO and Cochrane Library databases as of 19 July 2022 was performed. Pooled odds ratios and effect sizes were calculated through random effects meta-analysis. Subgroup and meta-regression analyses were performed to explore differences by follow-up time, proportion of each sex and mean age. The Meta-analysis Of Observational Studies in Epidemiology guidelines were strictly followed. RESULTS Twenty studies with a total of 208 190 adults (aged 34.4-71.7 years) were included, with 17 of them being used in the meta-analysis. Individuals with SRP at baseline had a 1.79-fold higher incidence (odds ratio [OR] = 1.79; 95% CI: 1.55, 2.08; I2 = 84.7%; P < 0.001) and a 2.04-fold higher persistence (OR = 2.04; 95% CI: 1.42, 2.94; I2 = 88.5%; P < 0.005) of CMP than those without SRP. In the subgroup analysis of the association between SRP and CMP, the longer the follow-up time of the studies, the higher the heterogeneity between them. In the corresponding meta-regression, no significant effect was observed for follow-up time, sex proportion or age. Individuals with CMP at baseline had a 2.02-fold higher incidence of SRP (OR = 2.02; 95% CI: 1.62, 2.53; I2 = 90.0%; P < 0.001) than those without CMP. CONCLUSION This study provides robust evidence concerning the longitudinal association between SRP and incidence-persistence of CMP in adults. In addition, the available prospective studies support the existence of a bidirectional relationship between CMP and SRP. PROSPERO REGISTRATION NUMBER CRD42020212360.
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Affiliation(s)
- Mayara Santos
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Parana, Brazil
| | - Flávia L Gabani
- Department of Nursing, Universidade Estadual de Londrina, Londrina, Parana, Brazil
| | - Selma M de Andrade
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Parana, Brazil
| | - Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Instituto Superior de Educación Física, Universidad de la República, Rivera, Uruguay
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Alberto D González
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Parana, Brazil
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
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Phiri D, Amelia VL, Muslih M, Dlamini LP, Chung MH, Chang PC. Prevalence of sleep disturbance among adolescents with substance use: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2023; 17:100. [PMID: 37633926 PMCID: PMC10464186 DOI: 10.1186/s13034-023-00644-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/24/2023] [Indexed: 08/28/2023] Open
Abstract
PURPOSE Sleep disturbance has become a major challenge among adolescents worldwide. Substance use is among the most common factors contributing to sleep disturbance. This systematic review and meta-analysis examined the prevalence and categories of sleep disturbance among adolescents with substance use. METHODS We comprehensively searched for relevant studies published in the following databases from inception to August 2022: CINHAL (via EBSCOhost), PubMed, Scopus, Ovid Medline, Embase, ProQuest, and Web of Science. Data analysis was performed using Comprehensive Meta-Analysis version 3 software. We used a random-effects model to pool prevalence rates with 95% confidence intervals (CIs). Forest plots and p values for the Cochran Q statistic were used to evaluate heterogeneity among studies. Subgroup and meta-regression analyses were performed to compare the groups and identify the sources of heterogeneity. RESULTS We examined 18 studies that reported insomnia, hypersomnolence, sleep-related breathing disorders as sleep disturbances among adolescents with the use of alcohol, smoking, marijuana, and coffee. The total sample was 124,554. The overall prevalence rate of sleep disturbance was 29% (95% CI: 0.201-0.403). Subgroup analysis revealed that the prevalence rates of insomnia and hypersomnolence were higher among alcohol users (31%; 95% CI: 0.100-0.654) and smokers (46%; 95% CI: 0.232-0.700). The study design and method of assessment groups were the significant moderators that showed the source of variation in the included studies. CONCLUSION Sleep disturbance is highly prevalent among adolescents with substance use. Insomnia and hypersomnolence are more prevalent among alcohol users and smokers, respectively. On the basis of our findings, health-care providers can develop effective targeted interventions to reduce substance use, prevent sleep disturbance, and promote healthy sleep habits among adolescents.
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Affiliation(s)
- Doreen Phiri
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Vivi Leona Amelia
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- Universitas Muhammadiyah Purwokerto, Purwokerto, Central Java, Indonesia
| | - Muhammad Muslih
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
- School of Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, Indonesia
| | | | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan.
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25
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Shi Y, Sun Q, Wang Y, Chen C, Jin J, Wang W, Lu Y, Hua Y, Liu J, Bian J, Yi Z. Can dexamethasone improve postoperative sleep and postoperative delirium in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy? Protocol for a prospective, randomized, double-blind, controlled study. Trials 2023; 24:505. [PMID: 37550718 PMCID: PMC10408050 DOI: 10.1186/s13063-023-07521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Perioperative sleep disorders (PSD) are an independent risk factor for postoperative delirium (POD), which is a common complication after surgery. Elderly patients who undergo robot-assisted radical prostatectomy (RARP) often experience perioperative sleep disorders (PSD). Dexamethasone, a medication that works by inhibiting the hypothalamic-pituitary-suprarenal cortical axis, can reduce the negative effects of surgical stress. The objective of this study was to determine whether intravenous administration of dexamethasone at the time of anesthesia induction could improve postoperative sleep quality in elderly patients, thereby indirectly reducing the risk of postoperative cognitive impairment and accelerating postoperative rehabilitation. METHODS/DESIGN This study is a randomized, double-blind, placebo-controlled trial that was conducted at a single center. A sample size of 116 patients was determined through calculation, and these patients were randomly assigned to either the dexamethasone group (group D, n = 58) or the blank control group (group C, n = 58). On the day of surgery, the anesthesia nurse prepared either diluted dexamethasone or saline in advance, according to the patient's assigned group. The blinded anesthesiologist administered the medication during induction, and a dedicated person followed up with the patient for three consecutive postoperative days. All other aspects of care were managed equally between the two groups. The primary outcome measure was sleep quality, while secondary outcome measures included postoperative sleep time, postoperative delirium (POD), pain scores, and other complications. Relevant test measures were recorded for analysis. DISCUSSION This study aims to investigate the impact of intravenous dexamethasone on sleep quality and duration of patients undergoing robot-assisted radical prostatectomy (RARP). If the findings of this study protocol are affirmative, it could enhance the sleep quality of elderly patients after surgery, thereby minimizing the risk of postoperative delirium (POD), and providing substantial evidence for the perioperative enhanced recovery management of elderly patients. TRIAL REGISTRATION Chinese clinical trial registry: ChiCTR2200063488, Registered on 5 October 2022.
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Affiliation(s)
- Yaping Shi
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China
| | - Qingyu Sun
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China
| | - Yue Wang
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China
| | - Chunting Chen
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China
| | - Jianfei Jin
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China
| | - Wei Wang
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China
| | - Yuting Lu
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China
| | - Yi Hua
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China
| | - Jianming Liu
- Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
| | - Jinjun Bian
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.
| | - Zhou Yi
- Department of Anesthesiology, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.
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Liu Y, Rao K, Li Z, Huang C. Improvement of neurological recovery in the insomnia rats by Warming Yang Strategy through targeting SIRT4 by inhibiting inflammation and apoptosis. Immun Inflamm Dis 2023; 11:e964. [PMID: 37647454 PMCID: PMC10408374 DOI: 10.1002/iid3.964] [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: 12/24/2022] [Revised: 03/24/2023] [Accepted: 07/17/2023] [Indexed: 09/01/2023] Open
Abstract
The incidence rate of insomnia is increasing, but the mechanism of it remains unclear. Warming Yang Strategy (WY) is a kind of Traditional Chinese Medicine, and it is proved to be effective in treating insomnia patients. The insomnia animal was established with chlorophenylalanine (PCPA). Morris water maze and open field test were performed to evaluate the influence of WY on the neurological recovery of insomnia rats. TUNEL staining and flow cytometry were used to measure apoptosis level. WY promoted the neurological recovery in the insomnia rats through Morris water maze and open field test evaluation. The increase of γ-aminobutyric acid, dopamine, 5-hydroxytryptamine, and norepinephrine caused by WY was suppressed by siSIRT4. The decrease of apoptosis and inflammation factors expression induced by WY was promoted by siRNA-SIRT4 (siSIRT4). WY improve neurological recovery in the insomnia rats through SIRT4 by inhibiting inflammation and apoptosis. This research might provide a novel insight for the prevention and treatment of insomnia through targeting SIRT4.
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Affiliation(s)
- Yuanyuan Liu
- Department of Cardiology, Jiangxi Provincial People's HospitalThe First Affiliated Hospital of Nanchang Medical CollegeNanchangChina
| | - Kaihua Rao
- Department of NeurologyAffiliated Hospital of Jiangxi University of Traditional Chinese MedicineNanchangChina
| | - Zhengfeng Li
- Department of EndocrinologyAffiliated Hospital of Jiangxi University of Traditional Chinese MedicineNanchangChina
| | - Chunhua Huang
- Department of NeurologyAffiliated Hospital of Jiangxi University of Traditional Chinese MedicineNanchangChina
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Yang Z, Wang D, Fan Y, Ma Z, Chen X, Zhang Y, Fan F. Relationship between sleep disturbance and burnout among Chinese urban teachers: Moderating roles of resilience. Sleep Med 2023; 108:29-37. [PMID: 37311321 DOI: 10.1016/j.sleep.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/16/2023] [Accepted: 06/01/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sleep disturbance and burnout are prevalent among primary and secondary school teachers. Nevertheless, little is known about the relationship between sleep disturbance and burnout, and the mechanisms connecting this link. Our study aimed to explore the relationship between sleep disturbance and burnout among urban teachers, as well as to investigate this influencing mechanism further with resilience as a moderator. METHODS 14,218 primary and secondary school teachers provided valid data. We assessed demographic information, sleep disturbance, burnout, and resilience. Multivariable logistic regression, Spearman correlation, and moderation analyses were used to evaluate the relationship between sleep disturbance and burnout and the moderating role of resilience. RESULTS Of the participants, the prevalence of sleep disturbance and sleep deprivation among teachers was 20.0% and 31.7%, respectively. Additionally, 58.4% of teachers reported moderate or severe burnout, and 15.3% had both sleep disturbance and burnout. Sleep disturbance was significant and positively related to burnout. Resilience was found to moderate the association between sleep disturbance and burnout. CONCLUSIONS These findings suggested strong associations between sleep disturbance and burnout. Interventions in improving resilience may protect teachers with sleep disturbance from burnout.
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Affiliation(s)
- Zheng Yang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Yunge Fan
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Xiaoyan Chen
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Yifan Zhang
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China.
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Gao X, Li J, Xu S, Li X, Wang X, Li Y, Huang Y, Liu S, Zeng Q. Oral nicotinamide mononucleotide (NMN) to treat chronic insomnia: protocol for the multicenter, randomized, double-blinded, placebo-controlled trial. Trials 2023; 24:340. [PMID: 37202819 DOI: 10.1186/s13063-023-07351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 04/20/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND The treatment of insomnia, which is the most common sleep disorder, includes drug and behavioral treatment, but each treatment measure has its limitations. So new treatment method needs to be taken to improve the treatment effect. MN supplementation is a potential promising new method for the treatment of insomnia, resulting in a rising need for methodological research towards verifying its efficacy. METHODS/DESIGN We describe a proposal for a multicenter, patient-assessor-blinded, randomized controlled trial with two parallel arms. A total of 400 chronic insomnia patients will be allocated 1:1 to the intervention group (treatment with oral NMN 320 mg/day) or control group (treatment with oral placebo). All subjects are clinical chronic insomnia patients who meet all inclusion criteria. All subjects are treated by taking NMN or placebo. The primary outcome is the score on the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes are the score on the Insomnia Severity Index (ISI) and Epworth Sleeping Scale (ESS), the total sleep time (TST), sleep efficiency (SE), sleep latency, and REM sleep latency to assess sleep quality changes. Subjects are assessed at two time points: baseline and follow-up. The duration of the clinical trial is 60 days. DISCUSSION This study will provide more evidence on the effects of NMN on improving sleep quality among patients with chronic insomnia. If proven effective, NMN supplement can be used as a new treatment for chronic insomnia in the future. TRIAL REGISTRATION Chinese Clinical Trial Registry (chictr.org.cn) ChiCTR2200058001. Registered on 26 March 2022.
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Affiliation(s)
- Xiangyang Gao
- Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Junhua Li
- Health Management Center, Handan Central Hospital, Hebei Province, Handan, China
| | - Sanping Xu
- Health Management Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hebei Province, Wuhan, China
| | - Xueying Li
- Department of Biostatistics, Peking University First Hospital, Beijing, 100034, China
| | - Xicheng Wang
- Beijing Dublin International Collage, Beijing University of Technology, Beijing, 100124, China
| | - Yongli Li
- Health Management Center, Henan Provincial People's Hospital, Zhengzhou, China
| | - Yan Huang
- Health Management Center, West China Hospital, Sichuan University, Sichuan Province, Chengdu, China
| | - Shaohui Liu
- Health Management Center, Xiangya Hospital, Central South Hospital, Hunan Province, Changsha, China
| | - Qiang Zeng
- Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
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Jin Y, Li J, Ye J, Luo X, Wilson A, Mu L, Zhou P, Lv Y, Wang Y. Mapping associations between anxiety and sleep problems among outpatients in high-altitude areas: a network analysis. BMC Psychiatry 2023; 23:341. [PMID: 37189050 PMCID: PMC10184966 DOI: 10.1186/s12888-023-04767-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Anxiety and sleep problems are common comorbidities among outpatients living in high-altitude areas. Network analysis is a novel method to investigate the interaction and the association between symptoms across diverse disorders. This study used network analysis to investigate the network structure symptoms of anxiety and sleep problems among outpatients in high-altitude areas, and to explore the differences in symptom associations in various sex, age, educational levels and employment groups. METHODS The data was collected from the Sleep Medicine Center of The First People's Hospital of Yunnan Province from November 2017 to January 2021 with consecutive recruitment (N = 11,194). Anxiety and sleep problems were measured by the Chinese version of the seven-item Generalized Anxiety Disorder Scale (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI) respectively. Central symptoms were identified based on centrality indices and bridge symptoms were identified with bridge indices. The difference of network structures in various sex, age, educational levels and employment groups were also explored. RESULTS Among all the cases, 6,534 (58.37%; 95% CI: 57.45-59.29%) reported experiencing anxiety (GAD-7 total scores ≥ 5), and 7,718 (68.94%; 95% CI: 68.08-69.80%) reported experiencing sleep problems (PSQI total scores ≥ 10). Based on the results of network analysis, among participants, "Nervousness", "Trouble relaxing", "Uncontrollable worry" were the most critical central symptoms and bridge symptoms within the anxiety and sleep problems network structure. The adjusted network model after controlling for covariates was significantly correlated with the original (r = 0.75, P = 0.46). Additionally, there were significant differences in edge weights in the comparisons between sex, age and educational levels groups (P < 0.001), while the employed and unemployed groups did not show significant differences in edge weights (P > 0.05). CONCLUSIONS In the anxiety and sleep problems network model, among outpatients living in high-altitude areas, nervousness, uncontrollable worry, and trouble relaxing were the most central symptoms and bridge symptoms. Moreover, there were significant differences between various sex, age and educational levels. These findings can be used to provide clinical suggestions for psychological interventions and measures targeting to reduce symptoms that exacerbate mental health.
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Affiliation(s)
- Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Jing Ye
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Xianyu Luo
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Lanxue Mu
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Pinyi Zhou
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Yunhui Lv
- Department of Sleep Medicine, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Baskaran A, Marogi E, Bitar R, Attarian H, Saadi A. Improving Sleep Health Among Refugees: A Systematic Review. Neurol Clin Pract 2023; 13:e200139. [PMID: 36936393 PMCID: PMC10022726 DOI: 10.1212/cpj.0000000000200139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/05/2022] [Indexed: 03/15/2023]
Abstract
Purpose of Review Sleep disorders among refugees are common yet understudied. Interventions are difficult in resource-limited settings where most of these populations live. A systematic review of sleep disorders in refugee populations is warranted to identify prevalence, comorbidities, and the limitations of the current state of sleep health among refugees. Recent Findings Sleep disturbances, particularly insomnia and nightmares, occur with a higher prevalence among refugees. Diseases associated with insomnia in this population included fibromyalgia, posttraumatic stress disorder, depression, and anxiety. Risk factors include trauma, migration, lower socioeconomic status, lower educational level, and settlement in areas with a high influx of new residents or proximity to conflict. Only a few partially successful therapies were identified. Summary This review identifies the high prevalence of the disturbed sleep in this population and its risk factors. It proposes ways of increasing awareness of it in this vulnerable population as a first step toward remediation.
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Affiliation(s)
- Archit Baskaran
- Department of Neurology (AB), University of Chicago, IL; Department of Internal Medicine (EM), University of California San Francisco, CA; American University of Beirut (RB), Lebanon; Department of Neurology (HA), Northwestern University, Chicago, IL; Department of Neurology (AS), MGH Asylum Clinic, Harvard Medical School, Boston, MA
| | - Emily Marogi
- Department of Neurology (AB), University of Chicago, IL; Department of Internal Medicine (EM), University of California San Francisco, CA; American University of Beirut (RB), Lebanon; Department of Neurology (HA), Northwestern University, Chicago, IL; Department of Neurology (AS), MGH Asylum Clinic, Harvard Medical School, Boston, MA
| | - Ricardo Bitar
- Department of Neurology (AB), University of Chicago, IL; Department of Internal Medicine (EM), University of California San Francisco, CA; American University of Beirut (RB), Lebanon; Department of Neurology (HA), Northwestern University, Chicago, IL; Department of Neurology (AS), MGH Asylum Clinic, Harvard Medical School, Boston, MA
| | - Hrayr Attarian
- Department of Neurology (AB), University of Chicago, IL; Department of Internal Medicine (EM), University of California San Francisco, CA; American University of Beirut (RB), Lebanon; Department of Neurology (HA), Northwestern University, Chicago, IL; Department of Neurology (AS), MGH Asylum Clinic, Harvard Medical School, Boston, MA
| | - Altaf Saadi
- Department of Neurology (AB), University of Chicago, IL; Department of Internal Medicine (EM), University of California San Francisco, CA; American University of Beirut (RB), Lebanon; Department of Neurology (HA), Northwestern University, Chicago, IL; Department of Neurology (AS), MGH Asylum Clinic, Harvard Medical School, Boston, MA
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Shaheen SH, Abdullah EA, Razik MMA, Mostafa N. Prevalence of insomnia in a sample of Internet addicts in different age groups in Abu Dhabi, UAE. MIDDLE EAST CURRENT PSYCHIATRY 2023. [DOI: 10.1186/s43045-023-00301-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
Abstract
Background
Internet addiction, insomnia, and depression have a major health concern. The association of these problems can severely affect education, work productivity with negative outcomes for society. Internet addiction has been reported to be associated with insomnia and depression that may differ by age. The aim of the study is to assess the prevalence of insomnia and depression and their correlation with Internet addiction in all age groups and to detect age differences. A total of 386 participants were recruited. Data were collected using an online survey that contains questions about sociodemographic, Insomnia Severity Index (ISI), Internet Addiction Test (IAT), and Patient Health Questionnaire (PHQ9) to measure insomnia, Internet addiction, and depression, respectively.
Results
The overall prevalence of clinically significant insomnia was 22.5% while subthreshold insomnia was present in 38.5%. There was a significant negative correlation of age with IAT and PHQ9. Also, a highly significant positive correlation was found between ISI, IAT, and PHQ9 within the total sample and each age group (p = 0.000).
Conclusions
A great proportion of the general population suffers from insomnia, Internet addiction, and depression, and their prevalence rates differ by age. Also, there is a strong association between them. Identifying these problems is important, and interventions should include the three problems.
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Wang J, Zhao H, Shi K, Wang M. Treatment of insomnia based on the mechanism of pathophysiology by acupuncture combined with herbal medicine: A review. Medicine (Baltimore) 2023; 102:e33213. [PMID: 36930068 PMCID: PMC10019201 DOI: 10.1097/md.0000000000033213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023] Open
Abstract
Insomnia is a sleep disorder which severely affects patients mood, quality of life and social functioning, serves as a trigger or risk factor to a variety of diseases such as depression, cardiovascular and cerebrovascular diseases, obesity and diabetes, and even increases the risk of suicide, and has become an increasingly widespread concern worldwide. Considerable research on insomnia has been conducted in modern medicine in recent years and encouraging results have been achieved in the fields of genetics and neurobiology. Unfortunately, however, the pathogenesis of insomnia remains elusive to modern medicine, and pharmacological treatment of insomnia has been regarded as conventional. However, in the course of treatment, pharmacological treatment itself is increasingly being questioned due to potential dependence and drug resistance and is now being replaced by cognitive behavior therapy as the first-line treatment. As an important component of complementary and alternative medicine, traditional Chinese medicine, especially non-pharmacological treatment methods such as acupuncture, is gaining increasing attention worldwide. In this article, we discuss the combination of traditional Chinese medicine, acupuncture, and medicine to treat insomnia based on neurobiology in the context of modern medicine.
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Affiliation(s)
- Jie Wang
- Department of Pain, Datong Hospital of Traditional Chinese Medicine, Shanxi Province, Datong, China
| | - Haishen Zhao
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
| | - Kejun Shi
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
| | - Manya Wang
- Department of Rehabilitation, Luchaogang Community Health Service Center, Pudong New District, Shanghai, China
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Wang W, Ji X, Guo HY, Tao M, Jin L, Chen M, Yuan H, Peng H. Investigation on sleep-related cognition of Chinese health care workers during the first wave of COVID-19 pandemic. Front Psychiatry 2023; 14:1019837. [PMID: 36993928 PMCID: PMC10040544 DOI: 10.3389/fpsyt.2023.1019837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/17/2023] [Indexed: 03/14/2023] Open
Abstract
BackgroundThe COVID pandemic has brought tremendous negative effects on the mental health of health care workers, such as anxiety, depression, and sleep disorders. We conducted this study to evaluate the sleep-related cognition of Chinese health care workers (HCWs) during the first wave of COVID-19 pandemic and analyze its association with sleep quality, so as to provide scientific reference for improving sleep of HCWs.Patients and methodsA total of 404 HCWs from Yijishan Hospital of Wuhu City, China were enrolled in the study, selected by randomized cluster sampling in May 2020. We made a questionnaire to collect the general demographic information of the participants. The Pittsburgh Sleep Quality Index (PSQI) and a brief version of Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16) were used to measure sleep quality and sleep-related cognition, respectively.ResultsThe results showed that 312 HCWs (77.2%) had false beliefs and attitudes about sleep, while only 92 HCWs (22.8%) had correct beliefs about sleep. In addition, we found that those HCWs who were older, married, with a bachelor’s degree or higher, nurses, more daily working hours (> 8 h) and monthly night shifts (≥ 5 times), had higher DBAS-16 scores (all p < 0.05). However, we did not find significant differences between men and women in DBAS-16 scores. According to the definition of PSQI, a total of 1/4 of the HCWs are poor sleepers and their DBAS-16 score was higher than good sleepers (t = 7.622, p < 0.001). In the end, we confirmed a positive correlation between sleep cognition and sleep quality (r = 0.392, p < 0.01).ConclusionOur study revealed false beliefs and attitudes about sleep were prevalent among HCWs during the first wave of COVID-19 pandemic, and these false beliefs about sleep were closely correlated to sleep quality. We recommend fighting against these false beliefs about sleep.
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Affiliation(s)
- Wei Wang
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Xincan Ji
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Hao-Yang Guo
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Mengjun Tao
- Health Management Center, The First Affiliated Hospital of Wanan Medical Collegue, Wuhu, Anhui, China
| | - Lairun Jin
- School of Public Health, Southeast University, Nanjin, Jiangsu, China
| | - Miao Chen
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Hui Yuan
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
- *Correspondence: Hui Yuan,
| | - Hui Peng
- Department of Science and Technology Administration, The First Affiliated Hospital of Wanan Medical Collegue, Wuhu, Anhui, China
- Hui Peng,
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Zhang C, Liu Y, Guo X, Liu Y, Shen Y, Ma J. Digital Cognitive Behavioral Therapy for Insomnia Using a Smartphone Application in China: A Pilot Randomized Clinical Trial. JAMA Netw Open 2023; 6:e234866. [PMID: 36972049 PMCID: PMC10043748 DOI: 10.1001/jamanetworkopen.2023.4866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Importance Digital cognitive behavioral therapy for insomnia (DCBT-I) requires adaptation to different sociocultural contexts. Moreover, studies comparing DCBT-I and sleep education in the same operating interface are lacking. Objective To investigate the efficacy of a smartphone-based Chinese culture-adapted DCBT-I application (app) for insomnia compared with sleep education using the same app. Design, Setting, and Participants This was a single-blinded, randomized clinical trial conducted from March 2021 to January 2022. Screening and randomization were conducted at Peking University First Hospital. Follow-up visits were performed online or in the same hospital. After assessing for eligibility, eligible participants were enrolled and allocated (1:1) to DCBT-I or sleep education groups. Data were analyzed from January to February 2022. Interventions A Chinese smartphone-based app with the same interface was used in both DCBT-I and sleep education groups over 6 weeks, with 1-, 3-, and 6-month follow-ups. Main Outcomes and Measures The primary outcome was Insomnia Severity Index (ISI) scores with the intention-to-treat principle. Secondary and exploratory outcomes included sleep diary measures; self-reported scales assessing dysfunctional beliefs about sleep, mental health, and quality of life; and smart bracelet measures. Results Of 82 participants (mean [SD] age, 49.67 [14.49] years; 61 [74.4%] females), with 41 randomized to sleep education and 41 randomized to DCBT-I; 77 participants completed the 6-week intervention (39 participants in the sleep education group and 38 participants in the DCBT-I group; full analysis data set) and 73 completed the 6-month follow-up (per protocol data set). Mean (SD) ISI scores in the DCBT-I group were significantly lower than those in the sleep education group after the 6-week intervention (12.7 [4.8] points vs 14.9 [5.0] points; Cohen d = 0.458; P = .048) and at the 3-month follow-up (12.1 [5.4] points vs 14.8 [5.5] points; Cohen d = 0.489; P = .04). There were significant improvements from before to after the intervention for both the sleep education and DCBT-I groups, with large effect sizes(sleep education: d = 1.13; DCBT-I: d = 1.71). Some of the sleep diary measures and self-reported scales showed more improvements in the DCBT-I group than sleep education group, such as total sleep time (mean [SD]: 3 months, 403.9 [57.6] minutes vs 363.2 [72.3] minutes; 6 months, 420.3 [58.0] minutes vs 389.7 [59.4] minutes) and sleep efficiency (mean [SD]: 3 months, 87.4% [8.3%] vs 76.7% [12.1%]; 6 months, 87.5% [8.2%] vs 78.1% [10.9%]). Conclusions and Relevance In this randomized clinical trial, the smartphone-based Chinese culture-adapted DCBT-I improved insomnia severity compared with sleep education. Future multicenter clinical trials with large sample sizes are needed to validate its effectiveness in the Chinese population. Trial Registration ClinicalTrials.gov Identifier: NCT04779372.
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Affiliation(s)
- Cheng Zhang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yuxuan Liu
- Department of General Medicine, Pingan Hospital, Beijing, China
| | - Xiaoming Guo
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Yanan Liu
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yane Shen
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Jing Ma
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
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Guo P, Xu M, Pan J, Lin J, Hu T, Wei Y, Chen Y, Guo Y. A Systematic Review and Meta-Analysis Protocol to Establish How Common Clinical Acupoint Stimulation-Related Therapies Should Be Used for Managing Insomnia. J Pain Res 2023; 16:1069-1079. [PMID: 37013154 PMCID: PMC10066717 DOI: 10.2147/jpr.s394328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
Background Many studies have now investigated the effects of common clinical acupoint stimulation-related therapies (ASRTs) following the meridian theory of traditional Chinese medicine for the management of insomnia. However, ASRT choice is currently based on personal clinical experience or patient preference. This study will review the common ASRTs reported in clinical trials and analyze their efficacy and safety for managing insomnia with or without co-morbidities. Methods English and Chinese databases will be thoroughly searched, and other potentially eligible trials will be obtained by reviewing reference lists of identified studies and previous reviews. Only randomized controlled trials (RCTs) of common clinical ASRTs to manage insomnia published in peer-reviewed journals will be considered. Sleep quality questionnaires or indices will be considered as the main outcome, while the secondary outcomes will include sleep parameters, daytime dysfunction, quality of life, and adverse effects. Two reviewers will independently investigate eligible RCTs, extract information, analyze their methodological quality, and employ Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria to evaluate the strength of the evidence. The treatment impact of various ASRTs will be calculated using meta-analysis techniques, and the degree of study heterogeneity will be assessed using Cochrane's Q and I-squared statistics. Subgroup and sensitivity analyses will be used to evaluate the reliability of the results. Results Our systematic review and meta-analysis will present up-to-date evidence on: 1) which common clinical ASRTs are beneficial for the management of insomnia; and 2) whether the effects of common clinical ASRTs on insomnia vary depending on clinical, participant, and treatment characteristics. Conclusion The results of our review should help decision-makers make educated choices regarding evidence-based non-pharmacological management options for insomnia. Study Registration The International Platform of Registered Systematic Review and Meta-analysis (INPLASY), record INPLASY2021120137.
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Affiliation(s)
- Pei Guo
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu City, People’s Republic of China
| | - Mingmin Xu
- School of Traditional Chinese Medicine, Jinan University, Guangzhou City, People’s Republic of China
| | - Jiongwei Pan
- School of Traditional Chinese Medicine, Jinan University, Guangzhou City, People’s Republic of China
| | - Jiayi Lin
- School of Traditional Chinese Medicine, Jinan University, Guangzhou City, People’s Republic of China
| | - Tiannuo Hu
- School of Traditional Chinese Medicine, Jinan University, Guangzhou City, People’s Republic of China
| | - Yulong Wei
- School of Acupuncture–Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing City, People’s Republic of China
| | - Yue Chen
- School of Acupuncture–Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing City, People’s Republic of China
| | - Yu Guo
- School of Traditional Chinese Medicine, Jinan University, Guangzhou City, People’s Republic of China
- Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou City, People’s Republic of China
- Correspondence: Yu Guo, School of Traditional Chinese Medicine, Jinan University, No. 601 Huangpu Road West, Tianhe District, Guangzhou City, People’s Republic of China, Email
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Chen SC, Cheung TW, Yu BYM, Chan MY, Yeung WF, Li L. Improving Sleep with Far-Infrared-Emitting Pajamas: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3870. [PMID: 36900881 PMCID: PMC10002002 DOI: 10.3390/ijerph20053870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Far infrared (FIR)-based clothing may alleviate sleep disturbance. This study aimed to explore the effects of FIR-emitting pajamas on sleep quality. This was a pilot randomized, sham-controlled trial. Forty subjects with poor sleep quality were randomized to FIR-emitting-pajamas and sham-pajamas groups in a 1:1 ratio. The primary outcome measure was the Pittsburgh Sleep Quality Index (PSQI). Other measures included the Insomnia Severity Index, and 7 day sleep diary, the Multidimensional Fatigue Inventory (MFI), the Hospital Anxiety and Depression Scale, the Epworth Sleepiness Scale, and the Satisfaction with Life Scale. Outcomes were measured at baseline and weeks 2, 4, and 6. Both groups showed within-group improvements in the PSQI score, but there was no significant difference between the two groups. However, FIR-emitting pajamas appeared to perform better than sham pajamas in reducing the MFI-physical score, with large effect sizes at three time points (dppc2 = 0.958, 0.841, 0.896); however, the differences were statistically insignificant. The intervention compliance was satisfactory. The effects of FIR-emitting pajamas on sleep quality were not superior to those in the control group. However, these pajamas may improve physical fatigue in adults with poor sleep quality, which warrants further exploration.
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Affiliation(s)
- Shu-Cheng Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Tin-Wai Cheung
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Branda Yee-Man Yu
- Department of Psychology, The University of Hong Kong, Hong Kong SAR 999077, China
| | - Mei-Yan Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Li Li
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
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Zee PC, Bertisch SM, Morin CM, Pelayo R, Watson NF, Winkelman JW, Krystal AD. Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence. J Clin Med 2023; 12:jcm12041629. [PMID: 36836164 PMCID: PMC9959182 DOI: 10.3390/jcm12041629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/22/2023] Open
Abstract
While evidence supports the benefits of medications for the treatment of chronic insomnia, there is ongoing debate regarding their appropriate duration of use. A panel of sleep experts conducted a clinical appraisal regarding the use of insomnia medications, as it relates to the evidence supporting the focus statement, "No insomnia medication should be used on a daily basis for durations longer than 3 weeks at a time". The panelists' assessment was also compared to findings from a national survey of practicing physicians, psychiatrists, and sleep specialists. Survey respondents revealed a wide range of opinions regarding the appropriateness of using the US Food and Drug Administration (FDA)-approved medications for the treatment of insomnia lasting more than 3 weeks. After discussion of the literature, the panel unanimously agreed that some classes of insomnia medications, such as non-benzodiazepines hypnotics, have been shown to be effective and safe for long-term use in the appropriate clinical setting. For eszopiclone, doxepin, ramelteon and the newer class of dual orexin receptor antagonists, the FDA label does not specify that their use should be of a limited duration. Thus, an evaluation of evidence supporting the long-term safety and efficacy of newer non-benzodiazepine hypnotics is timely and should be considered in practice recommendations for the duration of pharmacologic treatment of chronic insomnia.
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Affiliation(s)
- Phyllis C. Zee
- Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University, Chicago, IL 60611, USA
- Correspondence: ; Tel.: +1-312-503-4409
| | - Suzanne M. Bertisch
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Charles M. Morin
- Department of Psychology, Cervo Brain Research Centre, Laval University, Québec City, QC G1V 0A6, Canada
| | - Rafael Pelayo
- Department of Psychiatry and Behavioral Sciences, Stanford University Sleep Medicine Center, Redwood City, CA 94305, USA
| | - Nathaniel F. Watson
- Department of Neurology, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - John W. Winkelman
- Department of Psychiatry and Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Andrew D. Krystal
- Department of Psychiatry and Neurology, UCSF Weill Institute for Neurosciences, San Francisco, CA 94158, USA
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Xu Y, Ma L, Liu F, Yao L, Wang W, Yang S, Han T. Lavender essential oil fractions alleviate sleep disorders induced by the combination of anxiety and caffeine in mice. JOURNAL OF ETHNOPHARMACOLOGY 2023; 302:115868. [PMID: 36309115 DOI: 10.1016/j.jep.2022.115868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Lavender (Lavandula angustifolia Mill.) essential oil is renowned for its use in the treatment of insomnia and mental disorder diseases in folk medicine. Previous pharmacological studies have also shown that lavender essential oil displays sedative and hypnotic activities. However, the active ingredients and mechanism of lavender essential oil for sleep-improving effect remain unclear. AIM OF THE STUDY This study investigates whether inhalation of different fractions of lavender essential oil can attenuate the sleep disturbances induced by combined anxiety and caffeine and explores the underlying mechanisms. MATERIALS AND METHODS Molecular distillation was applied to separate lavender essential oil into fractions containing different chemical components, and GC-MS was used to analyze the volatile compounds of lavender essential oil and its fractions. The elevated plus maze test, pentobarbital-induced sleep test, and neurotransmitters enzyme-linked immunosorbent assay were conducted to evaluate the anxiolytic and hypnotic effects of lavender essential oil and its fractions on mice suffering from sleep disorders. RESULTS The results of behavioral tests indicated that lavender essential oil and its fractions (3%, v/v) exerted an ameliorating effect on sleep disturbances induced by anxiety and caffeine. The light fraction and heavy fractions exhibited complementary chemical composition, with the former enriched in linalool and trans-β-ocimene and the latter in linalyl acetate, lavandulyl acetate, trans-caryophyllene, etc. The light fraction contributed more to sleep maintenance, and the heavy fraction performed better at sleep initiation. The neurobiological parameters elucidated that the mechanism of lavender essential oil for sleep-improving was multifaceted, related to the GABAergic system, cholinergic system, histaminergic system, and monoamines in the limbic system. The heavy fraction shared a similar mechanism with the lavender essential oil, while the light fraction did not actively participate in the cholinergic system, histaminergic system, and dopaminergic system. CONCLUSION Taken together, our results demonstrated that different fractions of lavender essential oil played different roles in ameliorating sleep disorders, and this may be credited to their compositional differences and the complicated interactions with the central nervous system. The results are informative for future investigations on the molecular level mechanisms and provide guidance for appropriate applications of lavender essential oil.
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Affiliation(s)
- Yue Xu
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, No. 800 Dong Chuan Road, Shanghai, 200240, China; R&D Center for Aromatic Plants, Shanghai Jiao Tong University, No. 800 Dong Chuan Road, Shanghai, 200240, China.
| | - Li Ma
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, No. 800 Dong Chuan Road, Shanghai, 200240, China; R&D Center for Aromatic Plants, Shanghai Jiao Tong University, No. 800 Dong Chuan Road, Shanghai, 200240, China.
| | - Fei Liu
- Shandong Freda Biotech Co., Ltd., No. 888 Xinluo Street, High-tech Zone, Jinan, 250101, Shandong, China.
| | - Lei Yao
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, No. 800 Dong Chuan Road, Shanghai, 200240, China; R&D Center for Aromatic Plants, Shanghai Jiao Tong University, No. 800 Dong Chuan Road, Shanghai, 200240, China.
| | - Wencui Wang
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, No. 800 Dong Chuan Road, Shanghai, 200240, China; R&D Center for Aromatic Plants, Shanghai Jiao Tong University, No. 800 Dong Chuan Road, Shanghai, 200240, China.
| | - Suzhen Yang
- Shandong Freda Biotech Co., Ltd., No. 888 Xinluo Street, High-tech Zone, Jinan, 250101, Shandong, China.
| | - Tingting Han
- Shandong Freda Biotech Co., Ltd., No. 888 Xinluo Street, High-tech Zone, Jinan, 250101, Shandong, China.
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Ernstsen L, Zotcheva E, Sui X, Engstrøm M, Martínez-Velilla N, Bjerkeset O, Bjorvatn B, Havnen A. Association Between Cardiorespiratory Fitness and Incident Purchase of Hypnotic Drugs in Adults: The HUNT Study. Mayo Clin Proc 2023; 98:229-238. [PMID: 36244824 DOI: 10.1016/j.mayocp.2022.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess whether cardiorespiratory fitness (CRF) is associated with first purchase of a prescribed hypnotic drug in the adult population. METHODS A total of 34,357 adult participants (53.9% women) with a mean age of 51.5 years (SD 15.6 years) from the third Trøndelag Health Study (HUNT) of 2006 to 2008 were observed until January 1, 2018. Cardiorespiratory fitness was estimated from a validated nonexercise algorithm. Data on first hypnotics prescription were obtained through linkage to the National Norwegian Prescription Database. Cox regression with 95% CIs was used to estimate hazard ratios (HRs). RESULTS After 304,899 person-years of follow-up, 5791 participants had their first registered purchase of prescribed hypnotics, corresponding to an incidence rate of 1.90 per 100 person-years. Each 1-metabolic equivalent of task increase in CRF was significantly associated with 5% (HR, 0.95; 95% CI, 0.91 to 0.99; P=.02) and 4% (HR, 0.96; 95% CI, 0.92 to 1.00; P=.046) risk reduction for incident use of hypnotics in men and women, respectively. When CRF was categorized into tertiles with lowest CRF as the reference group, reduced risk was 13% (HR, 0.87; 95% CI, 0.79 to 0.96; P=.006) and 15% (HR, 0.85; 95% CI, 0.77 to 0.95; P=.003) for men in the intermediate and highest CRF category, respectively. In women with highest CRF, the reduced risk was 5% (HR, 0.95; 95% CI, 0.87 to 1.03; P=.22). CONCLUSION Cardiorespiratory fitness in adulthood is associated with incident purchase of prescription medication commonly used for sleep problems. These findings suggest that fitness should be considered a target for preventing sleep problems in adults.
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Affiliation(s)
- Linda Ernstsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway.
| | - Ekaterina Zotcheva
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway; Department of Physical Health and Aging, Norwegian Institute of Public Health, Norway
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Morten Engstrøm
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Norway; Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Nicolás Martínez-Velilla
- Geriatrics Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
| | - Ottar Bjerkeset
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway; Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Bjørn Bjorvatn
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology, Norway; Division of Psychiatry, St. Olavs Hospital, Trondheim University Hospital, Norway
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Eysenbach G, Zheng S, Wen Q, Fang H, Wang T, Liang J, Han H, Lei J. Mining the Influencing Factors and Their Asymmetrical Effects of mHealth Sleep App User Satisfaction From Real-world User-Generated Reviews: Content Analysis and Topic Modeling. J Med Internet Res 2023; 25:e42856. [PMID: 36719730 PMCID: PMC9929723 DOI: 10.2196/42856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/14/2022] [Accepted: 11/28/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Sleep disorders are a global challenge, affecting a quarter of the global population. Mobile health (mHealth) sleep apps are a potential solution, but 25% of users stop using them after a single use. User satisfaction had a significant impact on continued use intention. OBJECTIVE This China-US comparison study aimed to mine the topics discussed in user-generated reviews of mHealth sleep apps, assess the effects of the topics on user satisfaction and dissatisfaction with these apps, and provide suggestions for improving users' intentions to continue using mHealth sleep apps. METHODS An unsupervised clustering technique was used to identify the topics discussed in user reviews of mHealth sleep apps. On the basis of the two-factor theory, the Tobit model was used to explore the effect of each topic on user satisfaction and dissatisfaction, and differences in the effects were analyzed using the Wald test. RESULTS A total of 488,071 user reviews of 10 mainstream sleep apps were collected, including 267,589 (54.8%) American user reviews and 220,482 (45.2%) Chinese user reviews. The user satisfaction rates of sleep apps were poor (China: 56.58% vs the United States: 45.87%). We identified 14 topics in the user-generated reviews for each country. In the Chinese data, 13 topics had a significant effect on the positive deviation (PD) and negative deviation (ND) of user satisfaction. The 2 variables (PD and ND) were defined by the difference between the user rating and the overall rating of the app in the app store. Among these topics, the app's sound recording function (β=1.026; P=.004) had the largest positive effect on the PD of user satisfaction, and the topic with the largest positive effect on the ND of user satisfaction was the sleep improvement effect of the app (β=1.185; P<.001). In the American data, all 14 topics had a significant effect on the PD and ND of user satisfaction. Among these, the topic with the largest positive effect on the ND of user satisfaction was the app's sleep promotion effect (β=1.389; P<.001), whereas the app's sleep improvement effect (β=1.168; P<.001) had the largest positive effect on the PD of user satisfaction. The Wald test showed that there were significant differences in the PD and ND models of user satisfaction in both countries (all P<.05), indicating that the influencing factors of user satisfaction with mHealth sleep apps were asymmetrical. Using the China-US comparison, hygiene factors (ie, stability, compatibility, cost, and sleep monitoring function) and 2 motivation factors (ie, sleep suggestion function and sleep promotion effects) of sleep apps were identified. CONCLUSIONS By distinguishing between the hygiene and motivation factors, the use of sleep apps in the real world can be effectively promoted.
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Affiliation(s)
| | - Shaojiang Zheng
- Cancer Institute, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Department of Pathology, Hainan Women and Children Medical Center, Hainan Medical University, Haikou, China
| | - Qinglian Wen
- Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hongjuan Fang
- Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tong Wang
- Department of Medical Informatics, School of Public Health, Jilin University, Changchun, China
| | - Jun Liang
- IT Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,School of Public Health, Zhejiang University, Hangzhou, China
| | - Hongbin Han
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China.,Department of Radiology, Peking University Third Hospital, Health Science Center, Peking University, Beijing, China
| | - Jianbo Lei
- Clinical Research Center, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Center for Medical Informatics, Health Science Center, Peking University, Beijing, China.,School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, China
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Li P, Wang Y, Liu B, Wu C, He C, Lv X, Jiang Y. Association of job stress, FK506 binding protein 51 (FKBP5) gene polymorphisms and their interaction with sleep disturbance. PeerJ 2023; 11:e14794. [PMID: 36743961 PMCID: PMC9893914 DOI: 10.7717/peerj.14794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/03/2023] [Indexed: 01/31/2023] Open
Abstract
Background Sleep disturbance is an outcome of multiple factors including environmental and genetic influences. Job stress, a complex environmental factor, likely affects sleep quality, significantly reducing the quality of life of workers. Additionally, FK506 binding protein 51 (FKBP5) may be a pathogenic factor for sleep disturbance as it regulates hypothalamic-pituitary-adrenal (HPA) axis activity, where HPA axis has been found to be involved in the regulation mechanism of sleep and stress response. Objectives The main aim of this study was to investigate the association between job stress and FKBP5 gene polymorphism as well as their interaction with sleep disturbance in Chinese workers; to date, these relationships have not been explored. Methods This is a cross-sectional study. A total of 675 railway workers (53.8% male) completed a short Effort-Reward Imbalance questionnaire and the Pittsburgh Sleep Quality Index. The SNaPshot single nucleotide polymorphism (SNP) assay was carried out by screening for FKBP5 SNPs in every participant. Generalized multifactor dimensionality reduction (GMDR) was used to identify the strongest G×E interaction combination. Results The findings showed that job stress was significantly associated with sleep disturbance; specifically, scores on the PSQI subscales (sleep disturbance, sleep medication, and daytime dysfunction) exhibited significant differences between the two job stress groups (X2 = 18.10, p = 0.01). Additionally, the FKBP5 SNP rs1360780-TT (adjusted odds ratio [AOR] = 4.98, 95% confidence interval [CI] = 2.80-8.84) and rs3800373-CC genotype (AOR = 2.06, CI = 1.10-3.86) were associated with an increased risk of sleep disturbance. Job stress and rs1360780 and rs3800373 variants showed a high-dimensional interaction with sleep disturbance as determined by the GMDR model. Conclusion The FKBP5 gene may increase susceptibility to job stress and result in sleep disturbance, especially in the presence of negative work-related events. These findings contribute to the field of sleep disturbance prevention and treatment.
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Sedentary behaviour and sleep quality. Sci Rep 2023; 13:1180. [PMID: 36670182 PMCID: PMC9859796 DOI: 10.1038/s41598-023-27882-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/09/2023] [Indexed: 01/21/2023] Open
Abstract
High-quality sleep is an important factor in sustaining health and improving well-being. Previous evidence has demonstrated the positive associations between increased physical activity and reduced sedentary behaviour (SB) with sleep quality. The substitutional relationships between SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) need to be considered when examining how a particular behaviour may impact sleep quality. No studies, to our knowledge, have explored these substitutional relationships in middle-aged adulthood. Using an isotemporal substitution approach, this study examined the associations of replacing sedentary time with physical activity on sleep quality measures in a sample of middle-aged adults in Japan. Data from 683 adults aged 40-64 living in Japan were used. The average daily time spent in SB, LPA, and MVPA was objectively assessed by accelerometers. Two self-reported sleep quality measures were obtained using questionnaires, including rest by sleep and sleep quality. Multivariable linear regression models were used to assess the associations of SB, LPA, and MVPA with the sleep quality measures stratified by gender. We found that each 60 min unit of SB or LPA replaced with MVPA was favourably associated with rest by sleep among women (β = 0.16, 95% CI 0.07, 0.28, p < 0.001; β = 0.18, 95% CI 0.07, 0.32, p < 0.05, respectively). There were no significant associations between SB, LPA, and MVPA with sleep measures in men across all three models. These findings indicate that higher MVPA has a positive association with sleep quality in middle-aged women.
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Li X, Zhai Q, Gou X, Quan M, Li Y, Zhang X, Deng B, Tian Y, Wang Q, Hou L. Involvement of Paired Immunoglobulin-Like Receptor B in Cognitive Dysfunction Through Hippocampal-Dependent Synaptic Plasticity Impairments in Mice Subjected to Chronic Sleep Restriction. Mol Neurobiol 2023; 60:1132-1149. [PMID: 36417104 PMCID: PMC9899186 DOI: 10.1007/s12035-022-03127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022]
Abstract
Sleep loss is often associated with cognitive dysfunction. Alterations in the structure and function of synapses in the hippocampus are thought to underlie memory storage. Paired immunoglobulin-like receptor B (PirB) plays a negative role in various neurological diseases by inhibiting axon regeneration and synaptic plasticity. However, the contributions of PirB to the mechanisms underlying the changes in synaptic plasticity after sleep loss that ultimately promote deficits in cognitive function have not been well elucidated. Here, we showed that chronic sleep restriction (CSR) mice displayed cognitive impairment and synaptic deficits accompanied by upregulation of PirB expression in the hippocampus. Mechanistically, PirB caused the dysregulation of actin through the RhoA/ROCK2/LIMK1/cofilin signalling pathway, leading to abnormal structural and functional plasticity, which in turn resulted in cognitive dysfunction. PirB knockdown alleviated synaptic deficits and cognitive impairment after CSR by inhibiting the RhoA/ROCK2/LIMK1/cofilin signalling pathway. Moreover, we found that fasudil, a widely used ROCK2 inhibitor, could mimic the beneficial effect of PirB knockdown and ameliorate synaptic deficits and cognitive impairment, further demonstrating that PirB induced cognitive dysfunction after CSR via the RhoA/ROCK2/LIMK1/cofilin signalling pathway. Our study sheds new light on the role of PirB as an important mediator in modulating the dysfunction of synaptic plasticity and cognitive function via the RhoA/ROCK2/LIMK1/cofilin signalling pathway, which indicated that hippocampal PirB is a promising therapeutic target for counteracting cognitive impairment after CSR. This illustration depicts the signalling pathway by PirB in mediating cognitive impairment and synaptic deficits in CSR mice. In the hippocampus of CSR mice, the expression level of PirB was significantly increased. In addition, CSR increases RhoA and ROCK2 levels and reduces levels of both LIMK1 and cofilin phosphorylation. PirB knockdown reverses cognitive impairment and synaptic plasticity disorders caused by CSR through the RhoA/ROCK2/LIMK1/cofilin signalling pathway.
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Affiliation(s)
- Xuying Li
- Department of Anesthesiology, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361102 Fujian China ,Department of Anesthesiology, Affiliated Haikou Hospital, Xiangya Medical College of Central South University, Haikou, 570000 Hainan China
| | - Qian Zhai
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi China
| | - Xingchun Gou
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic and Translational Medicine, Xi’an Medical University, Xi’an, 710021 Shaanxi China
| | - Minxue Quan
- Department of Anesthesiology, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361102 Fujian China
| | - Yansong Li
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi China
| | - Xiaohua Zhang
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic and Translational Medicine, Xi’an Medical University, Xi’an, 710021 Shaanxi China
| | - Bin Deng
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi China
| | - Yi Tian
- Department of Anesthesiology, Affiliated Haikou Hospital, Xiangya Medical College of Central South University, Haikou, 570000 Hainan China
| | - Qiang Wang
- Department of Anesthesiology & Center for Brain Science, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi China
| | - Lichao Hou
- Department of Anesthesiology, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361102 Fujian China
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Milanak ME, Witcraft SM, Park JY, Hassell K, McMahon T, Wilkerson AK. A Transdiagnostic group therapy for sleep and anxiety among adults with substance use disorders: Protocol and pilot investigation. Front Psychiatry 2023; 14:1160001. [PMID: 37065898 PMCID: PMC10090550 DOI: 10.3389/fpsyt.2023.1160001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/09/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Treatment of substance use disorders (SUDs) is challenging with high rates of treatment dropout and relapse, particularly among individuals with comorbid psychiatric conditions. Anxiety and insomnia are prevalent among those with SUD and exacerbate poor treatment outcomes. Interventions that concurrently target anxiety and insomnia during the early stages of SUD treatment are lacking. To this end, we investigated the feasibility and preliminary effectiveness in a single-arm pilot trial of an empirically informed group transdiagnostic intervention, Transdiagnostic SUD Therapy, to concurrently reduce anxiety and improve sleep among adults receiving treatment for SUD. Specifically, we hypothesized that participants would evidence declines in anxiety and insomnia and improvements in sleep health, a holistic, multidimensional pattern of sleep-wakefulness that promotes wellbeing. A secondary aim was to describe the protocol for Transdiagnostic SUD Therapy and how it may be implemented into a real-world addiction treatment setting. Method Participants were 163 adults (Mage = 43.23; 95.1% White; 39.93% female) participating in an intensive outpatient program for SUD who attended at least three of four Transdiagnostic SUD Therapy sessions. Participants had diverse SUDs (58.3% alcohol use disorder, 19.0% opioid use disorder) and nearly a third of the sample met criteria for two SUDs and comorbid mental health diagnoses (28.9% anxiety disorder, 24.6% major depressive disorder). Results As anticipated, anxiety and insomnia reduced significantly across the 4-week intervention period from clinical to subclinical severity, and sleep health significantly improved (ps < 0.001). These statistically significant improvements following Transdiagnostic SUD Therapy demonstrated medium to large effects (ds > 0.5). Conclusion Transdiagnostic SUD Therapy is designed to be flexibly administered in "real-world" clinical settings and, preliminarily, appears to be effective in improving emotional and behavioral factors that increase risk for return to substance use and poor SUD treatment outcomes. Additional work is needed to replicate these findings, determine the feasibility of widespread uptake of Transdiagnostic SUD Therapy, and examine whether the treatment effects translate to improvement in substance use outcomes.
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Affiliation(s)
- Melissa E. Milanak
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Sara M. Witcraft
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Jie Young Park
- Edward Via College of Osteopathic Medicine–Carolinas, Spartanburg, SC, United States
| | | | - Tierney McMahon
- Department of Psychology, Northwestern University, Evanston, IL, United States
| | - Allison K. Wilkerson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- *Correspondence: Allison K. Wilkerson,
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Chen P, Zhang L, Sha S, Lam MI, Lok KI, Chow IHI, Si TL, Su Z, Cheung T, Feng Y, Jackson T, Xiang YT. Prevalence of insomnia and its association with quality of life among Macau residents shortly after the summer 2022 COVID-19 outbreak: A network analysis perspective. Front Psychiatry 2023; 14:1113122. [PMID: 36873201 PMCID: PMC9978518 DOI: 10.3389/fpsyt.2023.1113122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/26/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The latest wave of the coronavirus disease 2019 (COVID-19) pandemic in Macau began on 18 June 2022 and was more serious than previous waves. Ensuing disruption from the wave is likely to have had a variety of negative mental health consequences for Macau residents including increased risk for insomnia. This study investigated the prevalence and correlates of insomnia among Macau residents during this wave as well as its association with quality of life (QoL) from a network analysis perspective. METHODS A cross-sectional study was conducted between 26 July and 9 September 2022. Univariate and multivariate analyses explored correlates of insomnia. Analysis of covariance (ANCOVA) examined the relationship between insomnia and QoL. Network analysis assessed the structure of insomnia including "Expected influence" to identify central symptoms in the network, and the flow function to identify specific symptoms that were directly associated with QoL. Network stability was examined using a case-dropping bootstrap procedure. RESULTS A total of 1,008 Macau residents were included in this study. The overall prevalence of insomnia was 49.0% (n = 494; 95% CI = 45.9-52.1%). A binary logistic regression analysis indicated people with insomnia were more likely to report depression (OR = 1.237; P < 0.001) and anxiety symptoms (OR = 1.119; P < 0.001), as well as being quarantined during the COVID-19 pandemic (OR = 1.172; P = 0.034). An ANCOVA found people with insomnia had lower QoL (F(1,1,008) = 17.45, P < 0.001). "Sleep maintenance" (ISI2), "Distress caused by the sleep difficulties" (ISI7) and "Interference with daytime functioning" (ISI5) were the most central symptoms in the insomnia network model, while "Sleep dissatisfaction" (ISI4), "Interference with daytime functioning" (ISI5), and "Distress caused by the sleep difficulties" (ISI7) had the strongest negative associations with QoL. CONCLUSION The high prevalence of insomnia among Macau residents during the COVID-19 pandemic warrants attention. Being quarantined during the pandemic and having psychiatric problems were correlates of insomnia. Future research should target central symptoms and symptoms linked to QoL observed in our network models to improve insomnia and QoL.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Kiang Wu Nursing College of Macau, Macao, Macao SAR, China
| | - Ka-In Lok
- Kiang Wu Nursing College of Macau, Macao, Macao SAR, China
| | - Ines Hang Iao Chow
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University & Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao, Macao SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, and Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
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Nuo M, Fang H, Wang T, Liang J, He Y, Han H, Lei J. Understanding the research on tracking, diagnosing, and intervening in sleep disorders using mHealth apps: Bibliometric analysis and systematic reviews. Digit Health 2023; 9:20552076231165967. [PMID: 37051563 PMCID: PMC10084565 DOI: 10.1177/20552076231165967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 04/14/2023] Open
Abstract
Objectives In solving the global challenge of sleep disorders, Mobile Health app is one of the important means to monitor, diagnose, and intervene in sleep disorders. This study aims to (1) summarize the status and trends of research in this field; (2) assess the production and usage of sleep mHealth apps; (3) calculate the conversion rate of grants that the proportion of newly developed apps from being funded and developed to published on application stores. Methods Using bibliometric and content analysis methods, based on "Research Paper-Product Output-Product Application" chain and considering the "Research Grants" of articles, we conducted a systematic review of eight databases, to identify relevant studies over the last decade. Results Over the past decade, 1399 authors published 313 papers in 182 journals and conferences. The number of publications increased with an average annual growth of 41.6%. The current focus area is research using cognitive behavioral therapy to intervene in sleep. Sleep-staging tracking is a shortcoming of this field. A total 368 sleep mHealth apps (233 newly developed and 135 existing) were examined in 313 papers; 323 grants supported 178 articles (56.9%). Only 12 of the newly developed apps are used in the real world, resulting in a 9% grant conversion rate. Conclusions In the last decade, the field of tracking, diagnosing, and intervening in sleep disorders using mHealth apps has shown a trend of rapid development. However, the conversion rate of products from being funded and developed for use by end-users is low.
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Affiliation(s)
- Mingfu Nuo
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
| | - Hongjuan Fang
- Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tong Wang
- Department of Medical Informatics, School of Public Health, Jilin University, Changchun, China
| | - Jun Liang
- IT Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
- Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yunfan He
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Hongbin Han
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
- Department of Radiology, Peking University Third Hospital, Health Science Center, Peking University, Beijing, China
| | - Jianbo Lei
- Institute of Medical Technology, Health Science Center, Peking University, Beijing, China
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, China
- School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, China
- Jianbo Lei, Institute of Medical Technology, Health Science Center, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, China.
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Luo XW, Li QX, Shen LS, Zhou X, Zou FY, Tang WJ, Guo RM. Quantitative association of cerebral blood flow, relaxation times and proton density in young and middle-aged primary insomnia patients: A prospective study using three-dimensional arterial spin labeling and synthetic magnetic resonance imaging. Front Neurosci 2023; 17:1099911. [PMID: 37025376 PMCID: PMC10070794 DOI: 10.3389/fnins.2023.1099911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/03/2023] [Indexed: 04/08/2023] Open
Abstract
Objectives To quantitatively measure the T1 value, T2 value, proton density (PD) value, and cerebral blood flow (CBF) in young and middle-aged primary insomnia (PI) patients, and analyze the correlations between relaxation times, PD, and CBF to explore potential brain changes. Methods Cranial magnetic resonance (MR) images of 44 PI patients and 30 healthy subjects were prospectively collected for analysis. The T1, T2, PD, and CBF values of the frontal lobe, parietal lobe, temporal lobe, and occipital lobe were independently measured using three-dimensional arterial spin labeling (3D-ASL), synthetic magnetic resonance imaging (syMRI) and a whole-brain automatic segmentation method. The differences of these imaging indices were compared between PI patients and healthy subjects. Follow-up MR images were obtained from PI patients after 6 months to compare with pre-treatment images. The Wilcoxon signed rank test and Spearman rank were used for statistical analysis. Results Bilateral CBF asymmetry was observed in 38 patients, with significant differences in both the T2 value and CBF between the four lobes of the brain (p < 0.01). However, no significant difference was found in the T1 and PD values between the bilateral lobes. A negative correlation was found between CBF and T2 values in the right four lobes of patients with primary insomnia (PI). During follow-up examinations, five PI patients showed a disappearance of insomnia symptoms and a decrease in CBF in both brain lobes. Conclusion Insomnia symptoms may be associated with high CBF, and most PI patients have higher CBF and lower T2 values in the right cerebral hemispheres. The right hemisphere appears to play a critical role in the pathophysiology of PI. The 3D-ASL and syMRI technologies can provide a quantitative imaging basis for investigating the brain conditions and changes in young and middle-aged PI patients.
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Xiang T, Liao J, Cai Y, Fan M, Li C, Zhang X, Li H, Chen Y, Pan J. Impairment of GABA inhibition in insomnia disorders: Evidence from the peripheral blood system. Front Psychiatry 2023; 14:1134434. [PMID: 36846238 PMCID: PMC9947704 DOI: 10.3389/fpsyt.2023.1134434] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
AIM To explore the change characteristics and related factors of various indexes of GABAergic system in peripheral blood of patients with insomnia disorder. METHODS In this study, a total of 30 patients who met the DSM-5 diagnostic criteria for insomnia disorder and 30 normal controls were included. All subjects had a structured clinical interview with the Brief International Neuropsychiatric Disorder Interview, and PSQI was used to evaluate the sleep status of the subjects. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum γ-aminobutyric acid (GABA), and RT-PCR was used to detect GABAA receptor α1 and α2 subunit mRNA. All data were statistically analyzed using SPSS 23.0. RESULTS Compared with the normal control group, the mRNA levels of GABAA receptor α1 and α2 subunits in the insomnia disorder group were significantly lower, but there was no significant difference in the serum GABA levels between the two groups. And in the insomnia disorder group, there was no significant correlation between the GABA levels and the mRNA expression levels of α1 and α2 subunits of GABAA receptors. Although no significant correlation was found between PSQI and serum levels of these two subunit mRNAs, its component factors sleep quality and sleep time were negatively correlated with GABAA receptor α1 subunit mRNA levels, and daytime function was inversely correlated with GABAA receptor α2 subunit mRNA levels. CONCLUSION The inhibitory function of serum GABA in patients with insomnia may be impaired, and the decreased expression levels of GABAA receptor α1 and α2 subunit mRNA may become a reliable indicator of insomnia disorder.
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Affiliation(s)
- Ting Xiang
- Sleep Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Jiwu Liao
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Yixian Cai
- Sleep Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Mei Fan
- Sleep Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Congrui Li
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Xiaotao Zhang
- Sleep Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Hongyao Li
- Sleep Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Yushan Chen
- Sleep Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Jiyang Pan
- Sleep Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.,Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
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Zhang P, Liu XL, Li X, Yang JH, Zhang RM. Association Between the Fatigue and Sleep Quality of Kidney Transplant Recipients: The Mediating Role of Rumination. J Nerv Ment Dis 2023; 211:23-28. [PMID: 35926188 DOI: 10.1097/nmd.0000000000001564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
ABSTRACT Sleep disorders persist in renal transplant patients. Previous studies have showed that fatigue and rumination are an important determinant of sleep quality. However, very few studies have explored the mediating role of rumination in the relationship between fatigue and sleep quality in kidney transplant recipients. A descriptive cross-sectional research design was implemented, and 192 kidney transplant patients completed the short questionnaire about their recent experiences of fatigue, rumination, and sleep quality. The prevalence of sleep disorders among kidney transplant recipients was 19.3%. With rumination as a partial mediator, fatigue indirectly affected the patients' sleep quality. This indirect effect was 0.10 (95% confidence interval, 0.154-0.419). Our results indicate that the incidence of sleep disorders after renal transplantation was high, and the more tired kidney transplant recipients become, the more likely they are to ruminate, which leads to a decline in sleep quality.
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Affiliation(s)
- Ping Zhang
- Department of Transplantation, Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Tian Y, Yue Y, Yang J, Chen H, Wang J, Liu J, Ding H, Lu L, Zhou J, Li Y. Sociodemographic, occupational, and personal factors associated with sleep quality among Chinese medical staff: A web-based cross-sectional study. Front Public Health 2022; 10:1060345. [PMID: 36620291 PMCID: PMC9814119 DOI: 10.3389/fpubh.2022.1060345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Sleep quality among medical staff affects not only their own health but also the health of their patients. This study aimed to investigate the sociodemographic, occupational, and personal factors associated with sleep quality among medical staff in mainland China. Methods An online survey was conducted from January 10 to February 5, 2019, involving 3,684 medical staff (female: 84.9%; mean age: 31.6 ± 7.7; age range: 18-72). Sleep quality was measured by the Chinese version of the Pittsburgh Sleep Quality Index (C-PSQI). Sociodemographic, occupational characteristics, and personal lifestyle factors were measured by standard questions. Binary logistic regression analyses were used to determine the factors associated with sleep quality. Results 57.9% (95% CI: 56.3-59.5%) of the study population experienced poor sleep quality (C-PSQI > 5). Binary logistic regression showed that poor sleep quality were associated with lower level of education, higher level of hospital care, longer weekly working hours, more than 30 min of cell phone use at bedtime, shift work (OR 1.33, 95% CI[1.12-1.58], P = 0.001), lack of regular naps (OR 1.46, 95% CI[1.26-1.69], P < 0.001) and lack of routine exercise (OR 1.69, 95% CI[1.46-1.97], P < 0.001). Conclusions Poor sleep quality is highly prevalent among medical staff in mainland China. The findings indicate that appropriate strategies, such as implementing regular breaks, regulating overtime work and vacation interruptions, as well as developing exercise programs, relaxation training, and stress-management programs could help improve the sleep quality of medical staff.
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Affiliation(s)
- Yusheng Tian
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuchen Yue
- Department of Psychiatry, Restigouche Hospital Center, Campbellton, NB, Canada
| | - Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hui Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jizhi Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Junyu Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hui Ding
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lulu Lu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,*Correspondence: Jiansong Zhou ✉
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China,Yamin Li ✉
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