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Cribbet MR, Thayer JF, Jarczok MN, Fischer JE. High-Frequency Heart Rate Variability Is Prospectively Associated With Sleep Complaints in a Healthy Working Cohort. Psychosom Med 2024; 86:342-348. [PMID: 38724040 PMCID: PMC11090416 DOI: 10.1097/psy.0000000000001302] [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] [Indexed: 05/15/2024]
Abstract
OBJECTIVE Vagus nerve functioning, as indexed by high-frequency heart rate variability (HF-HRV), has been implicated in a wide range of mental and physical health conditions, including sleep complaints. This study aimed to test associations between HF-HRV measured during sleep (sleep HF-HRV) and subjective sleep complaints 4 years later. METHODS One hundred forty-three healthy employees (91% male; MAge = 47.8 years [time 2], SD = 8.3 years) of an industrial company in Southern Germany completed the Jenkins Sleep Problems Scale, participated in a voluntary health assessment, and were given a 24-hour ambulatory heart rate recording device in 2007. Employees returned for a health assessment and completed the Jenkins Sleep Problems Scale 4 years later. RESULTS Hierarchical regression analyses showed that lower sleep HF-HRV measured in 2007 was associated with higher self-reported sleep complaints 4 years later after controlling for covariates (rab,c = -0.096, b = -0.108, 95% CI, -0.298 to 0.081, ΔR2 = 0.009, p = .050). CONCLUSIONS These data are the first to show that lower sleep HF-HRV predicted worse sleep 4 years later, highlighting the importance of vagus nerve functioning in adaptability and health.
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Affiliation(s)
- Matthew R. Cribbet
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama
| | - Julian F. Thayer
- Department of Psychological Science, The University of California at Irvine, Irvine, CA
| | - Marc N. Jarczok
- Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Joachim E. Fischer
- General Medicine, Center for Preventive Medicine and Digital Health, Mannheim Medical Facility, Heidelberg University, Mannheim, Germany
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Andersen TO, Sejling C, Jensen AK, Drews HJ, Ritz B, Varga TV, Rod NH. Nighttime smartphone use, sleep quality, and mental health: investigating a complex relationship. Sleep 2023; 46:zsad256. [PMID: 37758231 DOI: 10.1093/sleep/zsad256] [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: 06/01/2023] [Revised: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
STUDY OBJECTIVES This study investigated the complex relationship between nighttime smartphone use, sleep, and mental health among adult populations in Denmark. METHODS Data from three interconnected samples (aged 16-89 years) from the SmartSleep Study included 5798 individuals with survey and register data; 4239 individuals also provided high-resolution smartphone tracking data. Logistic regression models and causal discovery algorithms, which suggest possible causal pathways consistent with the underlying data structure, were used to infer the relationship between self-reported and tracked nighttime smartphone use, self-reported sleep quality, mental health indicators, and register-based psychotropic medication use. RESULTS Frequent self-reported nighttime smartphone use was associated with high perceived stress (OR: 2.24, 95% CI = 1.42 to 3.55) and severe depressive symptoms (OR: 2.96, 95% CI = 2.04 to 4.28). We found no clear associations between tracked nighttime smartphone use and mental health outcomes, except for the cluster that used their smartphones repeatedly during the sleep period, which was associated with severe depressive symptoms (OR = 1.69, 95% CI = 1.24 to 2.31). Poor sleep quality (vs. good sleep quality) was associated with high perceived stress (OR = 5.07, 95% CI = 3.72 to 6.90), severe depressive symptoms (OR = 9.67, 95% CI = 7.09 to 13.19), and psychotropic medication use (OR = 2.13, 95% CI = 1.36 to 3.35). The causal discovery models suggest that nighttime smartphone use affects mental health through both problematic smartphone use and poor sleep quality. CONCLUSION The complex relationship between nighttime smartphone use, sleep, and poor mental health may create a vicious circle over time, and nighttime smartphone use may constitute a potential leverage point for public health interventions aimed at improving sleep and mental health.
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Affiliation(s)
- Thea Otte Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Christoffer Sejling
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Kryger Jensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Henning Johannes Drews
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, LA, USA
| | - Tibor V Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Genario R, Gil S, Oliveira-Júnior G, Leitão AE, Franco T, Dos Santos Sales RC, Ferriolli E, Busse AL, Filho WJ, Gualano B, Roschel H. Sleep quality is a predictor of muscle mass, strength, quality of life, anxiety and depression in older adults with obesity. Sci Rep 2023; 13:11256. [PMID: 37438429 DOI: 10.1038/s41598-023-37921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
We aimed to investigate associations between sleep quality with selected quantitative and qualitative parameters of health in older individuals with obesity. Cross-sectional assessment (n = 95 men/women; ≥ 65 years; BMI ≥ 30 kg/m2) of sleep quality, body composition, handgrip strength, quality-of-life, anxiety/depression. Mean PSQI score was 6.3. Poor sleepers (n = 49) presented lower appendicular lean mass (ALM) (16.2 vs 17.8 kg; p = 0.0273), ALM/BMI (0.47 vs 0.53 kg/BMI; p = 0.0085), fat mass (48.6 vs 46.6%; p = 0.0464), handgrip strength (19.7 vs 22.0 kgf; p = 0.0542) and handgrip/BMI (0.57 vs 0.66 kgf/BMI; p = 0.0242) than good sleepers. They also had higher anxiety (8.6 vs 5.6; p = 0.0100) and depression (4.8 vs 3.2; p = 0.0197) scores, worse health-related quality-of-life and lower scores in mental (62.8 vs 73.0; p = 0.0223) and physical (52.9 vs 67.3; p = 0.0015) domains. Adjusted models showed that PSQI was negatively associated with ALM (β = - 0.13, 95% CI - 0.25; - 0.01) and health-related quality of life on physical (β = - 2.76, 95% CI - 3.82; - 1.70) and mental (β = - 2.25, 95% CI - 3.38; - 1.12) domains, and positively associated with anxiety (β = 0.57; 95% CI 0.26; 0.87) and depression (β = 0.31; 95% CI 0.13; 0.49). Poor sleep quality associates with impaired selected quantitative and qualitative parameters of health. Additionally, sleep quality was shown as an independent predictor of ALM, health-related quality-of-life, anxiety and depression in older individuals with obesity.
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Affiliation(s)
- Rafael Genario
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Saulo Gil
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Gersiel Oliveira-Júnior
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alice Erwig Leitão
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Tathiane Franco
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ruan Célio Dos Santos Sales
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Ferriolli
- Division of Internal and Geriatric Medicine, Department of Internal Medicine-Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Alexandre Leopold Busse
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Wilson Jacob Filho
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil.
- Rheumatology Division, Clinical Hospital, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
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Olgun H, Yazar T, Çakmak BB, Arıcı YK. Assessment of Sleep Disturbances on Mental Health in Patients with Restless Legs Syndrome. Neurol India 2023; 71:693-698. [PMID: 37635500 DOI: 10.4103/0028-3886.383850] [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] [Indexed: 08/29/2023]
Abstract
Background and Objective In our study, we aimed to evaluate the sleep disturbances of patients diagnosed with restless legs syndrome (RLS) regarding their mental health according to the severity of the disease. Materials and Methods The study included 166 patients diagnosed with RLS and 161 healthy controls in the same age interval as patients. Sleep disturbances of patients were defined with the "personal information form" (PIF) prepared by the researchers, while the mental health status of patients was defined with the "Brief Symptom Inventory" (BSI). Results All RLS patients had an increase in BSI subscale points, with a positive correlation to disease severity, and subscale points were significantly higher than the control group (p < 0.05). Those with the "frequent waking" problem had higher BSI subscale points compared to those without the problem (p<0.01 or 0.001). Those with "waking with respiratory distress," "daytime sleepiness," "very early waking," and "sleep disorder" problems had statistically significantly high BSI subscale points for all subscales, apart from hostility, compared to those without these problems (p<0.01 or 0.001). Conclusion It is considered that assessment of sleep disturbances causing disrupted quality of life and mood disorders is beneficial for the treatment of patients with RLS. Our study data appears to be related to the result that sleep disturbances and mental health disruptions might be associated with the disease severity among RLS patients.
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Affiliation(s)
- Hulya Olgun
- İstanbul Taksim Educational and Research Hospital, Neurology, Neurology Department, İstanbul, Turkey
| | - Tamer Yazar
- Kanuni Sultan Süleyman Training and Research Hospital, Neurology Department, İstanbul, Turkey
| | | | - Yeliz K Arıcı
- Ordu University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Ordu, Turkey
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Mezian K, Hrehová L. High prevalence of insomnia among physiatrists in the Czech Republic: A web-based questionnaire survey. Work 2023:WOR220050. [PMID: 36641721 DOI: 10.3233/wor-220050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Physicians who suffer from poor sleep quality are at an increased risk of mistakes and poor decision-making. We deemed it noteworthy to assess sleep quality in practicing physiatrists, previously reported to be at higher risk of physician burnout, which was documented associated with sleep deprivation. OBJECTIVE The aim was to estimate the prevalence of sleep disturbance among practicing physiatrists and evaluate the association of sleep quality with their sleep hygiene habits and depression. METHODS Of the 101 study participants (77 females) who met the inclusion criteria, the majority was between the age of 25 and 40 years (70.3% ); 62 (61.4% ) were specialists and 39 (38.6% ) were in training. In this cross-sectional study, practicing physiatrists were invited to complete an anonymous and voluntary web-based survey. The survey consisted of questions covering demographic information, nicotine and caffeine consumption, exercise habits, and three questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory-II (BDI-II), and the Sleep Hygiene Index (SHI). RESULTS Sixty-five (64.4% ) respondents showed poor sleep quality (PSQI > 5), and 23 (22.8% ) showed at least mild symptoms of depression (BDI-II>13). The mean PSQI, SHI, BDI-II scores were 6.85±3.09, 18.18±5.35, and 8.36±7.52, respectively. Poor sleep quality was significantly positively correlated with symptoms of depression and sleep hygiene misbehavior. CONCLUSION We found that 64.4% of practicing physiatrists suffered from poor sleep quality, and 22.8% showed at least mild symptoms of depression. Considerable efforts should be directed toward sleep hygiene behavior and mental health improvement.
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Affiliation(s)
- Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Laura Hrehová
- Institute of General Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Association between the number of hours of sleep during weekdays and suicidality among Korean adolescents: Mediating role of depressive and anxiety symptoms. J Affect Disord 2023; 320:74-80. [PMID: 36155234 DOI: 10.1016/j.jad.2022.09.079] [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: 11/30/2021] [Revised: 05/22/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Adolescent suicide is a serious concern worldwide. Sleep problems are a risk factor for suicide. Therefore, the aim of this study was to evaluate associations between sleep duration and suicidal ideation/suicide attempts and determine the extent to which depressive and anxiety symptoms mediate these associations. METHODS Data from 54,948 middle and high school students in South Korea were collected by the stratified cluster method through the Korea Youth Risk Behavior Web-based Survey. RESULTS The weighted prevalences of short and long sleep durations were 19.5 % (95 % confidence interval [CI] = 18.9-20.2) and 4.6 % (95 % CI = 4.3-4.8), respectively. Short sleep duration (<5 h/day) increased the odds of suicidal ideation and suicide attempts by 1.43 (95 % CI = 1.29-1.58) and 1.78 (95 % CI = 1.41-2.25), respectively. Long sleep duration (>9 h/day) increased the odds of suicide attempts by 1.5 (95 % CI = 1.02-2.21). Depressive and anxiety symptoms significantly mediated the relationship between sleep duration and suicidal intensity with a satisfactory goodness of fit. LIMITATIONS Causal relationships could not be examined due to the cross-sectional study design. Information on other psychopathologies, besides depression and anxiety, was unavailable. CONCLUSIONS Short sleep duration was associated with suicidal ideation and suicide attempts among Korean adolescents. Long sleep duration was associated with suicide attempts only. Both depressive and anxiety symptoms mediated the association between sleep duration and suicidal intensity; therefore, both sleep hour restoration and treatment of depressive/anxiety symptoms should be the goals of suicide prevention strategies.
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Lin KY, Eow PY, Kohli S, Math SY. Correlation of Medical Comorbidities and Upper Airway Measurements among Dental Patients at Risk of Developing Obstructive Sleep Apnea. Clin Pract 2022; 12:284-298. [PMID: 35645311 PMCID: PMC9149922 DOI: 10.3390/clinpract12030034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022] Open
Abstract
Obstructive Sleep Apnea (OSA) is a partial or total upper airway collapse resulting in sleep-breathing disturbances. There are many medical comorbidities associated with OSA; hence, this study is important as the prevalence of patients with medical comorbidities associated with OSA is increasing. The study aimed to correlate medical comorbidities and OSA symptoms of the patients along with their upper airway dimensions using Cone Beam Computed Tomography (CBCT) scans to identify patients at risk of developing OSA. This cross-sectional study included patients who had CBCT imaging taken between 2014 and 2020. A questionnaire was used to gather information on patients’ medical history and OSA symptoms. The upper airway dimensions of the CBCT scans were evaluated before logistic regression and Fisher’s exact test were carried out to determine the relationships between the variables. p ≤ 0.05 was considered statistically significant. Logistic regression revealed an association of longer length (p = 0.016), smaller total volume (p = 0.017) and width (p = 0.010) of upper airways with hypertension. Furthermore, loud snoring was seen in patients with hypertension, heart disease and obesity whereas difficulty concentrating during the day was present in subjects with deviated nasal septum, tonsillitis and depression. For upper airway dimensions, a smaller average volume was associated with loud snoring (p = 0.037), difficulty concentrating during the day (p = 0.002) and mood changes (p = 0.036). A larger anterior-posterior dimension was also associated with excessive daytime sleepiness (p = 0.042), difficulty concentrating during the day (p < 0.001) and mood changes (p = 0.009). Longer airway length was additionally found to be associated with loud snoring (p = 0.021). CBCT taken for dental investigations could be correlated with patients’ medical history and OSA symptoms to screen patients at risk of OSA.
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Kim B, Troxel WM, Dubowitz T, Hunter GP, Ghosh-Dastidar B, Chaix B, Rudolph KE, Morrison CN, Branas CC, Duncan DT. Mediating role of psychological distress in the associations between neighborhood social environments and sleep health. Sleep 2022; 45:6568592. [PMID: 35421893 PMCID: PMC9366649 DOI: 10.1093/sleep/zsac087] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/21/2022] [Indexed: 01/14/2023] Open
Abstract
STUDY OBJECTIVES The characteristics of neighborhood social environments, such as safety and social cohesion, have been examined as determinants of poor sleep. The current study investigates associations between neighborhood social characteristics and sleep health, as well as the mediating role of psychological distress on these possible associations. METHODS Three waves of PHRESH Zzz (n = 2699), a longitudinal study conducted in two low-income, predominately Black neighborhoods, were utilized for this analysis. The characteristics of neighborhood social environments were measured using crime rates, a neighborhood social disorder index, and self-reported social cohesion. Sleep health was measured via 7 days of wrist-worn actigraphy as insufficient sleep, sleep duration, wake after sleep onset (WASO), and sleep efficiency. G-estimations based on structural nested mean models and mediation analyses were performed to estimate the effects of neighborhood social environments on sleep as well as direct/indirect effects through psychological distress. RESULTS Crime rate around residential addresses was associated with increased risk of insufficient sleep (risk ratio: 1.05 [1.02, 1.12]), increased WASO (β: 3.73 [0.26, 6.04]), and decreased sleep efficiency (β: -0.54 [-0.91, -0.09]). Perceived social cohesion was associated with decreased risk of insufficient sleep (OR: 0.93 [0.88, 0.97]). Psychological distress mediated part of the associations of crime and social cohesion with insufficient sleep. CONCLUSIONS Neighborhood social environments may contribute to poor sleep health in low-income, predominantly Black neighborhoods, and psychological distress can be a salient pathway linking these neighborhood characteristics and sleep health.
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Affiliation(s)
- Byoungjun Kim
- Corresponding author. Byoungjun Kim, Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave 5th Floor, New York, NY 10016, USA.
| | | | | | | | | | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique IPLESP, Nemesis Team, Paris, France
| | - Kara E Rudolph
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Christopher N Morrison
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Charles C Branas
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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Kim B, Branas CC, Rudolph KE, Morrison CN, Chaix B, Troxel WM, Duncan DT. Neighborhoods and sleep health among adults: A systematic review. Sleep Health 2022; 8:322-333. [DOI: 10.1016/j.sleh.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
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Romigi A, Mercuri NB, Caccamo M, Testa F, Vitrani G, Tripaldi MC, Centonze D, Jacoangeli F. Subjective sleep disorders and daytime sleepiness in patients with restrictive type anorexia nervosa and effects on quality of life: a case-control study. Sleep Biol Rhythms 2022; 20:181-189. [PMID: 38469262 PMCID: PMC10899920 DOI: 10.1007/s41105-021-00352-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/26/2021] [Indexed: 12/26/2022]
Abstract
To evaluate sleep disorders and daytime drowsiness in a cohort of patients affected by anorexia nervosa and their impact on health-related quality of life. We evaluated patients affected by restricting-type of anorexia nervosa (AN-R) and healthy controls by the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Beck Depression Index. We also used the Short-Form Health Survey (SF-36) questionnaire to assess the quality of life in both AN-R and controls. Twenty-eight out of 34 AN-R patients (82.3%) in contrast with ten out of 34 healthy subjects (29.4%) had a pathological PSQI score compared to HC (p < 0.0001). The overall PSQI score (p < 0.001), sleep quality (p < 0.001), sleep duration (p = 0.02), sleep efficiency (p = 0.002), sleep disturbances (p = 0.03) and daytime dysfunction (p = 0.004) were significantly higher in AN-R than in controls. SF36 showed significantly reduced scores of standardized physical components (p = 0.01) and standardized mental components (p < 0.001), physical function (p < 0.001), physical role (p < 0.001) and general health (p < 0.001), vitality (p < 0.001), social functioning (p < 0.001) emotional role (p = 0.001) and mental health (p < 0.001) in AN-R. We found a significant correlation between the PSQI score and both the physical role (r = - 0.35, p = 0.03) and level of education (r = 0.38, p = 0.02). Our data showed reduced overall sleep quality without excessive daytime sleepiness in AN-R. Sleep quality correlated significantly with quality of life (physical role) and level of education.
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Affiliation(s)
- Andrea Romigi
- Sleep Medicine Center, IRCCS Neuromed, Via Atinense 18, Pozzilli, IS Italy
| | - Nicola B. Mercuri
- Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marco Caccamo
- Sleep Medicine Center, IRCCS Neuromed, Via Atinense 18, Pozzilli, IS Italy
| | - Federica Testa
- Sleep Medicine Center, IRCCS Neuromed, Via Atinense 18, Pozzilli, IS Italy
| | - Giuseppe Vitrani
- Sleep Medicine Center, IRCCS Neuromed, Via Atinense 18, Pozzilli, IS Italy
| | - Maria Carmela Tripaldi
- Clinical Nutrition and Eating Disorders Unit, Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Diego Centonze
- Sleep Medicine Center, IRCCS Neuromed, Via Atinense 18, Pozzilli, IS Italy
| | - Fabrizio Jacoangeli
- Clinical Nutrition and Eating Disorders Unit, Department of System Medicine, University of Rome Tor Vergata, Rome, Italy
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Selfe TK, Montgomery C, Klatt M, Wen S, Sherman KJ, Innes KE. An Exploratory Randomized Controlled Trial of a 12-Week Yoga Versus Educational Film Program for the Management of Restless Legs Syndrome: Feasibility and Acceptability. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:309-319. [PMID: 35426733 PMCID: PMC9051873 DOI: 10.1089/jicm.2021.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives: The primary objectives of this pilot trial were to assess the study feasibility and acceptability of the 12-week yoga and educational film programs for the management of restless legs syndrome (RLS) in preparation for a future randomized controlled trial (RCT). Materials and Methods: This pilot, parallel-arm, randomized feasibility trial was conducted at two sites, Morgantown, WV and Columbus, OH. Yoga group participants attended 75-min Iyengar yoga classes, twice weekly for 4 weeks, then once a week for 8 weeks (16 total classes), and completed a 30-min homework routine on nonclass days. Educational film group participants attended once weekly, 75-min classes (12 total classes), which included information on RLS and other sleep disorders, RLS management including sleep hygiene practices, and complementary therapies. Feasibility and acceptability outcomes included program satisfaction and recruitment, retention, and adherence rates. In addition, participants were asked their preferences regarding three yoga class schedule scenarios for a future study. Attendance, yoga, and treatment logs were collected weekly. Program evaluation and yoga scheduling questionnaires were collected at week 12. Results: Forty-one adults with moderate to severe RLS were randomized to a 12-week yoga (n = 19) or educational film (n = 22) program. Thirty participants (73%) completed the program. Yoga and education group participants attended an average of 13.0 ± 0.84 (81%) and 10.3 ± 0.3 classes (85%), respectively. Participants from both groups indicated satisfaction with the study. All yoga group respondents to the program evaluation reported they would likely (n = 6) or very likely (n = 7) continue yoga practice; 86.7% of education group respondents (13 of 15) indicated that they were likely (n = 7) or very likely (n = 6) to make lasting changes based on what they had learned. The preferred schedule for a future study was a 16-week study with once-weekly yoga classes. Conclusions: The findings of this study suggest that a larger RCT comparing yoga with an educational film group for the management of RLS is feasible. Trial registration: Clinicaltrials.gov: NCT03570515; 02/01/2017.
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Affiliation(s)
- Terry Kit Selfe
- Academic Research Consulting & Services, Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Caitlin Montgomery
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Maryanna Klatt
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Sijin Wen
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Karen J. Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Kim E. Innes
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
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Jung S, Jung S. The Impact of COVID-19 Infodemic on Depression and Sleep Disorders; Focusing On Uncertainty Reduction Strategies and Level of Interpretation Theory. JMIR Form Res 2021; 6:e32552. [PMID: 34870609 PMCID: PMC8812143 DOI: 10.2196/32552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/15/2021] [Accepted: 10/27/2021] [Indexed: 11/28/2022] Open
Abstract
Background During the COVID-19 pandemic, information diffusion about the COVID-19 has attracted public attention through social media. The World Health Organization declared an infodemic of COVID-19 on February 15, 2020. Misinformation and disinformation, including overwhelming amounts of information about COVID-19 on social media, could promote adverse psychological effects. Objective This study used the Psychological Distance and Level of Construal theory (CLT) to predict peoples’ negative psychological symptoms from social media usage. In this study, the CLT intended to show peoples’ psychological proximity to objects and events with respect to the COVID-19 pandemic. Furthermore, this study links the uncertainty reduction strategy (URS) and CLT for COVID-19–related preventive behaviors and affective reactions to assess their effects on mental health problems. Methods A path model was tested (N=297) with data from a web-based survey to examine how social media usage behaviors are associated with URS and psychological distance with COVID-19 (based on the CLT), leading to preventive behaviors and affective reactions. Finally, the path model was used to examine how preventive behaviors and affective reactions are associated with mental health problems including anxiety and sleep disorder. Results After measuring participants’ social media usage behavior, we found that an increase in general social media usage led to higher use of the URS and lower construal level on COVID-19. The URS is associated with preventive behaviors, but the CLT did not show any association with preventive behaviors; however, it increases affective reactions. Moreover, increased preventive behavior showed negative associations with symptoms of mental health problems; that is, depression and sleep disorder. However, the affective reaction tends to be positively associated with depression and sleep disorder. Owing to the infodemic of COVID-19, the psychological perception of the pandemic negatively influenced users’ mental health problems. Conclusions Our results imply that the information from social media usage heightened concerns and had a lower construal level; this does not facilitate taking preventive actions but rather reinforces the negative emotional reaction and mental health problems. Thus, higher URS usage is desirable.
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Affiliation(s)
- Soyoung Jung
- The School of Journalism and Communication, Renmin University of China, 59 Zhongguancun Street, Haidian District,Room 502, Mingde Building,, Beijing, CN
| | - Sooin Jung
- College of Education Department of Kinesiology and Health Education, University of Texas, at Austin, Austin, US
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13
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Holzinger B, Nierwetberg F, Klösch G. Case Report: Why Sleep and Dream Related Psychological Treatments, Such as Sleepcoaching (According to Holzinger&Klösch) and CBT-I Should Be Implemented in Treatment Concepts in the Public Health System-Description of the Nightmare Treatment Process in the Context of PTSD. Front Psychol 2021; 12:733911. [PMID: 34764915 PMCID: PMC8576602 DOI: 10.3389/fpsyg.2021.733911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/22/2021] [Indexed: 11/29/2022] Open
Abstract
In this case report, we explain the story of a woman diagnosed with severe PTSD, suffering from recurrent nightmares involving a traumatizing event. She participated in 6 week lucid dreaming training to help her reduce her nightmare frequency. Our descriptions include her dream reports as well as the results of the psychological assessment conducted. In only 6 weeks, she was able to begin to change her dream plots and to improve several of the psychological measures. In this case, we stated that paying more attention to sleep and, especially nightmares, not only in patients with PTSD, should be standard in treatment processes for psychiatric disorders. We, therefore, underpin our case with literature that explains the benefits of treatments, specifically for sleep problems that do not involve medication.
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Affiliation(s)
- Brigitte Holzinger
- Institute for Consciousness and Dream Research, Vienna, Austria
- Certificate Program Sleep Coaching, Medical University of Vienna, Vienna, Austria
| | | | - Gerhard Klösch
- Institute for Consciousness and Dream Research, Vienna, Austria
- Certificate Program Sleep Coaching, Medical University of Vienna, Vienna, Austria
- Department of Neurology, Medical University of Vienna, Vienna, Austria
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14
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Anxiogenic Potential of Experimental Sleep Fragmentation Is Duration-Dependent and Mediated via Oxidative Stress State. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:2262913. [PMID: 34471462 PMCID: PMC8405322 DOI: 10.1155/2021/2262913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022]
Abstract
Sleep architecture alterations, among which sleep fragmentation is highly prevalent, represent risk factors for a variety of diseases, ranging from cardiovascular to brain disorders, including anxiety. What mediates anxiety occurrence upon sleep fragmentation is still a matter of debate. We hypothesized that the sleep fragmentation effects on anxiety are dependent on its duration and mediated by increased oxidative stress and alterations in the number of parvalbumin (PV+) interneurons in the hippocampus. Sleep was fragmented in rats by the treadmill method during a period of 14 days (SF group). Rats with undisturbed sleep in the treadmill (TC group) and those receiving equal amounts of treadmill belt motion (EC group) served as controls. To assess anxiety, we subjected rats to the open field, elevated plus maze, and light-dark tests on the 0, 7th, and 14th day. Upon the last test, brain structures were sampled for oxidative stress assessment and PV+ interneuron immunohistochemistry. The results of ethological tests of anxiety-linked behavior suggested duration-dependent anxiogenic potential of sleep fragmentation. Rats' anxiety-linked behavior upon sleep fragmentation significantly correlated with oxidative stress. The rats with fragmented sleep (SF) showed significantly higher oxidative stress in the hippocampus, thalamus, and cortex, compared to controls (TC and EC), while the antioxidant enzymes' activity was significantly decreased. No significant differences were observed in hippocampal PV+ interneurons among these groups. Our results showed that duration of sleep fragmentation is a significant determinant of anxiety-linked behavior, and these effects are mediated through oxidative distress in the brain. Herein, it is revealed that the sleep fragmentation-oxidative stress-anxiety axis contributes to our better understanding of pathophysiological processes, occurring due to disrupted sleep patterns.
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15
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Wang Y, Jiang P, Tang S, Lu L, Bu X, Zhang L, Gao Y, Li H, Hu X, Wang S, Jia Z, Roberts N, Huang X, Gong Q. Left superior temporal sulcus morphometry mediates the impact of anxiety and depressive symptoms on sleep quality in healthy adults. Soc Cogn Affect Neurosci 2021; 16:492-501. [PMID: 33512508 PMCID: PMC8095089 DOI: 10.1093/scan/nsab012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/21/2020] [Accepted: 01/29/2021] [Indexed: 02/05/2023] Open
Abstract
Anxiety and depressive symptoms may predispose individuals to sleep disturbance. Understanding how these emotional symptoms affect sleep quality, especially the underlying neural basis, could support the development of effective treatment. The aims of the present study were therefore to investigate potential changes in brain morphometry associated with poor sleep quality and whether this structure played a mediating role between the emotional symptoms and sleep quality. One hundred and forty-one healthy adults (69 women, mean age = 26.06 years, SD = 6.36 years) were recruited. A structural magnetic resonance imaging investigation was performed, and self-reported measures of anxiety, depressive symptoms and sleep quality were obtained for each participant. Whole-brain regression analysis revealed that worse sleep quality was associated with thinner cortex in left superior temporal sulcus (STS). Furthermore, the thickness of left STS mediated the association between the emotional symptoms and sleep quality. A subsequent commonality analysis showed that physiological component of the depressive symptoms had the greatest influence on sleep quality. In conclusion, thinner cortex in left STS may represent a neural substrate for the association between anxiety and depressive symptoms and poor sleep quality and may thus serve as a potential target for neuromodulatory treatment of sleep problems.
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Affiliation(s)
- Yanlin Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Ping Jiang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Shi Tang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Xuan Bu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhiyun Jia
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
| | - Neil Roberts
- School of Clinical Sciences, The Queen's Medical Research Institute (QMRI), University of Edinburgh, Edinburgh EH164TJ, UK
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan 610041, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan 610041, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu, Sichuan 610041, China
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16
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Tenorio-Lopes L, Kinkead R. Sex-Specific Effects of Stress on Respiratory Control: Plasticity, Adaptation, and Dysfunction. Compr Physiol 2021; 11:2097-2134. [PMID: 34107062 DOI: 10.1002/cphy.c200022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
As our understanding of respiratory control evolves, we appreciate how the basic neurobiological principles of plasticity discovered in other systems shape the development and function of the respiratory control system. While breathing is a robust homeostatic function, there is growing evidence that stress disrupts respiratory control in ways that predispose to disease. Neonatal stress (in the form of maternal separation) affects "classical" respiratory control structures such as the peripheral O2 sensors (carotid bodies) and the medulla (e.g., nucleus of the solitary tract). Furthermore, early life stress disrupts the paraventricular nucleus of the hypothalamus (PVH), a structure that has emerged as a primary determinant of the intensity of the ventilatory response to hypoxia. Although underestimated, the PVH's influence on respiratory function is a logical extension of the hypothalamic control of metabolic demand and supply. In this article, we review the functional and anatomical links between the stress neuroendocrine axis and the medullary network regulating breathing. We then present the persistent and sex-specific effects of neonatal stress on respiratory control in adult rats. The similarities between the respiratory phenotype of stressed rats and clinical manifestations of respiratory control disorders such as sleep-disordered breathing and panic attacks are remarkable. These observations are in line with the scientific consensus that the origins of adult disease are often found among developmental and biological disruptions occurring during early life. These observations bring a different perspective on the structural hierarchy of respiratory homeostasis and point to new directions in our understanding of the etiology of respiratory control disorders. © 2021 American Physiological Society. Compr Physiol 11:1-38, 2021.
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Affiliation(s)
- Luana Tenorio-Lopes
- Department of Physiology and Pharmacology, Hotchkiss Brain Institute, The University of Calgary, Calgary, Alberta, Canada
| | - Richard Kinkead
- Département de Pédiatrie, Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
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17
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Geoffroy PA, Oquendo MA, Courtet P, Blanco C, Olfson M, Peyre H, Lejoyeux M, Limosin F, Hoertel N. Sleep complaints are associated with increased suicide risk independently of psychiatric disorders: results from a national 3-year prospective study. Mol Psychiatry 2021; 26:2126-2136. [PMID: 32355334 DOI: 10.1038/s41380-020-0735-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 12/21/2022]
Abstract
Prior research suggests that sleep disturbances are associated with increased risk of suicide. However, sleep disturbances are associated with a wide range of psychiatric disorders, and it is unknown whether this association is independent of psychopathology. In a large nationally representative prospective survey, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we used structural equation modeling to examine the shared and specific effects of three sleep complaints (i.e., trouble falling asleep, early morning awakening, and hypersomnia) on the 3-year occurrence of attempting suicide. Because psychiatric disorders increase the risk of suicide attempt almost exclusively through a general psychopathology factor representing their shared effect, covariates included that factor, prior history of suicide attempt, and a wide range of sociodemographic and clinical characteristics. The 3-year prevalence rate of suicide attempt was 0.6% (n = 241). Compared with participants who did not attempt suicide between the two waves, those who did reported significantly more frequently having trouble falling asleep (44.6% vs. 16.6%), early morning awakening (38.9% vs. 12.7%), and hypersomnia (35.0% vs. 10.7%). Following adjustments, effects of sleep complaints on this risk were significant and exerted almost exclusively through a general sleep complaints factor representing the shared effect across all sleep complaints. There were no residual associations of any individual sleep complaint with attempting suicide above that association. Sleep complaints are associated with an increased risk of attempting suicide independently of psychopathology, and should be included in suicide risk assessments as these symptoms may provide targets for reducing the risks of suicidal behaviors.
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Affiliation(s)
- Pierre A Geoffroy
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, 75013, Paris, France. .,Université de Paris, NeuroDiderot, Inserm, F-75019, Paris, France. .,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France.
| | - Maria A Oquendo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philippe Courtet
- INSERM, U1061, Neuropsychiatry, University Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, Montpellier, France
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, 10032, USA
| | - Hugo Peyre
- Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department, Paris, France.,Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Michel Lejoyeux
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, 75013, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Frédéric Limosin
- Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.,Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,Faculté de médecine Paris Descartes, Université de Paris, Paris, France.,Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Nicolas Hoertel
- Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France.,Centre Ressource Régional de Psychiatrie du Sujet Agé (CRRPSA), Service de Psychiatrie et d'Addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP.Centre-Université de Paris, Paris, France.,Faculté de médecine Paris Descartes, Université de Paris, Paris, France.,Inserm U1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
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18
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Tucker JA, Osann K, Hsieh S, Wahi A, Monk BJ, Wenzel L, Nelson EL. Longitudinal Changes in Sleep: Associations with Shifts in Circulating Cytokines and Emotional Distress in a Cancer Survivor Population. Int J Behav Med 2021; 28:140-150. [PMID: 33598780 PMCID: PMC7925505 DOI: 10.1007/s12529-020-09950-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Sleep disturbances are associated with numerous mood disorders. Similarly, anxiety and depression are associated with modulation of the psychoneuroimmune (PNI) axis. This study hypothesized that changes in both monitored and self-reported measures of sleep would relate to changes in circulating cytokine levels in an emotionally distressed population of cervical cancer survivors. METHODS Biospecimens, patient-reported outcome (PRO) measures, and actigraphy were collected from cervical cancer survivors enrolled in a biobehavioral clinical trial. Longitudinal changes over a 4-month period were examined. Sleep time measured by actigraphy and PRO were analyzed for correlative changes with emotional distress and serum cytokines (n = 71). RESULTS Longitudinal change in the actigraph measure of sleep time was inversely associated with changes in depression and anxiety (test for linear trend, p = 0.02 and p = 0.05 respectively), as well as acute-phase response/pro-inflammatory cytokines (test for linear trend, p = 0.003, interleukin (IL)-2; 0.022, IL-1β; 0.0002, IL-6; and 0.049, tumor necrosis factor α). Conversely, changes in self-reported sleep problems were related to an increase in depression and anxiety (p = 0.001 and p = 0.01 respectively), the T helper 2 (Th2) cytokine IL-5 (p = 0.027), and the counter-regulatory cytokine IL-10 (0.016). CONCLUSION This study showed that an increase in sleep time or decrease in sleep problems corresponded with a reduction in self-reported emotional distress and attenuation of pro-inflammatory, Th2, and counter-regulatory cytokines. Our results support sleep measurement as a meaningful biobehavioral variable in cancer survivorship. This study also indicates that sleep investigators should be aware that choice of methodology might influence concordance with different classes of immune parameters.
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Affiliation(s)
- Jo A. Tucker
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, CA USA
| | - Kathryn Osann
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, CA USA
- Chao Family Comprehensive Cancer Center, University of California, Irvine, CA USA
| | - Susie Hsieh
- Department of Medicine, Division of General Internal Medicine, University of California, Irvine, CA USA
| | - Aditi Wahi
- Department of Medicine, Division of General Internal Medicine, University of California, Irvine, CA USA
| | - Bradley J. Monk
- Arizona Oncology, US Oncology Network, University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix, AZ USA
| | - Lari Wenzel
- Chao Family Comprehensive Cancer Center, University of California, Irvine, CA USA
- Department of Medicine, Division of General Internal Medicine, University of California, Irvine, CA USA
- Program in Public Health, University of California, Irvine, CA USA
| | - Edward L. Nelson
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, CA USA
- Department of Medicine, Division of General Internal Medicine, University of California, Irvine, CA USA
- Institute for Immunology, University of California, Irvine, CA 92617 USA
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19
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Bjorvatn B, Jernelöv S, Pallesen S. Insomnia - A Heterogenic Disorder Often Comorbid With Psychological and Somatic Disorders and Diseases: A Narrative Review With Focus on Diagnostic and Treatment Challenges. Front Psychol 2021; 12:639198. [PMID: 33643170 PMCID: PMC7904898 DOI: 10.3389/fpsyg.2021.639198] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/21/2021] [Indexed: 12/11/2022] Open
Abstract
Patients with insomnia complain of problems with sleep onset or sleep maintenance or early morning awakenings, or a combination of these, despite adequate opportunity and circumstances for sleep. In addition, to fulfill the diagnostic criteria for insomnia the complaints need to be associated with negative daytime consequences. For chronic insomnia, the symptoms are required to be present at least 3 days per week for a duration of at least 3 months. Lastly, for insomnia to be defined as a disorder, the sleep complaints and daytime symptoms should not be better explained by another sleep disorder. This criterion represents a diagnostic challenge, since patients suffering from other sleep disorders often complain of insomnia symptoms. For instance, insomnia symptoms are common in e.g., obstructive sleep apnea and circadian rhythm sleep-wake disorders. It may sometimes be difficult to disentangle whether the patient suffers from insomnia disorder or whether the insomnia symptoms are purely due to another sleep disorder. Furthermore, insomnia disorder may be comorbid with other sleep disorders in some patients, e.g., comorbid insomnia and sleep apnea (COMISA). In addition, insomnia disorder is often comorbid with psychological or somatic disorders and diseases. Thus, a thorough assessment is necessary for correct diagnostics. For chronic insomnia disorder, treatment-of-choice is cognitive behavioral therapy, and such treatment is also effective when the insomnia disorder appears comorbid with other diagnoses. Furthermore, studies suggest that insomnia is a heterogenic disorder with many different phenotypes or subtypes. Different insomnia subtypes may respond differently to treatment, but more research on this issue is warranted. Also, the role of comorbidity on treatment outcome is understudied. This review is part of a Research Topic on insomnia launched by Frontiers and focuses on diagnostic and treatment challenges of the disorder. The review aims to stimulate to more research into the bidirectional associations and interactions between insomnia disorder and other sleep, psychological, and somatic disorders/diseases.
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Affiliation(s)
- Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Susanna Jernelöv
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ståle Pallesen
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
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20
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Zhang YS, Jin Y, Rao WW, Jiang YY, Cui LJ, Li JF, Li L, Ungvari GS, Ng CH, Li KQ, Xiang YT. Prevalence and socio-demographic correlates of poor sleep quality among older adults in Hebei province, China. Sci Rep 2020; 10:12266. [PMID: 32703962 PMCID: PMC7378171 DOI: 10.1038/s41598-020-68997-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 06/23/2020] [Indexed: 01/28/2023] Open
Abstract
Poor sleep quality is associated with negative health outcomes and high treatment burden. This study investigated the prevalence of poor sleep quality and its socio-demographic correlates among older adults in Hebei province, which is a predominantly agricultural region of China. A large-scale cross-sectional epidemiological survey was conducted from April to August 2016. The study used a multistage, stratified, cluster random sampling method. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). A total of 3,911 participants were included. The prevalence of poor sleep quality (defined as PSQI > 7) was 21.0% (95% CI 19.7–22.2%), with 22.3% (95% CI 20.9–23.8%) in rural areas and 15.9% (95% CI 13.4–18.4%) in urban areas. Multivariable logistic regression analyses found that female gender (P < 0.001, OR 2.4, 95% CI 2.00–2.82), rural areas (P = 0.002, OR 1.5, 95% CI 1.14–1.86), presence of major medical conditions (P < 0.001, OR 2.4, 95% CI 2.02–2.96) and family history of psychiatric disorders (P < 0.001, OR 2.7, 95% CI 1.60–4.39) were independently associated with higher risk of poor sleep quality. Poor sleep quality was common among older adults in Hebei province of China. Regular assessment of sleep quality and accessible sleep treatments for older population should be provided in agricultural areas of China.
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Affiliation(s)
- Yun-Shu Zhang
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China
| | - Yu Jin
- Unit of Psychiatry, Centre for Precision Medicine Research and Training, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau SAR, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Centre for Precision Medicine Research and Training, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau SAR, China
| | - Yuan-Yuan Jiang
- Unit of Psychiatry, Centre for Precision Medicine Research and Training, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau SAR, China
| | - Li-Jun Cui
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China
| | - Jian-Feng Li
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China
| | - Lin Li
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia.,University of Notre Dame, Australia, Fremantle, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Ke-Qing Li
- Hebei Provincial Mental Health Centre, Hebei Provincial Sixth People's Hospital, Baoding, Hebei, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Centre for Precision Medicine Research and Training, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau SAR, China. .,Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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21
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Prevalence of Sleep Disturbance and Potential Associated Factors among Medical Students from Mashhad, Iran. SLEEP DISORDERS 2020; 2020:4603830. [PMID: 32695519 PMCID: PMC7362288 DOI: 10.1155/2020/4603830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/31/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022]
Abstract
Methods In this cross-sectional study, 315 medical students chosen by stratified random sampling participated in the academic year 2018-2019. The Pittsburgh Instrument and DASS-21 questionnaire were used to evaluate sleep quality and anxiety, depression, and stress, respectively. Also, demographic, educational, and socioeconomic information was collected. SPSS 16 software was used for data analysis. Results Out of 300 students who completed the questionnaires, 165 (55%) were male, with a mean age of 21.94 ± 2.28 years old. The prevalence of poor sleep quality was 51.3%. We did not find significant associations among age, sex, and poor sleep quality. Concurrent psychological symptoms such as stress, depression, and anxiety were significantly associated with sleep disorders. After adjusting variables in the multivariable regression model, depression (OR = 2.81, 95% CI: 1.35-5.87; p = 0.006) and the number of hours spent on using smartphones in 24 hours (OR = 1.13, 95% CI: 1.02-1.25; p = 0.01) were significantly associated with poor sleep quality among medical students. Conclusion The prevalence of poor sleep quality among medical students was high, and we found that increased use of smartphones during the day and depression were associated with sleep disorders.
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Caldwell JA, Knapik JJ, Shing TL, Kardouni JR, Lieberman HR. The association of insomnia and sleep apnea with deployment and combat exposure in the entire population of US army soldiers from 1997 to 2011: a retrospective cohort investigation. Sleep 2020; 42:5491797. [PMID: 31106808 PMCID: PMC6685319 DOI: 10.1093/sleep/zsz112] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/07/2019] [Indexed: 12/20/2022] Open
Abstract
Since 2001, the United States has been engaged in the longest and most expensive overseas conflict in its history. Sleep disorders, especially insomnia and obstructive sleep apnea (OSA), are common in service members and appear related to deployment and combat exposure, but this has not been systematically examined. Therefore, the incidence of clinically diagnosed insomnia and OSA from 1997 to 2011 in the entire population of US Army soldiers was determined and associations of these disorders with deployment and combat exposure examined. This observational retrospective cohort study linked medical, demographic, deployment, and combat casualty data from all active duty US Army soldiers serving from 1997 to 2011 (n = 1 357 150). The mediating effects of multiple known comorbid conditions were considered. From 2003 to 2011, there were extraordinary increases in incidence of insomnia (652%) and OSA (600%). Factors increasing insomnia risk were deployment (risk ratio [RR] [deployed/not deployed] = 2.06; 95% confidence interval [CI], 2.04-2.08) and combat exposure (RR [exposed/not exposed] = 1.20; 95% CI, 1.19-1.22). Risk of OSA was increased by deployment (RR [deployed/not deployed] = 2.14; 95% CI, 2.11-2.17), but not combat exposure (RR [exposed/not exposed] = 1.00; 95% CI, 0.98-1.02). These relationships remained after accounting for other factors in multivariable analyses. A number of comorbid medical conditions such as posttraumatic stress disorder and traumatic brain injury mediated a portion of the association between the sleep disorders and deployment. It is essential to determine underlying mechanisms responsible for these very large increases in insomnia and OSA and introduce effective preventive measures.
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Affiliation(s)
- John A Caldwell
- Oak Ridge Institute for Science and Education, Belcamp, MD.,Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Joseph J Knapik
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Tracie L Shing
- Oak Ridge Institute for Science and Education, Belcamp, MD.,Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Joseph R Kardouni
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
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Powell TA, Mysliwiec V, Aden JK, Morris MJ. Burn pit exposure in military personnel: is there an effect on sleep-disordered breathing? Sleep Breath 2020; 25:479-485. [PMID: 32185632 DOI: 10.1007/s11325-020-02060-x] [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: 01/10/2020] [Revised: 02/19/2020] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Exposure to elevated concentrations of respirable particulate matter (< 10 μm) may influence sleep-disordered breathing. Burn pits as utilized by the US military in the Middle East until 2011 produced elevated particle matter concentrations. We seek to determine if subjective exposure to burn pits during deployment affects prevalence or severity of obstructive sleep apnea (OSA) in military personnel. METHODS As part of a prospective observational study of previously deployed military personnel with exertional dyspnea (n = 145), all patients underwent pulmonary function testing, screening for burn pit exposure, and if warranted by questionnaires, overnight polysomnography. A total of 100 patients completed all testing. For analysis, patients were classified into a burn pit exposure group (45 patients) and a no exposure group (55 patients). Additional analyses were performed on those endorsing burn pit maintenance during deployment (25 patients) and those with > 12 h of daily exposure (17 patients). RESULTS The prevalence of OSA, defined by apnea-hypopnea index (AHI) > 5/h, was similarly high in both groups (69% vs. 71%, p = 0.83). Surprisingly, the mean AHI was lower in the exposed group (12.8/h vs. 19.7/h, p = 0.04) while nadir of oxygen saturation was similar (87% vs. 86%, p = 0.39). Subgroup analyses revealed similar findings in those who performed burn pit maintenance (prevalence = 80%, p = 0.58; AHI = 14.8, p = 0.16) and those with > 12 h of daily exposure (prevalence = 88%, p = 0.33; AHI = 18.0, p = 0.62). CONCLUSIONS Subjective burn pit exposure does not appear to influence OSA development in previously deployed military personnel. Given the high rate of OSA in this cohort, continued investigation of deployment exposures which may influence sleep-disordered breathing is recommended.
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Affiliation(s)
- Tyler A Powell
- Sleep Medicine Service, Wilford Hall Ambulatory Surgical Center, JBSA Lackland AFB, San Antonio, TX, 78234, USA.
| | - Vincent Mysliwiec
- Sleep Medicine Service, Wilford Hall Ambulatory Surgical Center, JBSA Lackland AFB, San Antonio, TX, 78234, USA
| | - James K Aden
- Graduate Medical Education, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, TX, USA
| | - Michael J Morris
- Graduate Medical Education, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, TX, USA
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24
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Gauld N, Braganza C, Arroll B. Adapting the Auckland Sleep Screening Tool for pharmacy: pharmacists' experience and feedback. J Prim Health Care 2020; 11:170-177. [PMID: 32171360 DOI: 10.1071/hc19003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/20/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Insomnia has negative health effects and may indicate underlying serious conditions, but is underdiagnosed and often not discussed with a doctor. AIM This study aimed to explore the utility and workability in New Zealand community pharmacies of a 23-question sleep-screening tool adapted from the Short Auckland Sleep Questionnaire. METHODS A multidisciplinary advisory group (sleep specialist, general practitioner and pharmacists) discussed the tool, pharmacists' capability in managing insomnia and training needs for pharmacists, and recommended management strategies, including referral points. Twelve community pharmacists piloted the tool with people with insomnia who presented in pharmacies, recording the time it took to administer the tool. The pharmacists were then surveyed about their experiences with the tool and possible improvements. RESULTS Ten pharmacists took an average of 12.4 min (range 4-35 min) for each use of the screening tool with 62 people with insomnia. Most pharmacists found the screening tool easy to administer, organised and easy to follow and nine of 10 said it provided better information than their usual consultation. Seven of 10 pharmacists would use it again. Time limitations and low recruitment were potential barriers to usage especially for pharmacy owners. DISCUSSION The screening tool could provide a useful addition to pharmacists' toolkits, aiding information gathering and better than usual practice. The tool was acceptable to most pharmacists, but its use takes time and remuneration needs consideration.
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Affiliation(s)
- Natalie Gauld
- School of Pharmacy, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; and Corresponding author.
| | - Crystal Braganza
- Natalie Gauld Ltd, PO Box 9349, Newmarket, Auckland 1023, New Zealand
| | - Bruce Arroll
- Department of General Practice and Primary Health Care, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
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25
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Oliveira ESD, Silva AFRD, Silva KCBD, Moura TVC, Araújo ALD, Silva ARVD. Stress and health risk behaviors among university students. Rev Bras Enferm 2020; 73:e20180035. [PMID: 32049225 DOI: 10.1590/0034-7167-2018-0035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 06/01/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the level of stress and its relationship with health risk behaviors among university students. METHOD Cross-sectional analytical study carried out at a higher education institution in Picos-PI. A total of 377 students were evaluated for socio-demographic and academic variables, stress profile, sleep quality, alcohol use, smoking habits and level of physical activity. The Statistical Package for the Social Sciences (SPSS), version 20.0 was used for data processing and analysis. RESULTS Sleep quality was poor for 65.3% of the subjects, and sleep disturbances were found in 17.0%. Stress was observed in 68.7% of the sample. Stress was associated with the following variables: gender, time in the institution, poor sleep quality. CONCLUSION Most of the students evaluated present some level of stress associated with poor sleep quality, which is a risk to the quality of life of these individuals.
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HACIMUSALAR YUNUS, KARAASLAN OZGUL. Assessment of sleep quality of patients with panic disorder and generalized anxiety disorder during remission: a case-control study. ACTA ACUST UNITED AC 2020. [DOI: 10.1590/0101-60830000000224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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27
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Sleep therapeutics and neuropsychiatric illness. Neuropsychopharmacology 2020; 45:166-175. [PMID: 31376815 PMCID: PMC6879486 DOI: 10.1038/s41386-019-0474-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/23/2019] [Accepted: 07/30/2019] [Indexed: 11/08/2022]
Abstract
Alterations in sleep are extremely common in patients with neuropsychiatric illness. In addition, sleep disorders such as insomnia, obstructive sleep apnea, rapid eye movement sleep behavior disorder, and circadian rhythm disorders commonly occur at a rate greater than the general population in neuropsychiatric conditions. Historically, sleep problems have been viewed as symptoms of associated neuropsychiatric disorders. However, there is increasing evidence suggesting a complex inter-relationship with possible bidirectional causality. The inter-relatedness of these conditions represents an opportunity for understanding mechanisms and improving clinical treatment. To the extent that sleep problems affect neuropsychiatric conditions, it may be possible to address sleep problems and have a positive impact on the course of neuropsychiatric illnesses. Further, some treatments for sleep disorders have direct effects on neuropsychiatric illnesses that may be unrelated to their effects on sleep disorders. Similarly, neuropsychiatric conditions and their treatments can affect sleep and sleep disorders. This article reviews available evidence on the effects of therapies for sleep disorders on neuropsychiatric conditions and also secondarily considers the impacts of therapies for neuropsychiatric conditions on sleep. Primary goals of this review are to identify gaps in current research, to determine the extent to which the cross-therapeutic effects of these treatments help to elucidate therapeutic or pathological mechanisms, and to assist clinicians in optimizing therapeutic choice in patients with sleep disorders and neuropsychiatric conditions.
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Garbarino S, Bardwell WA, Guglielmi O, Chiorri C, Bonanni E, Magnavita N. Association of Anxiety and Depression in Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis. Behav Sleep Med 2020; 18:35-57. [PMID: 30453780 DOI: 10.1080/15402002.2018.1545649] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: Obstructive sleep apnea (OSA) has been associated with mental disorders, but the strength of this association is unknown. The aim of our study was to investigate the association among OSA, depression, and anxiety in adults and to quantitatively summarize the results. Methods: A literature search in Medline, PubMed, PsycInfo, Scopus, and Web of Science was conducted. Seventy-three articles were selected for study. Results: The pooled prevalence of depressive and anxious symptoms in OSA patients was 35% (95% CI, 28-41%) and 32% (95% CI, 22-42%), respectively. Conclusions: The association between OSA, anxiety, and depression indicates the value of an early diagnosis and personalized treatment of OSA to improve mental disorders conditioning compliance to therapy. These conditions share a probably bidirectional relationship.
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Affiliation(s)
- Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Wayne A Bardwell
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Ottavia Guglielmi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genoa, Genoa, Italy
| | - Enrica Bonanni
- Center of Sleep Medicine, Neurology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Nicola Magnavita
- Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Hussain Z, Griffiths MD. The Associations between Problematic Social Networking Site Use and Sleep Quality, Attention-Deficit Hyperactivity Disorder, Depression, Anxiety and Stress. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00175-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AbstractSocial networking sites (SNSs) are now used by billions of users worldwide and can help facilitate communication and the sharing of information. However, there is evidence that problematic SNS use (PSNSU) can have negative effects on health. The present study examined the associations between PSNSU, sleep quality, attention-deficit/hyperactivity disorder (ADHD), depression, anxiety and stress among SNS users. A total of 638 SNS users (mean age = 32.03 years, SD = 10.08) completed an online survey comprising instruments assessing SNS addiction, sleep quality, ADHD, depression, anxiety and stress. Regression analysis indicated that the factors of age (β = − .24, p < .01), relationship status (i.e., being in a relationship) (β = − .09, p < .05), ADHD (β = .43, p < .01) and anxiety (β = .12, p < .01) explained 23.9% of the variance in problematic SNS use. Bivariate correlations identified moderate positive correlations between PSNSU, poor sleep quality (r = .24, p < .01, R2 = .06), ADHD (r = .47, p < .01, R2 = .22), depression (r = .32, p < .01, R2 = .10), anxiety (r = .38, p < .01, R2 = .14) and stress (r = .34, p < .01, R2 = .12). The study demonstrated that PSNSU was associated with psychopathological and psychiatric disorders symptoms, the findings will help inform future interventions for reducing and tackling PSNSU.
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30
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Lin CE, Chung CH, Chen LF, Chien WC, Chou PH. The Impact of Antidepressants on the Risk of Developing Obstructive Sleep Apnea in Posttraumatic Stress Disorder: A Nationwide Cohort Study in Taiwan. J Clin Sleep Med 2019; 15:1233-1241. [PMID: 31538594 PMCID: PMC6760393 DOI: 10.5664/jcsm.7910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/16/2019] [Accepted: 04/16/2019] [Indexed: 12/15/2022]
Abstract
STUDY OBJECTIVES The association between posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) has been reported inconsistently, and the association between antidepressant use and the risk of developing OSA in patients with PTSD has not been previously studied. Therefore, we used the Longitudinal National Health Insurance Database (LHID) to investigate the impact of PTSD and antidepressant use on the risk of OSA development. METHODS Identified from the LHID, 2,316 individuals aged ≥ 18 years with PTSD, but with no history of OSA, and 23,160 control individuals matched for age, sex, obesity and index date were enrolled between 2000 and 2015 and followed up until the end of 2015 to identify the development of OSA. A two-tailed Bonferroni-corrected P < .00038 (.05/13) was considered statistically significant as we examined 13 antidepressants. RESULTS Individuals with PTSD had increased risk of developing OSA (adjusted hazard ratio 4.672, 95% confidence interval 2.246-9.787, P < .001) after adjusting for demographic data, medical comorbidities, and medication. Treatment with antidepressants was not significantly associated with an increased risk of developing OSA compared to no antidepressant treatment. CONCLUSIONS Asian patients with PTSD had increased risk of developing OSA, and treatment with antidepressants did not play a key role in increasing the risk of OSA development. Further studies are required to investigate the underlying mechanisms of PTSD and the roles of antidepressants on the risk of developing OSA. CITATION Lin C-E, Chung C-H, Chen L-F, Chien W-C, Chou P-H. The impact of antidepressants on the risk of developing obstructive sleep apnea in posttraumatic stress disorder: a nationwide cohort study in taiwan. J Clin Sleep Med. 2019;15(9):1233-1241.
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Affiliation(s)
- Ching-En Lin
- Department of Psychiatry, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Li-Fen Chen
- Department of Psychiatry, Hualien Armed Forces General Hospital, Taiwan
| | - Wu-Chien Chien
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Po-Han Chou
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Taichung, Taiwan
- Department of Psychiatry, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
- Biological Optimal Imaging Lab, Department of Photonics, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
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31
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Madsen MT, Huang C, Zangger G, Zwisler ADO, Gögenur I. Sleep Disturbances in Patients With Coronary Heart Disease: A Systematic Review. J Clin Sleep Med 2019; 15:489-504. [PMID: 30853047 DOI: 10.5664/jcsm.7684] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/08/2019] [Indexed: 12/19/2022]
Abstract
STUDY OBJECTIVES Investigation into sleep and coronary heart disease (CHD) has predominantly been focused on sleep disturbances as a risk factor for developing CHD. Objectively measured and self-reported sleep at a patient level has only been sparsely and not systematically reported. Therefore, we set out to review the literature for studies using objectively measured and self-reported sleep in patients with CHD. The review focuses on patients with acute coronary syndrome (ACS) and stable CHD. METHODS A systematic review performed in four databases adhering to the PRISMA guidelines applying a qualitative synthesis of evidence. RESULTS Following ACS, we found sleep architecture to be significantly disturbed with changes normalizing over a period of up to 6 months. With increasing severity of CHD, sleep disturbances were more pronounced; however, the modulating effects of sleep-disordered breathing and ejection fraction on sleep in patients with CHD are conflicting. Overall, studies were predominantly cross-sectional in design and of low methodological quality. Polysomnography was the predominant outcome assessment tool and validated self-reported assessment tools were limited. CONCLUSIONS Future investigations in sleep and CHD applying both a longitudinal design and investigating objective and self-reported sleep assessments are warranted. SYSTEMATIC REVIEW REGISTRATION Registry: PROSPERO, Title: Sleep measures in relation to coronary heart disease: a systematic review, Identifier: CRD42017056377, URL: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=56377.
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Affiliation(s)
- Michael Tilling Madsen
- Center for Surgical Science, Zealand University Hospital, Denmark.,Department of Emergency, Zealand University Hospital, Denmark
| | - Chenxi Huang
- Center for Surgical Science, Zealand University Hospital, Denmark
| | - Graziella Zangger
- REHPA - Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Denmark
| | - Ann Dorthe Olsen Zwisler
- REHPA - Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Denmark
| | - Ismail Gögenur
- Center for Surgical Science, Zealand University Hospital, Denmark
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Selfe TK, Wen S, Sherman K, Klatt M, Innes KE. Acceptability and feasibility of a 12-week yoga vs. educational film program for the management of restless legs syndrome (RLS): study protocol for a randomized controlled trial. Trials 2019; 20:134. [PMID: 30770767 PMCID: PMC6377785 DOI: 10.1186/s13063-019-3217-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/21/2019] [Indexed: 01/28/2023] Open
Abstract
Background Restless legs syndrome (RLS) is a common and burdensome sleep disorder associated with profound impairment of health, well-being, and quality of life. Unfortunately, the medications used for RLS management carry risk of serious side effects, including augmentation of symptoms. Yoga, an ancient mind-body discipline designed to promote physical, emotional, and mental well-being, may offer a viable, low-risk new treatment. The primary objectives of this pilot, parallel-arm, randomized controlled trial (RCT) are to assess the acceptability and feasibility of a 12-week yoga vs. educational film program for the management of RLS. Methods Forty-four adults with confirmed moderate to severe RLS will be recruited and randomized to a 12-week yoga (n = 22) or standardized educational film program (N = 22). Yoga group participants will attend two 75-min Iyengar yoga classes per week for the first 4 weeks, then one 75-min class per week for the remaining 8 weeks, and will complete a 30-min homework routine on non-class days. Educational film group participants will attend one 75-min class per week for 12 weeks and complete a daily RLS treatment log; classes will include information on: RLS management, including sleep hygiene practices; other sleep disorders; and complementary therapies likely to be of interest to those participating in a yoga and sleep education study. Yoga and treatment logs will be collected weekly. Feasibility outcomes will include recruitment, enrollment, and randomization rates, retention, adherence, and program satisfaction. Program evaluation and yoga-dosing questionnaires will be collected at week 12; data on exploratory outcomes (e.g., RLS symptom severity (IRLS), sleep quality (PSQI), mood (POMS, PSS), and health-related quality of life (SF-36)) will be gathered at baseline and week 12. Discussion This study will lay the essential groundwork for a planned larger RCT to determine the efficacy of a yoga program for reducing symptoms and associated burden of RLS. If the findings of the current trial and the subsequent larger RCTs are positive, this study will also help support a new approach to clinical treatment of this challenging disorder, help foster improved understanding of RLS etiology, and ultimately contribute to reducing the individual, societal, and economic burden associated with this condition. Trial registration ClinicalTrials.gov, ID: NCT03570515. Retrospectively registered on 1 February 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3217-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Terry Kit Selfe
- Health Science Center Libraries, University of Florida, PO Box 100206, Gainesville, FL, 32610, USA.
| | - Sijin Wen
- Department of Biostatistics, West Virginia University School of Public Health, HSC N, PO Box 9190, Morgantown, WV, 26506, USA
| | - Karen Sherman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Maryanna Klatt
- Department of Family Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, HSC N, PO Box 9190, Morgantown, WV, 26506, USA
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Pradines M, Rey M, Dumas R, Rhondali W, Lemoine P, Azorin JM, Vedie C. Frequency of Past and Current Psychiatric Disorders in Patients Referred for Polysomnography: A Pilot Study. J Clin Sleep Med 2018; 14:1503-1507. [PMID: 30176960 DOI: 10.5664/jcsm.7324] [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: 04/14/2017] [Accepted: 05/18/2018] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The aim of this study was to assess the frequency of past and current psychiatric disorders among patients referred to a sleep unit for polysomnography. METHODS A total of 152 patients referred to the Sleep Center of Timone Hospital in Marseille were included from January 12 to March 31, 2015. Clinical data were collected using the Mini International Neuropsychiatric Interview. RESULTS The final sample consisted of 102 patients. Polysomnography helped diagnose the following common sleep disorders: obstructive sleep apnea, restless legs syndrome, insomnia, and non-rapid eye movement sleep arousal disorder. Ninety patients (88%) had psychiatric disorders. All patients (27) without a common sleep disorder diagnosis had psychiatric disorders and among patients with a common sleep disorder diagnosis 84% had psychiatric disorders. Among the psychiatric disorders a past major depressive episode was the most frequent pathology. CONCLUSIONS This study shows that patients referred to a sleep unit have a high prevalence of psychiatric disorders. This may be explained by residual symptoms of psychiatric illnesses, a diagnostic misdirection, a denial of psychiatric diagnosis, or an undiagnosed somatic symptom disorder. Finally, this study shows the importance of cross-disciplinary communication considering the diagnostic heterogeneity that may represent a sleep complaint.
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Affiliation(s)
| | - Marc Rey
- Centre du Sommeil, Hôpital de la Timone, Marseille, France
| | - Rémy Dumas
- Secteur 8, Hôpital Valvert, Marseille, France
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Rains JC. Sleep and Migraine: Assessment and Treatment of Comorbid Sleep Disorders. Headache 2018; 58:1074-1091. [PMID: 30095163 DOI: 10.1111/head.13357] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2018] [Indexed: 12/16/2022]
Abstract
The relationship of sleep and migraine is unequivocal and familiarity with the nature and magnitude of these associations may inform clinical practice. Recent prospective, longitudinal, and time-series analysis has begun to unravel the magnitude and temporal patterns of sleep and migraine. Prospective evidence has shown that sleep variables can trigger acute migraine, precede and predict new onset headache by several years, and indeed, sleep disturbance and snoring are risk factors for chronification. The presence of a sleep disorder is associated with more frequent and severe migraine and portends a poorer headache prognosis. Interestingly, the disorders linked to migraine are quite varied, including insomnia, snoring and obstructive sleep apnea, restless legs, circadian rhythm disorders, narcolepsy, and others. Insomnia is by far the most common sleep disorder in headache patients. In fact, the majority of patients with chronic migraine presenting for treatment have insomnia. Despite a rapidly expanding literature, very few controlled treatment studies have been published to guide clinical practice. This paper focuses on clinical assessment and treatment of sleep disorders. An algorithm is presented for sleep disorders management in the migraine patient, which highlights major sleep disorders and psychiatric comorbidity. Diagnostic procedures are recommended that are conducive to clinical practice. Suggested tools include the sleep history, screening mnemonics, prediction equation, and sleep diary. New developments in treatment have produced abbreviated and cost-effective therapies for insomnia and obstructive sleep apnea that may reach a larger population. Revisions in the diagnostic manuals for sleep and headache disorders enhance recognition of sleep-related headache. Recommendations include behavioral sleep regulation, shown in recent controlled trials to decrease migraine frequency, management for sleep apnea headache, cognitive behavioral therapy (CBT) for insomnia abbreviated for the physician practice setting, sleep-related headache trigger, and others. There is no empirical evidence that sleep evaluation should delay or supersede usual headache care. Rather, sleep management is complimentary to standard headache practice.
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Affiliation(s)
- Jeanetta C Rains
- Center for Sleep Evaluation, Elliot Hospital, Manchester, NH, USA
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35
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Brown BJ, Robinson D, Jensen JF, Seedall RB, Hodgson J, Norton MC. Will Improving My Marriage Improve My Sleep? JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2018. [DOI: 10.1080/15332691.2017.1417938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Braden J. Brown
- Department of Human Development and Family Science, East Carolina University, Greenville, NC/USA
| | - Dave Robinson
- Department of Family, Consumer, and Human Development, Utah State University, Logan, UT/USA
| | - Jakob F. Jensen
- Department of Human Development and Family Science, East Carolina University, Greenville, NC/USA
| | - Ryan B. Seedall
- Department of Family, Consumer, and Human Development, Utah State University, Logan, UT/USA
| | - Jennifer Hodgson
- Department of Human Development and Family Science, East Carolina University, Greenville, NC/USA
| | - Maria C. Norton
- Department of Family, Consumer, and Human Development, Utah State University, Logan, UT/USA
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Pocivavsek A, Rowland LM. Basic Neuroscience Illuminates Causal Relationship Between Sleep and Memory: Translating to Schizophrenia. Schizophr Bull 2018; 44:7-14. [PMID: 29136236 PMCID: PMC5768044 DOI: 10.1093/schbul/sbx151] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Patients with schizophrenia are often plagued by sleep disturbances that can exacerbate the illness, including potentiating psychosis and cognitive impairments. Cognitive dysfunction is a core feature of schizophrenia with learning and memory being particularly impaired. Sleep disruptions often accompanying the illness and may be key mechanism that contribute to these core dysfunctions. In this special translational neuroscience feature, we highlight the role of sleep in mediating cognitive function, with a special focus on learning and memory. By defining dysfunctional sleep architecture and rhythms in schizophrenia, we focus on the disarray of mechanisms critical to learning and memory and postulate an association between sleep disturbances and cognitive impairments in the disorder. Lastly, we review preclinical models of schizophrenia and highlight exciting translational research that may lead to new therapeutic approaches to alleviating sleep disturbances and effectively improving cognitive function in schizophrenia.
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Affiliation(s)
- Ana Pocivavsek
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Laura M Rowland
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
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Talih F, Ajaltouni J, Ghandour H, Abu-Mohammad AS, Kobeissy F. Insomnia in hospitalized psychiatric patients: prevalence and associated factors. Neuropsychiatr Dis Treat 2018; 14:969-975. [PMID: 29695907 PMCID: PMC5903832 DOI: 10.2147/ndt.s160742] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To quantify and describe the prevalence of insomnia in hospitalized psychiatric patients and to investigate the associations between insomnia and demographic and clinical factors in hospitalized psychiatric patients. METHODS The participants included 203 individuals hospitalized for psychiatric treatment at an academic medical center. Demographic information, psychiatric diagnoses, current psychotropic medication use, and history of substance use were collected. Insomnia screening was performed using the Insomnia Severity Index. Depressive and anxiety symptoms were also evaluated using the Generalized Anxiety Disorder questionnaire and the Patient Health Questionnaire. Restless legs syndrome (RLS) symptoms were evaluated using the Restless Legs Syndrome Rating Scale (RLSRS). Statistical analysis was conducted to detect the prevalence of insomnia among the participants and to examine possible associations among psychiatric disorders, psychotropic medications, and RLS. RESULTS Out of the 203 participants that completed the survey, 67.4% were found to have insomnia and 14.3% were found to have RLS. The severity of insomnia was found to be associated with the presence of RLS, depressive and anxious symptomatology, suicidal ideation, use of selective serotonin reuptake inhibitors, and use of benzodiazepines.
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Affiliation(s)
- Farid Talih
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jean Ajaltouni
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hiba Ghandour
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Firas Kobeissy
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Aarab G, Nikolopoulou M, Ahlberg J, Heymans MW, Hamburger HL, de Lange J, Lobbezoo F. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial on psychological distress. Clin Oral Investig 2017; 21:2371-2378. [PMID: 28083705 PMCID: PMC5559560 DOI: 10.1007/s00784-016-2045-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/07/2016] [Indexed: 11/30/2022]
Abstract
Objectives The aim of this randomized placebo-controlled trail was to compare the effects of an objectively titrated mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) and an intraoral placebo device on symptoms of psychological distress in OSA patients. Materials and methods In a parallel design, 64 mild/moderate OSA patients (52.0 ± 9.6 years) were randomly assigned to an objectively titrated MAD, nCPAP, or an intraoral placebo appliance. All patients filled out the Symptom Checklist-90-Revised twice: one before treatment and one after 6 months of treatment. The Symptom Checklist-90-Revised is a multidimensional symptom inventory designed to measure symptomatic psychological distress over the past week. Linear mixed model analyses were performed to study differences between the therapy groups for the different dimensions of the Symptom Checklist-90-Revised over time. Results The MAD group showed significant improvements over time in the dimensions “somatization,” “insufficiency of thinking and acting,” “agoraphobia,” “anxiety,” “sleeping problems,” and “global severity index” (F = 4.14–16.73, P = 0.048–0.000). These improvements in symptoms of psychological distress were, however, not significantly different from those observed in the nCPAP and placebo groups (P = 0.374–0.953). Conclusion There is no significant difference between MAD, nCPAP, and an intraoral placebo appliance in their beneficial effects on symptoms of psychological distress. Clinical relevance The improvement in psychological distress symptoms in mild/moderate OSA patients under MAD or nCPAP treatment may be explained by a placebo effect.
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Affiliation(s)
- Ghizlane Aarab
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - Maria Nikolopoulou
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Hans L Hamburger
- Department of Clinical Neurophysiology and Center for Sleep-Wake Disorders, Slotervaart Medical Center, Amsterdam, The Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery of the Academic Medical Centre of the University of Amsterdam and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
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Manoach DS, Pan JQ, Purcell SM, Stickgold R. Reduced Sleep Spindles in Schizophrenia: A Treatable Endophenotype That Links Risk Genes to Impaired Cognition? Biol Psychiatry 2016; 80:599-608. [PMID: 26602589 PMCID: PMC4833702 DOI: 10.1016/j.biopsych.2015.10.003] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/18/2015] [Accepted: 10/05/2015] [Indexed: 11/26/2022]
Abstract
Although schizophrenia (SZ) is defined by waking phenomena, abnormal sleep is a common feature. In particular, there is accumulating evidence of a sleep spindle deficit. Sleep spindles, a defining thalamocortical oscillation of non-rapid eye movement stage 2 sleep, correlate with IQ and are thought to promote long-term potentiation and enhance memory consolidation. We review evidence that reduced spindle activity in SZ is an endophenotype that impairs sleep-dependent memory consolidation, contributes to symptoms, and is a novel treatment biomarker. Studies showing that spindles can be pharmacologically enhanced in SZ and that increasing spindles improves memory in healthy individuals suggest that treating spindle deficits in patients with SZ may improve cognition. Spindle activity is highly heritable, and recent large-scale genome-wide association studies have identified SZ risk genes that may contribute to spindle deficits and illuminate their mechanisms. For example, the SZ risk gene CACNA1I encodes a calcium channel that is abundantly expressed in the thalamic spindle generator and plays a critical role in spindle activity based on a mouse knockout. Future genetic studies of animals and humans can delineate the role of this and other genes in spindles. Such cross-disciplinary research, by forging empirical links in causal chains from risk genes to proteins and cellular functions to endophenotypes, cognitive impairments, symptoms, and diagnosis, has the potential to advance the mechanistic understanding, treatment, and prevention of SZ. This review highlights the importance of deficient sleep-dependent memory consolidation among the cognitive deficits of SZ and implicates reduced sleep spindles as a potentially treatable mechanism.
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Affiliation(s)
- Dara S. Manoach
- Department of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Jen Q. Pan
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Shaun M. Purcell
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA,Division of Psychiatric Genomics, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
| | - Robert Stickgold
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA 02215 Harvard Medical School, Boston, MA, 02215
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Relation between insomnia and stress, anxiety, and depression among Egyptian medical students. MIDDLE EAST CURRENT PSYCHIATRY 2016. [DOI: 10.1097/01.xme.0000484345.57567.a9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Pinto JA, Ribeiro DK, Cavallini AFDS, Duarte C, Freitas GS. Comorbidities Associated with Obstructive Sleep Apnea: a Retrospective Study. Int Arch Otorhinolaryngol 2016; 20:145-50. [PMID: 27096019 PMCID: PMC4835326 DOI: 10.1055/s-0036-1579546] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 12/06/2015] [Indexed: 12/27/2022] Open
Abstract
Introduction Obstructive sleep apnea (OSA) is characterized by partial or complete recurrent upper airway obstruction during sleep. OSA brings many adverse consequences, such as hypertension, obesity, diabetes mellitus, cardiac and encephalic alterations, behavioral, among others, resulting in a significant source of public health care by generating a high financial and social impact. The importance of this assessment proves to be useful, because the incidence of patients with comorbidities associated with AOS has been increasing consistently and presents significant influence in natural disease history. Objective The objective of this study is to assess major comorbidities associated with obstructive sleep apnea (OSA) and prevalence in a group of patients diagnosed clinically and polysomnographically with OSA. Methods This is a retrospective study of 100 charts from patients previously diagnosed with OSA in our service between October 2010 and January 2013. Results We evaluated 100 patients with OSA (84 men and 16 women) with a mean age of 50.05 years (range 19–75 years). The prevalence of comorbidities were hypertension (39%), obesity (34%), depression (19%), gastroesophageal reflux disease (GERD) (18%), diabetes mellitus (15%), hypercholesterolemia (10%), asthma (4%), and no comorbidities (33%). Comorbidities occurred in 56.2% patients diagnosed with mild OSA, 67.6% with moderate OSA, and 70% of patients with severe OSA. Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations.
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Affiliation(s)
- José Antonio Pinto
- Department of Otolaryngology, Nucleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil; Department of Otorhinolaringology, Hospital São Camilo, São Paulo, São Paulo, Brazil
| | - Davi Knoll Ribeiro
- Department of Otolaryngology, Nucleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil; Department of Otorhinolaringology, Hospital São Camilo, São Paulo, São Paulo, Brazil
| | - Andre Freitas da Silva Cavallini
- Department of Otolaryngology, Nucleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil; Department of Otorhinolaringology, Hospital São Camilo, São Paulo, São Paulo, Brazil
| | - Caue Duarte
- Department of Otolaryngology, Nucleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil; Department of Otorhinolaringology, Hospital São Camilo, São Paulo, São Paulo, Brazil
| | - Gabriel Santos Freitas
- Department of Otolaryngology, Nucleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo, São Paulo, SP, Brazil; Department of Otorhinolaringology, Hospital São Camilo, São Paulo, São Paulo, Brazil
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Talih F, Ajaltouni J, Kobeissy F. Restless leg syndrome in hospitalized psychiatric patients in Lebanon: a pilot study. Neuropsychiatr Dis Treat 2016; 12:2581-2586. [PMID: 27785035 PMCID: PMC5067055 DOI: 10.2147/ndt.s116271] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To characterize and describe the prevalence of restless leg syndrome (RLS) in hospitalized psychiatric patients and to investigate the correlations between patient profile and RLS. METHODS Demographic information, psychiatric diagnoses, psychotropic medication use, and history of substance use were collected from hospitalized psychiatric patients at the American University of Beirut Medical Center; Beirut, Lebanon. A validated questionnaire to evaluate RLS symptomatology was also administered to 126 participants who agreed to participate, as well as questionnaires for insomnia, depression, and anxiety symptoms. Statistical analysis was conducted to detect the prevalence of RLS among the participants and to examine correlations with RLS in a hospitalized psychiatric population. RESULTS Out of the 126 participants who completed the survey, RLS was detected in 18% of the participants. Of interest, RLS was also found to be associated with higher depressive symptomatology, suicidal ideation, and working night shifts.
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Affiliation(s)
| | | | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Chu S, McNeill K, Ireland JL, Qurashi I. Facial emotion recognition and sleep in mentally disordered patients: A natural experiment in a high security hospital. Psychiatry Res 2015; 230:725-7. [PMID: 26456893 DOI: 10.1016/j.psychres.2015.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 07/27/2015] [Accepted: 10/01/2015] [Indexed: 11/27/2022]
Abstract
We investigated the relationship between a change in sleep quality and facial emotion recognition accuracy in a group of mentally-disordered inpatients at a secure forensic psychiatric unit. Patients whose sleep improved over time also showed improved facial emotion recognition while patients who showed no sleep improvement showed no change in emotion recognition.
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Affiliation(s)
- Simon Chu
- Ashworth Research Centre, Ashworth Hospital, Mersey Care NHS Trust, Maghull L31 1HW, UK; School of Psychology, University of Central Lancashire, Preston PR1 2HE, UK.
| | - Kimberley McNeill
- Ashworth Research Centre, Ashworth Hospital, Mersey Care NHS Trust, Maghull L31 1HW, UK; School of Psychology, University of Central Lancashire, Preston PR1 2HE, UK
| | - Jane L Ireland
- Ashworth Research Centre, Ashworth Hospital, Mersey Care NHS Trust, Maghull L31 1HW, UK; School of Psychology, University of Central Lancashire, Preston PR1 2HE, UK
| | - Inti Qurashi
- Ashworth Research Centre, Ashworth Hospital, Mersey Care NHS Trust, Maghull L31 1HW, UK
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Kelley-Cook E, Nguyen G, Lee S, Edwards TM, Sanchez-Reilly S. Medication Needs Vary for Terminally Ill Vietnam Era Veterans With and Without a Diagnosis of PTSD. Am J Hosp Palliat Care 2015; 33:625-32. [PMID: 25991568 DOI: 10.1177/1049909115586556] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This retrospective pilot study aims to evaluate the clinical impact of palliative care in the treatment of terminally ill Vietnam Veterans with a history of posttraumatic stress disorder (PTSD) versus those without PTSD, as it pertains to medications for symptom control at the end of life (EOL). Active prescriptions for benzodiazepines, hypnotics, antidepressants, and antipsychotic medications at the EOL were recorded. During EOL care, 28 (72%) participants with PTSD used these medications versus 55 (40%) of the non-PTSD participants (P = .0005). There was significant correlation between a lifetime diagnosis of PTSD with antidepressant use (P = .0002) and hypnotics (P = .0085) during EOL care but not with benzodiazepines or antipsychotics. The higher utilization of certain medication classes among participants with PTSD may indicate that PTSD treatment should continue at the EOL to improve care.
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Affiliation(s)
- Esther Kelley-Cook
- The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - George Nguyen
- Baylor Scott & White Health Care System, Temple, TX, USA
| | - Shuko Lee
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | | | - Sandra Sanchez-Reilly
- The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA South Texas Veterans Health Care System, San Antonio, TX, USA
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Azad MC, Fraser K, Rumana N, Abdullah AF, Shahana N, Hanly PJ, Turin TC. Sleep disturbances among medical students: a global perspective. J Clin Sleep Med 2015; 11:69-74. [PMID: 25515274 DOI: 10.5664/jcsm.4370] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 09/20/2014] [Indexed: 01/31/2023]
Abstract
Medical students carry a large academic load which could potentially contribute to poor sleep quality above and beyond that already experienced by modern society. In this global literature review of the medical students' sleep experience, we find that poor sleep is not only common among medical students, but its prevalence is also higher than in non-medical students and the general population. Several factors including medical students' attitudes, knowledge of sleep, and academic demands have been identified as causative factors, but other potential mechanisms are incompletely understood. A better understanding about the etiology of sleep problems in medical trainees is essential if we hope to improve the overall quality of medical students' lives, including their academic performance. Sleep self-awareness and general knowledge appear insufficient in many studied cohorts, so increasing education for students might be one beneficial intervention. We conclude that there is ample evidence for a high prevalence of the problem, and research in this area should now expand towards initiatives to improve general sleep education for medical students, identify students at risk, and target them with programs to improve sleep.
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Affiliation(s)
- Muhammad Chanchal Azad
- Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kristin Fraser
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nahid Rumana
- Sleep Center, Foothills Medical Center, University of Calgary, Alberta, Canada
| | - Ahmad Faris Abdullah
- Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Nahid Shahana
- Department of Medical Education, Bangladesh Medical College and Hospital, Dhaka, Bangladesh
| | - Patrick J Hanly
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Sleep Center, Foothills Medical Center, University of Calgary, Alberta, Canada
| | - Tanvir Chowdhury Turin
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Kotan Z, Bican A, Kotan VO, Bora İ, Yalvac HD, Ozkaya G, Akkaya C. Sleep measurements in women with dysthymic disorder and insomnia. Sleep Biol Rhythms 2014. [DOI: 10.1111/sbr.12092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Zeynep Kotan
- Department of Psychiatry; Abdurrahman Yurtaslan Ankara Onkoloji Training and Research Hospital; Ankara Turkey
| | - Aylin Bican
- Department of Neurology Medicine; Uludag University, Medical Faculty; Bursa Turkey
| | - Vahap Ozan Kotan
- Department of Psychiatry; Ankara Numune Training and Research Hospital; Ankara Turkey
| | - İbrahim Bora
- Department of Neurology Medicine; Uludag University, Medical Faculty; Bursa Turkey
| | - Hayriye Dilek Yalvac
- Department of Psychiatry; Abdurrahman Yurtaslan Ankara Onkoloji Training and Research Hospital; Ankara Turkey
| | - Güven Ozkaya
- Department of Biostatistics; Uludag University, Medical Faculty; Bursa Turkey
| | - Cengiz Akkaya
- Department of Psychiatry; Uludag University, Medical Faculty; Bursa Turkey
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Manoach DS, Demanuele C, Wamsley EJ, Vangel M, Montrose DM, Miewald J, Kupfer D, Buysse D, Stickgold R, Keshavan MS. Sleep spindle deficits in antipsychotic-naïve early course schizophrenia and in non-psychotic first-degree relatives. Front Hum Neurosci 2014; 8:762. [PMID: 25339881 PMCID: PMC4188028 DOI: 10.3389/fnhum.2014.00762] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 09/09/2014] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Chronic medicated patients with schizophrenia have marked reductions in sleep spindle activity and a correlated deficit in sleep-dependent memory consolidation. Using archival data, we investigated whether antipsychotic-naïve early course patients with schizophrenia and young non-psychotic first-degree relatives of patients with schizophrenia also show reduced sleep spindle activity and whether spindle activity correlates with cognitive function and symptoms. METHOD Sleep spindles during Stage 2 sleep were compared in antipsychotic-naïve adults newly diagnosed with psychosis, young non-psychotic first-degree relatives of schizophrenia patients and two samples of healthy controls matched to the patients and relatives. The relations of spindle parameters with cognitive measures and symptom ratings were examined. RESULTS Early course schizophrenia patients showed significantly reduced spindle activity relative to healthy controls and to early course patients with other psychotic disorders. Relatives of schizophrenia patients also showed reduced spindle activity compared with controls. Reduced spindle activity correlated with measures of executive function in early course patients, positive symptoms in schizophrenia and IQ estimates across groups. CONCLUSIONS Like chronic medicated schizophrenia patients, antipsychotic-naïve early course schizophrenia patients and young non-psychotic relatives of individuals with schizophrenia have reduced sleep spindle activity. These findings indicate that the spindle deficit is not an antipsychotic side-effect or a general feature of psychosis. Instead, the spindle deficit may predate the onset of schizophrenia, persist throughout its course and be an endophenotype that contributes to cognitive dysfunction.
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Affiliation(s)
- Dara S. Manoach
- Department of Psychiatry, Massachusetts General HospitalCharlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical ImagingCharlestown, MA, USA
- Harvard Medical SchoolBoston, MA, USA
| | - Charmaine Demanuele
- Department of Psychiatry, Massachusetts General HospitalCharlestown, MA, USA
- Athinoula A. Martinos Center for Biomedical ImagingCharlestown, MA, USA
- Harvard Medical SchoolBoston, MA, USA
| | - Erin J. Wamsley
- Harvard Medical SchoolBoston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical CenterBoston, MA, USA
| | - Mark Vangel
- Athinoula A. Martinos Center for Biomedical ImagingCharlestown, MA, USA
- Harvard Medical SchoolBoston, MA, USA
| | - Debra M. Montrose
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
| | - Jean Miewald
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
| | - David Kupfer
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
| | - Daniel Buysse
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
| | - Robert Stickgold
- Harvard Medical SchoolBoston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical CenterBoston, MA, USA
| | - Matcheri S. Keshavan
- Harvard Medical SchoolBoston, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical CenterBoston, MA, USA
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of MedicinePittsburgh, PA, USA
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Jalewa J, Wong-Lin K, McGinnity TM, Prasad G, Hölscher C. Increased number of orexin/hypocretin neurons with high and prolonged external stress-induced depression. Behav Brain Res 2014; 272:196-204. [DOI: 10.1016/j.bbr.2014.05.030] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 05/13/2014] [Accepted: 05/16/2014] [Indexed: 01/14/2023]
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