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Freeman JR, Saint-Maurice PF, Watts EL, Moore SC, Shams-White MM, Wolff-Hughes DL, Russ DE, Almeida JS, Caporaso NE, Hong HG, Loftfield E, Matthews CE. Actigraphy-derived measures of sleep and risk of prostate cancer in the UK Biobank. J Natl Cancer Inst 2024; 116:434-444. [PMID: 38013591 PMCID: PMC10919343 DOI: 10.1093/jnci/djad210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/02/2023] [Accepted: 10/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Studies of sleep and prostate cancer are almost entirely based on self-report, with limited research using actigraphy. Our goal was to evaluate actigraphy-measured sleep and prostate cancer and to expand on findings from prior studies of self-reported sleep. METHODS We prospectively examined 34 260 men without a history of prostate cancer in the UK Biobank. Sleep characteristics were measured over 7 days using actigraphy. We calculated sleep duration, onset, midpoint, wake-up time, social jetlag (difference in weekend-weekday sleep midpoints), sleep efficiency (percentage of time spent asleep between onset and wake-up time), and wakefulness after sleep onset. Cox proportional hazards models were used to estimate covariate-adjusted hazards ratios (HRs) and 95% confidence intervals (CIs). RESULTS Over 7.6 years, 1152 men were diagnosed with prostate cancer. Sleep duration was not associated with prostate cancer risk. Sleep midpoint earlier than 4:00 am was not associated with prostate cancer risk, though sleep midpoint of 5:00 am or later was suggestively associated with lower prostate cancer risk but had limited precision (earlier than 4:00 am vs 4:00-4:59 am HR = 1.00, 95% CI = 0.87 to 1.16; 5:00 am or later vs 4:00-4:59 am HR = 0.79, 95% CI = 0.57 to 1.10). Social jetlag was not associated with greater prostate cancer risk (1 to <2 hours vs <1 hour HR = 1.06, 95% CI = 0.89 to 1.25; ≥2 hours vs <1 hour HR = 0.90, 95% CI = 0.65 to 1.26). Compared with men who averaged less than 30 minutes of wakefulness after sleep onset per day, men with 60 minutes or more had a higher risk of prostate cancer (HR = 1.20, 95% CI = 1.00 to 1.43). CONCLUSIONS Of the sleep characteristics studied, higher wakefulness after sleep onset-a measure of poor sleep quality-was associated with greater prostate cancer risk. Replication of our findings between wakefulness after sleep onset and prostate cancer are warranted.
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Affiliation(s)
- Joshua R Freeman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Pedro F Saint-Maurice
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eleanor L Watts
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Steven C Moore
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marissa M Shams-White
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Dana L Wolff-Hughes
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Daniel E Russ
- Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jonas S Almeida
- Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hyokyoung G Hong
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Erikka Loftfield
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Feder MA, Baroni A. Just Let Me Sleep in: Identifying and Treating Delayed Sleep Phase Disorder in Adolescents. Psychiatr Clin North Am 2024; 47:163-178. [PMID: 38302205 DOI: 10.1016/j.psc.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Individuals with delayed sleep phase disorder (DSPD) are unable to naturally fall asleep and awake at conventional times; for this reason, DSPD is often mistaken for insomnia. However, unlike many patients with insomnia, those with DSPD struggle to get up at appropriate times. DSPD is associated with school refusal, academic difficulties, and lower employment rate. DSPD in youth has prevalence as high as 16%, and is often comorbid with other psychiatric disorders. Treatments include appropriate light exposure during the day, melatonin use, developing an evening routine that minimizes arousal-increasing activities, and gradually shifting sleep-wake times toward more functional ones.
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Affiliation(s)
- Michael A Feder
- Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, NYC H+H/Bellevue, New York, NY, USA; Child Study Center, One Park Avenue, 7th Floor, New York, NY 10016, USA
| | - Argelinda Baroni
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, One Park Avenue, 7th Floor, New York, NY 10016, USA.
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3
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van Andel E, Bijlenga D, Vogel SWN, Beekman ATF, Kooij JJS. Cardiovascular risk in adults with Delayed Sleep Phase Syndrome (DSPS) and Attention-Deficit/Hyperactivity Disorder (ADHD). Chronobiol Int 2023; 40:1566-1573. [PMID: 38017699 DOI: 10.1080/07420528.2023.2287058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 11/19/2023] [Indexed: 11/30/2023]
Abstract
TRIAL REGISTRATION FASE, https://www.trialregister.nl/, #NTR3831.
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Affiliation(s)
- Emma van Andel
- PsyQ, Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Denise Bijlenga
- PsyQ, Expertise Center Adult ADHD, The Hague, The Netherlands
- Sleep-Wake Center SEIN, Heemstede, The Netherlands
- Neurology, Leiden UMC, Leiden, The Netherlands
| | - Suzan W N Vogel
- PsyQ, Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Aartjan T F Beekman
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - J J Sandra Kooij
- PsyQ, Expertise Center Adult ADHD, The Hague, The Netherlands
- Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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4
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von Gall C, Holub L, Pfeffer M, Eickhoff S. Chronotype-Dependent Sleep Loss Is Associated with a Lower Amplitude in Circadian Rhythm and a Higher Fragmentation of REM Sleep in Young Healthy Adults. Brain Sci 2023; 13:1482. [PMID: 37891848 PMCID: PMC10605513 DOI: 10.3390/brainsci13101482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
In modern society, the time and duration of sleep on workdays are primarily determined by external factors, e.g., the alarm clock. This can lead to a misalignment of the intrinsically determined sleep timing, which is dependent on the individual chronotype, resulting in reduced sleep quality. Although this is highly relevant given the high incidence of sleep disorders, little is known about the effect of this misalignment on sleep architecture. Using Fitbit trackers and questionnaire surveys, our study aims to elucidate sleep timing, sleep architecture, and subjective sleep quality in young healthy adults (n = 59) under real-life conditions (average of 82.4 ± 9.7 days). Correlations between variables were calculated to identify the direction of relationships. On workdays, the midpoint of sleep was earlier, the sleep duration was shorter, and tiredness upon waking was higher than on free days. A higher discrepancy between sleep duration on workdays and free days was associated with a lower stability of the circadian rhythm of REM sleep and also with a higher fragmentation of REM sleep. Similarly, a higher tiredness upon waking on free days, thus under intrinsically determined sleep timing conditions, was associated with a lower proportion and a higher fragmentation of REM sleep. This suggests that the misalignment between extrinsically and intrinsically determined sleep timing affects the architecture of sleep stages, particularly REM sleep, which is closely connected to sleep quality.
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Affiliation(s)
- Charlotte von Gall
- Institute of Anatomy II, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (L.H.); (M.P.)
| | - Leon Holub
- Institute of Anatomy II, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (L.H.); (M.P.)
| | - Martina Pfeffer
- Institute of Anatomy II, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (L.H.); (M.P.)
| | - Simon Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany;
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, 52425 Jülich, Germany
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5
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Arab A, Karimi E, Garaulet M, Scheer FAJL. Social jetlag and dietary intake: A systematic review. Sleep Med Rev 2023; 71:101820. [PMID: 37544031 DOI: 10.1016/j.smrv.2023.101820] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 08/08/2023]
Abstract
The objective of the current systematic review was to critically review the available evidence regarding the link between social jetlag and diet among the general population using observational studies. Electronic databases, including PubMed, Scopus, and ISI Web of Sciences were searched systematically. We reviewed 348 references, of which 17 studies met inclusion criteria with a total sample size of 28,905. Qualitative analysis indicated a negative association between social jetlag and adherence to healthy eating habits, including a negative association with empirically-derived healthy dietary patterns, Japanese dietary patterns, Baltic Sea dietary patterns, and the Mediterranean diet, as well as a positive association with Meat and Starchy dietary pattern. On the other hand, the findings on the link of social jetlag with food groups and nutrients were mixed and controversial, except for a more consistent increase in sugar-sweetened beverages, total fat, and saturated fat intake. Our results indicate a possible link between social jetlag and dietary intake. Research suggests that individuals experiencing greater social jetlag exhibit reduced adherence to a healthy eating pattern. However, it is important to note that the reported association lacks consensus, emphasizing the need for additional longitudinal studies to gain further insights into this matter."
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Affiliation(s)
- Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Elham Karimi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran; Research Development Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Marta Garaulet
- Department of Physiology, Regional Campus of International Excellence, University of Murcia, Murcia, Spain; Biomedical Research Institute of Murcia, IMIB-Arrixaca-UMU, University Clinical Hospital, Murcia, Spain.
| | - Frank A J L Scheer
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.
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Yüksel A, Özakgül A. Evaluation of Nursing Students' Sleep Patterns, Social Jet Lag, and Quality of Life*,*. FLORENCE NIGHTINGALE JOURNAL OF NURSING 2023; 31:97-104. [PMID: 37404212 PMCID: PMC10440964 DOI: 10.5152/fnjn.2023.22176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/20/2023] [Indexed: 07/06/2023]
Abstract
AIM The aim of this study is to evaluate the relationship between the chronotypes of nursing students, social jet lag, and quality of life. METHOD This study was planned and performed in a descriptive, method. Research data were collected in the 2019-2020 fall semester. The research population consisted of nursing students working at the nursing departments of state and private universities in Istanbul. The study sample included 1152 nursing students who agreed to participate in the study after obtaining informed consent. Data were collected using the "Student Information Form," "Morningness- Eveningness Scale," and "Short Form of the Turkish WHO Quality of Life Scale." RESULTS Of the nursing students, 81.2% (n = 935) were women, 26.5% (n = 305) were first-year students, 86.5% (n = 997) were non-smoker, and 92.4% (n = 1065) not consumed alcohol. Most of the nursing students in this study were intermediate chronotypes (80.2%). Students' social-jet lag mean value was 1.36±0.73 hours (min:0-max:4.8). Multiple regression analysis showed that an increase in social jetlag decreases the average scores of the physical and environmental subdimension and an increase in the morning chronotype increases the average scores of the physical, mental, and social subdimension. CONCLUSION High social jet lag reduced the quality of life and a morning chronotype improved the quality of life.
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Affiliation(s)
- Azzet Yüksel
- Department of Fundamentals of Nursing, İstanbul University—Cerrahpaşa, Institute of Graduate Studies, Fundamentals of Nursing Thesis Master’s Program, Istanbul, Turkey
| | - Aylin Özakgül
- Department of Fundamentals of Nursing, İstanbul University—Cerrahpaşa, Florence Nightingale Faculty of Nursing, İstanbul, Turkey
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Alqaderi H, Abdullah A, Finkelman M, Abufarha M, Devarajan S, Abubaker J, Ramesh N, Tavares M, Al-Mulla F, Bin-Hasan S. The relationship between sleep and salivary and serum inflammatory biomarkers in adolescents. Front Med (Lausanne) 2023; 10:1175483. [PMID: 37305117 PMCID: PMC10250646 DOI: 10.3389/fmed.2023.1175483] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives Poor sleep behavior can trigger an inflammatory response and contribute to the development of inflammatory diseases. Cytokines can act as indicators of inflammation and may precede the onset of inflammatory diseases. This study aimed to determine the association between sleep timing parameters (bedtime, sleep duration, sleep debt, and social jetlag) and the levels of nine serum and salivary inflammatory and metabolic biomarkers. Methods Data were collected from 352 adolescents aged 16-19 years enrolled in Kuwait's public high schools. The levels of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), vascular endothelial growth factor (VEGF), monocyte chemoattractant protein-1 (MCP-1), adiponectin, leptin, and insulin were measured from saliva and serum samples. We conducted mixed-effect multiple linear regression modeling to account for the school variable as a random effect to assess the relationship between the sleep variables and salivary and serum biomarkers. Mediation analysis was conducted to check if BMI was a mediator between bedtime and the biomarkers. Results There was a statistically significant elevation in serum IL-6 level associated with later bedtime (0.05 pg./mL, p = 0.01). Adolescents with severe sleep debt of ≥2 h had an increase in salivary IL-6 biomarker levels (0.38 pg./mL, p = 0.01) compared to those who had sleep debt of <1 h. Adolescents with sleep debt of ≥2 h had significantly higher levels of serum CRP (0.61 μg/mL, p = 0.02) than those without sleep debt. Additionally, we found that the inflammatory biomarkers (CRP, IL-6, IL-8, IL-10, VEGF, and MCP-1) and metabolic biomarkers (adiponectin, leptin, and insulin) had more statistically significant associations with the bedtime variables than with sleep duration variables. CRP, IL-6, and IL-8 were associated with sleep debt, and IL-6, VEGF, adiponectin, and leptin levels were associated with social jetlag. BMIz was a full mediator in the relationship between late bedtime and increased serum levels of CRP, IL-6, and insulin. Conclusion Adolescents who go to bed at or later than midnight had dysregulated levels of salivary and serum inflammatory biomarkers, suggesting that disrupted circadian rhythm can trigger higher levels of systemic inflammation and potentially exacerbate chronic inflammation and the risk of metabolic diseases.
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Affiliation(s)
- Hend Alqaderi
- Dasman Diabetes Institute, Dasman, Kuwait
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, United States
| | - Abeer Abdullah
- Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Matthew Finkelman
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, United States
| | | | | | | | - Nikitha Ramesh
- Boston University School of Public Health, Boston, MA, United States
| | - Mary Tavares
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, United States
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8
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Cho SS, Chung BH, Lee HE, Kang MY. Association between social jetlag and chronic kidney disease among the Korean working population. Sci Rep 2023; 13:5998. [PMID: 37045895 PMCID: PMC10097717 DOI: 10.1038/s41598-023-33130-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/07/2023] [Indexed: 04/14/2023] Open
Abstract
Social jetlag refers to the discrepancy between social time and the body's internal rhythm, which can lead to unfavorable health outcomes. However, no study has directly explored the relation between social jetlag and chronic kidney disease (CKD). This study aims to investigate the relationship between social jetlag and CKD in a representative population of South Korea. This study included 8259 currently economically active Korean population in the Korea National Health and Nutrition Examination Survey. Social jetlag was calculated as the difference between the midpoint of sleep time on weekdays and free days. The estimated glomerular filtration rate (eGFR) was calculated the by using the serum creatinine value according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Participants with an eGFR less than 60 ml/min/1.73 m2 were defined as CKD cases. The estimated glomerular filtration rate decreased as social jetlag increased. Multiple logistic regression analysis showed that the adjusted odds ratio (95% confidence interval) of CKD for 1-2 h of social jetlag was 0.926 (0.660-1.299), while the odds ratio for more than 2 h was 2.042 (1.328-3.139) when less than 1 h was used as reference. This study found that social jetlag and risk of CKD were significantly related in the Korean working population.
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Affiliation(s)
- Seong-Sik Cho
- Department of Occupational and Environmental Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Byung Ha Chung
- Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hye-Eun Lee
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Relationship of sleep regularity with device-based sedentary behavior time and physical activity time in working adults. Sleep Health 2023; 9:86-92. [PMID: 36456449 DOI: 10.1016/j.sleh.2022.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/19/2022] [Accepted: 10/05/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to investigate the association of sleep regularity with time spent in sedentary behavior (SB) and physical activity (PA) in adults with full-time jobs. METHODS This was a cross-sectional study. Adults aged 21-64 years with full-time jobs were recruited between August 2019 and December 2020 in Taiwan. The time spent in SB/PA was assessed using triaxial accelerometers (Actigraph wGT3x-BT), and PA was further classified into light-intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA). Each participant recorded their daily sleep patterns and work hours in a log, which was further used to measure sleep variability and social jet lag. Linear regression was applied to examine the associations of indicators of sleep regularity with SB time and PA time. RESULTS A total of 192 adults (men = 28.13%; mean age = 38.56 ± 8.89 years) were included in this study. After adjusting for potential covariates, greater social jet lag was related to more SB time (unstandardized coefficient [B] = 14.39, P = .005) and less LPA time (B = -0.02, P = .010). No evidence of an association between other indicators of sleep regularity with SB/PA time was found. CONCLUSIONS These results provide evidence for a relationship between sleep regularity and SB/PA time in working adults. Maintaining regular sleep, especially a small social jet lag, was suggested to promote physical activity and avoid a sedentary lifestyle. Future research is recommended to examine work-related influences on the associations and bidirectional relationship between sleep regularity and SB/PA.
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10
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Zhang C, Qin G. Irregular sleep and cardiometabolic risk: Clinical evidence and mechanisms. Front Cardiovasc Med 2023; 10:1059257. [PMID: 36873401 PMCID: PMC9981680 DOI: 10.3389/fcvm.2023.1059257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
Sleep regularity is an essential part of the multidimensional sleep health framework. The phenomenon of irregular sleep patterns is widespread in contemporary lifestyles. This review synthesizes clinical evidence to summarize the measures of sleep regularity and discusses the role of different sleep regularity indicators in developing cardiometabolic diseases (coronary heart disease, hypertension, obesity, and diabetes). Existing literature has proposed several measurements to assess sleep regularity, mainly including the standard deviation (SD) of sleep duration and timing, sleep regularity index (SRI), interdaily stability (IS), and social jetlag (SJL). Evidence on associations between sleep variability and cardiometabolic diseases varies depending on the measure used to characterize variability in sleep. Current studies have identified a robust association between SRI and cardiometabolic diseases. In comparison, the association between other metrics of sleep regularity and cardiometabolic diseases was mixed. Meanwhile, the associations of sleep variability with cardiometabolic diseases differ across the population. SD of sleep characteristics or IS may be more consistently associated with HbA1c in patients with diabetes compared with the general population. The association between SJL and hypertension for patients with diabetes was more accordant than in the general population. Interestingly, the age-stratified association between SJL and metabolic factors was observed in the present studies. Furthermore, the relevant literature was reviewed to generalize the potential mechanisms through which irregular sleep increases cardiometabolic risk, including circadian dysfunction, inflammation, autonomic dysfunction, hypothalamic-pituitary-adrenal (HPA) axis disorder, and gut dysbiosis. Health-related practitioners should give more attention to the role of sleep regularity on human cardiometabolic in the future.
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Affiliation(s)
- Chengjie Zhang
- First School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Gang Qin
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, China
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11
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Galinde AAS, Al-Mughales F, Oster H, Heyde I. Different levels of circadian (de)synchrony -- where does it hurt? F1000Res 2022; 11:1323. [PMID: 37125019 PMCID: PMC10130703 DOI: 10.12688/f1000research.127234.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
A network of cellular timers ensures the maintenance of homeostasis by temporal modulation of physiological processes across the day. These so-called circadian clocks are synchronized to geophysical time by external time cues (or zeitgebers). In modern societies, natural environmental cycles are disrupted by artificial lighting, around-the-clock availability of food or shift work. Such contradictory zeitgeber input promotes chronodisruption, i.e., the perturbation of internal circadian rhythms, resulting in adverse health outcomes. While this phenomenon is well described, it is still poorly understood at which level of organization perturbed rhythms impact on health and wellbeing. In this review, we discuss different levels of chronodisruption and what is known about their health effects. We summarize the results of disrupted phase coherence between external and internal time vs. misalignment of tissue clocks amongst each other, i.e., internal desynchrony. Last, phase incoherence can also occur at the tissue level itself. Here, alterations in phase coordination can emerge between cellular clocks of the same tissue or between different clock genes within the single cell. A better understanding of the mechanisms of circadian misalignment and its effects on physiology will help to find effective tools to prevent or treat disorders arising from modern-day chronodisruptive environments.
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Affiliation(s)
- Ankita AS. Galinde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Faheem Al-Mughales
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
- Biochemistry Department, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Henrik Oster
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Isabel Heyde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
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Jin CX, Sutherland K, Gislason T, Thorarinsdottir EH, Bittencourt L, Tufik S, Singh B, McArdle N, Cistulli P, Bin YS. Influence of social jetlag on daytime sleepiness in obstructive sleep apnea. J Sleep Res 2022; 32:e13772. [PMID: 36345137 DOI: 10.1111/jsr.13772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/14/2022] [Accepted: 10/05/2022] [Indexed: 11/11/2022]
Abstract
Social jetlag is the discrepancy between socially determined sleep timing on workdays and biologically determined sleep timing on days free of social obligation. Poor circadian timing of sleep may worsen sleep quality and increase daytime sleepiness in obstructive sleep apnea (OSA). We analysed de-identified data from 2,061 participants (75.2% male, mean [SD] age 48.6 [13.4] years) who completed Sleep Apnea Global Interdisciplinary Consortium (SAGIC) research questionnaires and underwent polysomnography at 11 international sleep clinic sites. Social jetlag was calculated as the absolute difference in the midpoints of sleep between weekdays and weekends. Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Linear regression analyses were performed to estimate the association between social jetlag and daytime sleepiness, with consideration of age, sex, body mass index, ethnicity, insomnia, alcohol consumption, and habitual sleep duration as confounders. Of the participants, 61.5% had <1 h of social jetlag, 27.5% had 1 to <2 h, and 11.1% had ≥2 h. Compared to those with <1 h of social jetlag, those with ≥2 h of social jetlag had 2.07 points higher ESS (95% confidence interval [CI] 0.77-3.38, p = 0.002), and those with 1 to <2 h of social jetlag had 0.80 points higher ESS (95% CI 0.04-1.55, p = 0.04) after adjustment for potential confounding. Interaction with OSA severity was observed; social jetlag appeared to have the greatest effect on daytime sleepiness in mild OSA. As social jetlag exacerbates daytime sleepiness in OSA, improving sleep timing may be a simple but novel therapeutic target for reducing the impact of OSA.
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Affiliation(s)
- Charley Ximing Jin
- Sleep Research Group, Charles Perkins Centre University of Sydney Camperdown New South Wales Australia
| | - Kate Sutherland
- Sleep Research Group, Charles Perkins Centre University of Sydney Camperdown New South Wales Australia
- Department of Respiratory and Sleep Medicine Royal North Shore Hospital Camperdown New South Wales Australia
| | - Thorarinn Gislason
- Faculty of Medicine University of Iceland Reykjavik Iceland
- Department of Sleep Landspitali University Hospital Reykjavik Iceland
| | - Elin Helga Thorarinsdottir
- Faculty of Medicine University of Iceland Reykjavik Iceland
- Primary Health Care of the Capital Area Reykjavik Iceland
| | | | - Sergio Tufik
- Universidade Federal de São Paulo São Paulo Brazil
| | - Bhajan Singh
- Department of Pulmonary Physiology and Sleep Medicine West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital Nedlands Western Australia Australia
- Faculty of Human Sciences University of Western Australia Crawley Western Australia Australia
| | - Nigel McArdle
- Department of Pulmonary Physiology and Sleep Medicine West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital Nedlands Western Australia Australia
- Faculty of Human Sciences University of Western Australia Crawley Western Australia Australia
| | - Peter Cistulli
- Sleep Research Group, Charles Perkins Centre University of Sydney Camperdown New South Wales Australia
- Department of Respiratory and Sleep Medicine Royal North Shore Hospital Camperdown New South Wales Australia
| | - Yu Sun Bin
- Sleep Research Group, Charles Perkins Centre University of Sydney Camperdown New South Wales Australia
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13
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Troxel WM, Rodriguez A, Seelam R, Dong L, Perez LG, Tucker JS, Siconolfi D, D'Amico EJ. A latent class approach to understanding longitudinal sleep health and the association with alcohol and cannabis use during late adolescence and emerging adulthood. Addict Behav 2022; 134:107417. [PMID: 35853405 PMCID: PMC10431952 DOI: 10.1016/j.addbeh.2022.107417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/14/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Sleep is a multi-dimensional health behavior associated with elevated risk of substance use. This is the first study to utilize a latent class approach to characterize sleep health across multiple dimensions and across time from late adolescence to emerging adulthood, and to examine associations with alcohol and cannabis use trajectories. METHODS The sample included 2995 emerging adults (mean ages = 18 to 24 years across six waves of data collection; 54% female) who provided data on sleep dimensions (quality, duration, and social jetlag) and frequency and consequences of alcohol and cannabis use. Longitudinal latent class analysis (LLCA) models characterized participants according to the three sleep dimensions. Latent growth models examined trajectories of frequency and consequences of alcohol or cannabis use over time among emergent sleep classes, with and without controlling for covariates. RESULTS LLCA models identified four sleep classes: good sleepers (n = 451; 15.2%); untroubled poor sleepers (n = 1024; 34.2%); troubled, moderately good sleepers (n = 1056; 35.3%); and suboptimal sleepers (n = 460; 15.4%). Good sleepers reported significantly lower levels of alcohol or cannabis use and consequences, and less of an increase in alcohol consequences as compared to suboptimal sleepers. CONCLUSIONS Persistent poor sleep health was associated with higher levels of alcohol and cannabis use and consequences, and greater increases in alcohol-related consequences during the transition from late adolescence to emerging adulthood. Findings have important clinical implications, highlighting that addressing multi-dimensional sleep health may be an important, novel target of intervention to reduce substance use frequency and consequences.
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Affiliation(s)
- Wendy M Troxel
- RAND Corporation, Behavioral and Policy Sciences, 4501 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Anthony Rodriguez
- RAND Corporation, Behavioral and Policy Sciences, 20 Park Plaza #920, Boston, MA 02116, USA.
| | - Rachana Seelam
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Lu Dong
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Lilian G Perez
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Joan S Tucker
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Daniel Siconolfi
- RAND Corporation, Behavioral and Policy Sciences, 4501 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Elizabeth J D'Amico
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
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14
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Ikeda H, Kubo T, Izawa S, Nakamura-Taira N, Yoshikawa T, Akamatsu R. The Joint Association of Daily Rest Periods and Sleep Duration with Worker Health and Productivity: A Cross-Sectional Web Survey of Japanese Daytime Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11143. [PMID: 36078859 PMCID: PMC9518178 DOI: 10.3390/ijerph191711143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/02/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
A daily rest period (DRP) is a daily inter-work interval that contains sleep opportunity. This study investigates the joint association of DRP and sleep duration with worker health and productivity. A total of 13,306 Japanese daytime workers participated in this web-based cross-sectional survey. Participants reported on their DRPs and sleep duration; moreover, sleep difficulties, mental health, and presenteeism were assessed by the standardized questionnaires. The participants were divided into 10 groups based on their DRPs and sleep duration. Logistic regression analyses showed that the combination of quick return (QR: DRP of <11 h) and short sleep duration (<6 h) was found to be significantly associated with sleep difficulties (odds ratio [OR] = 4.45, 95% confidence interval [CI] = 2.83-7.01), poor mental health (OR = 3.04, 95% CI = 1.79-5.15), and presenteeism (OR = 2.35, 95% CI = 1.47-3.77) compared with the reference group (the combination of adequate DRP [15 h] and a normal sleep duration [≥6 h]). The combination of QR and normal sleep duration or adequate DRP and short sleep duration was significantly associated with high ORs for the outcomes. QR, short sleep duration, or both negatively affect worker health and productivity.
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Affiliation(s)
- Hiroki Ikeda
- National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Kawasaki 214-8585, Japan
| | - Tomohide Kubo
- National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Kawasaki 214-8585, Japan
| | - Shuhei Izawa
- National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Kawasaki 214-8585, Japan
| | - Nanako Nakamura-Taira
- Department of Psychology, Faculty of Letters, Chuo University, Tokyo 192-0393, Japan
| | - Toru Yoshikawa
- National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Kawasaki 214-8585, Japan
| | - Rie Akamatsu
- Natural Science Division, Faculty of Core Research, Ochanomizu University, Tokyo 112-8610, Japan
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15
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Ikeda Y, Morita E, Muroi K, Arai Y, Ikeda T, Takahashi T, Shiraki N, Doki S, Hori D, Oi Y, Sasahara S, Ishihara A, Matsumoto S, Yanagisawa M, Satoh M, Matsuzaki I. Relationships between sleep efficiency and lifestyle evaluated by objective sleep assessment: SLeep Epidemiology Project at University of Tsukuba. NAGOYA JOURNAL OF MEDICAL SCIENCE 2022; 84:554-569. [PMID: 36237889 PMCID: PMC9529619 DOI: 10.18999/nagjms.84.3.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/26/2021] [Indexed: 11/30/2022]
Abstract
Objectively measured sleep efficiency has recently been shown to be associated with health problems. Although several factors have previously been reported to be associated with sleep efficiency, most of these studies were conducted on older or younger adults, and the factors associated with sleep efficiency in healthy workers remain unknown. The aim of this study was to investigate the relationship between sleep efficiency and lifestyle factors using sleep measurement data recorded by an activity meter worn by workers. In total, 693 workers (male, 43.6%; mean age, 42.7 ± 11.3 years) were recruited from five offices in 2017. Sleep was measured over the period of 1 week by actigraphy. Workers' attributes, lifestyle habits, and occupational stress were identified using a questionnaire, and the association of sleep efficiency with lifestyle, occupational stress, and attributes was explored by logistic regression analysis. A logistic regression analysis using attributes and occupational stress as adjustment variables revealed that "longer sleeping hours on weekends than on weekdays" [odds ratios (OR), 0.66; 95% confidence interval (CI), 0.47-0.94], "water ingestion at bedtime" [OR, 2.09; 95% CI, 1.28-3.41], and "smartphone use at bedtime" [OR, 1.90; 95% CI, 1.28-2.83] were associated with decreased sleep efficiency. This study found that lifestyle habits were associated with sleep efficiency among workers. It is necessary to verify whether intervention in these lifestyle habits would contribute to the improvement of sleep efficiency in future studies.
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Affiliation(s)
- Yu Ikeda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Emi Morita
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,Forestry and Forest Products Research Institute, Forest Research and Management Organization, Tsukuba, Japan
| | - Kei Muroi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yo Arai
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tomohiko Ikeda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tsukasa Takahashi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Nagisa Shiraki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Shotaro Doki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Daisuke Hori
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuichi Oi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shin‐ichiro Sasahara
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Asuka Ishihara
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,PhD Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, Tsukuba, Japan
| | - Sumire Matsumoto
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,PhD Program in Human Biology, School of Integrative and Global Majors, University of Tsukuba, Tsukuba, Japan
| | - Masashi Yanagisawa
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Makoto Satoh
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
| | - Ichiyo Matsuzaki
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
,Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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16
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Laidi S, Haraj NE, El Aziz S, Chadli A. Have we forgotten the non-COVID-19 diabetic patients? Impact of lockdown on daily life, sleep and mental health: cross-sectional study in Moroccan diabetic patients. Pan Afr Med J 2022; 42:134. [PMID: 36060852 PMCID: PMC9429985 DOI: 10.11604/pamj.2022.42.134.30475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 05/28/2022] [Indexed: 11/24/2022] Open
Abstract
The main objective of this work is to describe the impact of lockdown on daily life, sleep and the mental health of Moroccan diabetics patients. The secondary objective is to study the factors affecting compliance with lockdown and deterioration of sleep in diabetic patients while lockdown. It´s a cross-sectional study including diabetic patients followed up at the Endocrinology department of Casablanca. Patients answered a questionnaire about Socio-demographic characteristics, Sleep-related characteristics and predominant activities during the lockdown. The psychological impact was assessed by the score of Anxiety and Depression Assessment Scale (HDAS). Statistical analysis was carried out using SPSS 20 software. Bedtime was shifted by 53 minutes during the lockdown. Waking time was also 1 hour 18 minutes later, while sleep duration increased from 8 hours 20 minutes before lockdown to 8 hours 30 minutes during it (p=0.24) with a deterioration in sleep quality reported by 53 patients. Sleep deterioration was not correlated with anxiety or duration of screen exposure, but was more related to age between 50 and 65 years old. HAD score showed anxiety in 29 patients which were correlated to the female gender. The study included 100 patients with an average age of 48 years. 38 patients had a professional activity before lockdown, 5 of them kept working face-to-face, 3 teleworked and 30 were unemployed. Only 59 % of them respected lockdown. This respect was correlated with female gender, educational level and the number of members under the same roof when it is more than 6. Deterioration in sleep, a change in bedtime and waking time and an increase in anxiety was observed in diabetic patients during the lockdown. Therefore, the psychiatric care system needs to adapt to provide psychological support not only to infected persons but also to other vulnerable communities including diabetic patients.
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Affiliation(s)
- Soukaina Laidi
- Mohammed VI University of Health Sciences, Casablanca, Morocco,,Corresponding author: Soukaina Laidi, Mohammed VI University of Health Sciences, Casablanca, Morocco.
| | - Nassim Essabah Haraj
- Endocrinology, Diabetology and Metabolic Diseases Department, CHU Ibn Rochd, Casablanca, Morocco,,Laboratory of Neurosciences and Mental Health, Casablanca, Morocco,,Faculty of Medicine and Pharmacy-University Hassan II, Casablanca, Morocco
| | - Siham El Aziz
- Endocrinology, Diabetology and Metabolic Diseases Department, CHU Ibn Rochd, Casablanca, Morocco,,Laboratory of Neurosciences and Mental Health, Casablanca, Morocco,,Faculty of Medicine and Pharmacy-University Hassan II, Casablanca, Morocco
| | - Asma Chadli
- Endocrinology, Diabetology and Metabolic Diseases Department, CHU Ibn Rochd, Casablanca, Morocco,,Laboratory of Neurosciences and Mental Health, Casablanca, Morocco,,Faculty of Medicine and Pharmacy-University Hassan II, Casablanca, Morocco
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17
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Jung S, Son KL, Jung S, Moon JY, Oh GH, Yeom CW, Lee KM, Kim WH, Jung D, Kim TY, Im SA, Lee KH, Spiegel D, Hahm BJ. The longitudinal effects of chronotype on chemotherapy-induced nausea and vomiting in patients with breast cancer receiving neoadjuvant chemotherapy. J Psychosom Res 2022; 157:110804. [PMID: 35381494 DOI: 10.1016/j.jpsychores.2022.110804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The object of this longitudinal cohort study was to investigate whether chronotype affects the incidence of chemotherapy-induced nausea and vomiting (CINV) among patients with breast cancer. METHODS The study included a total of 203 breast cancer patients who received neoadjuvant chemotherapy using a regimen of doxorubicin and cyclophosphamide with high emetogenicity. Patients received four cycles of chemotherapy in approximately three months. Patients completed questionnaires including the Munich Chronotype Questionnaire (MCTQ) before the first chemotherapy and the Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) after each of the four chemotherapy sessions. To confirm the effect of chronotype on CINV during the four cycles, we performed statistical analyses using a generalized estimating equation (GEE). RESULTS CINV occurred in 108 (53.2%), 112 (55.2%), 102 (50.3%), and 62 (30.5%) patients during four cycles of treatment. In the GEE approach, late and early chronotypes (vs. intermediate chronotype) were associated with an increased risk of CINV (late chronotype: odds ratio [OR], 2.06; 95% confidence interval [CI], 1.41-2.99; p < 0.001, early chronotype: OR, 1.84; CI, 1.25-2.73; p = 0.002), which remained significant even after adjusting for age, BMI, antiemetic treatment, history of nausea and vomiting, anxiety, and sleep quality. CONCLUSION Chronotype affected CINV across the four cycles of neoadjuvant chemotherapy in patients with breast cancer, suggesting the need to consider chronotype in predicting and managing CINV.
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Affiliation(s)
- Sanghyup Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Lak Son
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
| | - Saim Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Yoon Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Gyu Han Oh
- Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chan-Woo Yeom
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | | | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
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18
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Caliandro R, Streng AA, van Kerkhof LWM, van der Horst GTJ, Chaves I. Social Jetlag and Related Risks for Human Health: A Timely Review. Nutrients 2021; 13:nu13124543. [PMID: 34960096 PMCID: PMC8707256 DOI: 10.3390/nu13124543] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/11/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
The term social jetlag is used to describe the discrepancy between biological time, determined by our internal body clock, and social times, mainly dictated by social obligations such as school or work. In industrialized countries, two-thirds of the studying/working population experiences social jetlag, often for several years. Described for the first time in 2006, a considerable effort has been put into understanding the effects of social jetlag on human physiopathology, yet our understanding of this phenomenon is still very limited. Due to its high prevalence, social jetlag is becoming a primary concern for public health. This review summarizes current knowledge regarding social jetlag, social jetlag associated behavior (e.g., unhealthy eating patterns) and related risks for human health.
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Affiliation(s)
- Rocco Caliandro
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (R.C.); (A.A.S.); (G.T.J.v.d.H.)
| | - Astrid A. Streng
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (R.C.); (A.A.S.); (G.T.J.v.d.H.)
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands;
| | - Linda W. M. van Kerkhof
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands;
| | - Gijsbertus T. J. van der Horst
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (R.C.); (A.A.S.); (G.T.J.v.d.H.)
| | - Inês Chaves
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (R.C.); (A.A.S.); (G.T.J.v.d.H.)
- Correspondence: ; Tel.: +31-10-704-3456; Fax: +31-10-704-4743
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19
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Liu Z, Ting S, Zhuang X. COVID-19, circadian rhythms and sleep: from virology to chronobiology. Interface Focus 2021; 11:20210043. [PMID: 34956600 PMCID: PMC8504895 DOI: 10.1098/rsfs.2021.0043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 12/15/2022] Open
Abstract
Various aspects of our physiology and immune response to pathogens are under 24 h circadian control and its role in clinical and research practice is becoming increasingly recognized. Severe acute respiratory syndrome coronavirus-2, the causative agent of Coronavirus disease 2019 (COVID-19) has affected millions of people to date. Cross-disciplinary approaches and collaborative efforts have led to an unprecedented speed in developing novel therapies and vaccines to tackle the COVID-19 pandemic. Circadian misalignment and sleep disruption have a profound impact on immune function and subsequently on the ability of individuals to combat infections. This review summarizes the evidence on the interplay between circadian biology, sleep and COVID-19 with the aim to identify areas of translational potentials that may inform diagnostic and therapeutic strategies in this pandemic.
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Affiliation(s)
- Zulian Liu
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sharlene Ting
- National Institute for Health and Care Excellence, UK
| | - Xiaodong Zhuang
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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20
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Schmid SR, Höhn C, Bothe K, Plamberger CP, Angerer M, Pletzer B, Hoedlmoser K. How Smart Is It to Go to Bed with the Phone? The Impact of Short-Wavelength Light and Affective States on Sleep and Circadian Rhythms. Clocks Sleep 2021; 3:558-580. [PMID: 34842631 PMCID: PMC8628671 DOI: 10.3390/clockssleep3040040] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/25/2022] Open
Abstract
Previously, we presented our preliminary results (N = 14) investigating the effects of short-wavelength light from a smartphone during the evening on sleep and circadian rhythms (Höhn et al., 2021). Here, we now demonstrate our full sample (N = 33 men), where polysomnography and body temperature were recorded during three experimental nights and subjects read for 90 min on a smartphone with or without a filter or from a book. Cortisol, melatonin and affectivity were assessed before and after sleep. These results confirm our earlier findings, indicating reduced slow-wave-sleep and -activity in the first night quarter after reading on the smartphone without a filter. The same was true for the cortisol-awakening-response. Although subjective sleepiness was not affected, the evening melatonin increase was attenuated in both smartphone conditions. Accordingly, the distal-proximal skin temperature gradient increased less after short-wavelength light exposure than after reading a book. Interestingly, we could unravel within this full dataset that higher positive affectivity in the evening predicted better subjective but not objective sleep quality. Our results show disruptive consequences of short-wavelength light for sleep and circadian rhythmicity with a partially attenuating effect of blue-light filters. Furthermore, affective states influence subjective sleep quality and should be considered, whenever investigating sleep and circadian rhythms.
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Affiliation(s)
- Sarah R. Schmid
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, 5020 Salzburg, Austria; (S.R.S.); (C.H.); (K.B.); (C.P.P.); (M.A.)
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, 5020 Salzburg, Austria;
| | - Christopher Höhn
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, 5020 Salzburg, Austria; (S.R.S.); (C.H.); (K.B.); (C.P.P.); (M.A.)
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, 5020 Salzburg, Austria;
| | - Kathrin Bothe
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, 5020 Salzburg, Austria; (S.R.S.); (C.H.); (K.B.); (C.P.P.); (M.A.)
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, 5020 Salzburg, Austria;
| | - Christina P. Plamberger
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, 5020 Salzburg, Austria; (S.R.S.); (C.H.); (K.B.); (C.P.P.); (M.A.)
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, 5020 Salzburg, Austria;
| | - Monika Angerer
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, 5020 Salzburg, Austria; (S.R.S.); (C.H.); (K.B.); (C.P.P.); (M.A.)
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, 5020 Salzburg, Austria;
| | - Belinda Pletzer
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, 5020 Salzburg, Austria;
| | - Kerstin Hoedlmoser
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, 5020 Salzburg, Austria; (S.R.S.); (C.H.); (K.B.); (C.P.P.); (M.A.)
- Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, 5020 Salzburg, Austria;
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21
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Cheng W, Liu J, Zhi M, Shen D, Shao M, Zhang C, Wang G, Jiang Z. Stress and autonomic nerve dysfunction monitoring in perioperative gastric cancer patients using a smart device. Ann Noninvasive Electrocardiol 2021; 27:e12903. [PMID: 34669995 PMCID: PMC8739623 DOI: 10.1111/anec.12903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 12/22/2022] Open
Abstract
Background Heart rate variability (HRV), a sensitive marker of stress and autonomic nervous disorders, was significantly decreased in cardiovascular disease, inflammation, and surgical injury. However, the effect of radical gastrectomy on HRV parameters needs to be further investigated. Methods A prospective, observational study including 45 consecutive enrolled patients undergoing radical gastrectomy in our enhanced recovery after surgery (ERAS) programs was conducted. Frequency‐ and time‐domain parameters of HRV from 1 day prior to operation to 4 days postoperatively were continuously measured. Meanwhile, plasma cortisol and inflammatory markers were recorded and correlated to HRV parameters. Results Heart rate variability showed a solidly circadian rhythm. Anesthesia severely disturbed HRV parameters, resulting in a reduction of most of the HRV parameters. Frequency‐domain parameter (including VLF) and time‐domain parameters (including the SDNN, SDANN, and triangular index) of HRV demonstrated a significant reduction compared to preoperative values on the postoperative day 1 (Pod1), and these HRV parameters could return to baseline on Pod2 or Pod3, indicating surgical stress and autonomic nerve dysfunction existed in the early postoperative period. Inflammatory biomarkers were significantly elevated on Pod1 and Pod3. Plasma cortisol decreased significantly on Pod1 and Pod3. Both inflammatory biomarkers and plasma cortisol had no significant correlation with HRV parameters. Conclusions Compared with plasma cortisol and inflammation biomarkers, HRV is more sensitive to detect surgical stress and autonomic nervous dysfunction induced by radical gastrectomy in patients with gastric cancer.
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Affiliation(s)
- Wei Cheng
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiang Liu
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Mengwei Zhi
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Danli Shen
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Mingyue Shao
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Cheng Zhang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Gang Wang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhiwei Jiang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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22
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Abstract
Circadian disruption is pervasive and can occur at multiple organizational levels, contributing to poor health outcomes at individual and population levels. Evidence points to a bidirectional relationship, in that circadian disruption increases disease severity and many diseases can disrupt circadian rhythms. Importantly, circadian disruption can increase the risk for the expression and development of neurologic, psychiatric, cardiometabolic, and immune disorders. Thus, harnessing the rich findings from preclinical and translational research in circadian biology to enhance health via circadian-based approaches represents a unique opportunity for personalized/precision medicine and overall societal well-being. In this Review, we discuss the implications of circadian disruption for human health using a bench-to-bedside approach. Evidence from preclinical and translational science is applied to a clinical and population-based approach. Given the broad implications of circadian regulation for human health, this Review focuses its discussion on selected examples in neurologic, psychiatric, metabolic, cardiovascular, allergic, and immunologic disorders that highlight the interrelatedness between circadian disruption and human disease and the potential of circadian-based interventions, such as bright light therapy and exogenous melatonin, as well as chronotherapy to improve and/or modify disease outcomes.
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Affiliation(s)
- Anna B Fishbein
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Ann & Robert H. Lurie Children's Hospital, and
| | - Kristen L Knutson
- Department of Neurology and Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Phyllis C Zee
- Department of Neurology and Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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23
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Mota MC, Silva CM, Balieiro LCT, Fahmy WM, Marqueze EC, Moreno CRDC, Crispim CA. Social Jetlag Is Associated With Impaired Metabolic Control During a 1-Year Follow-Up. Front Physiol 2021; 12:702769. [PMID: 34539431 PMCID: PMC8445111 DOI: 10.3389/fphys.2021.702769] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
Previous studies have identified social jetlag (SJL) as a risk factor for non-communicable chronic diseases (NCCDs), but its association with metabolic control over time is unclear in the literature. Therefore, we examined the influence of SJL on metabolic parameters and blood pressure (BP) in patients with NCCDs over a 1-year follow-up. This retrospective, longitudinal study included 625 individuals (age: 56.0 +12.0 years; 76% female) with NCCDs [type 2 diabetes mellitus (TD2), systemic arterial hypertension (SHA), obesity, or dyslipidemia]. SJL was calculated based on the absolute difference between mid-sleep time on weekends and weekdays. Current metabolic parameters and BP of the patients were compared with data from a year prior. Generalized estimating equations (GEE) and multiple linear regression analyses were used to examine the association among SJL, metabolic parameters, and BP. Multiple linear regression analyses adjusted for confounders showed that SJL was positively associated with the delta difference of fasting glucose (β = 0.11, p = 0.02) and triglyceride levels (β = 0.09, p = 0.04) among all subjects with NCCDs, and with fasting glucose (β = 0.30, p = 0.0001) and triglyceride levels (β = 0.22, p = 0.01) in the TD2 group. GEE analysis demonstrated an isolated effect of SJL on diastolic BP. High SJL impaired clinical and metabolic control in individuals with NCCDs, leading to a worse profile after a 1-year follow-up, particularly among type II diabetics.
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Affiliation(s)
- Maria Carliana Mota
- Faculty of Medicine of the Federal University of Uberlândia, Uberlândia, Brazil
| | | | | | | | - Elaine Cristina Marqueze
- Public Health Graduate Program, Department of Epidemiology, Catholic University of Santos, Santos, Brazil.,Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Claudia Roberta de Castro Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil.,Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
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24
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Meléndez-Fernández OH, Walton JC, DeVries AC, Nelson RJ. Clocks, Rhythms, Sex, and Hearts: How Disrupted Circadian Rhythms, Time-of-Day, and Sex Influence Cardiovascular Health. Biomolecules 2021; 11:883. [PMID: 34198706 PMCID: PMC8232105 DOI: 10.3390/biom11060883] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular diseases are the top cause of mortality in the United States, and ischemic heart disease accounts for 16% of all deaths around the world. Modifiable risk factors such as diet and exercise have often been primary targets in addressing these conditions. However, mounting evidence suggests that environmental factors that disrupt physiological rhythms might contribute to the development of these diseases, as well as contribute to increasing other risk factors that are typically associated with cardiovascular disease. Exposure to light at night, transmeridian travel, and social jetlag disrupt endogenous circadian rhythms, which, in turn, alter carefully orchestrated bodily functioning, and elevate the risk of disease and injury. Research into how disrupted circadian rhythms affect physiology and behavior has begun to reveal the intricacies of how seemingly innocuous environmental and social factors have dramatic consequences on mammalian physiology and behavior. Despite the new focus on the importance of circadian rhythms, and how disrupted circadian rhythms contribute to cardiovascular diseases, many questions in this field remain unanswered. Further, neither time-of-day nor sex as a biological variable have been consistently and thoroughly taken into account in previous studies of circadian rhythm disruption and cardiovascular disease. In this review, we will first discuss biological rhythms and the master temporal regulator that controls these rhythms, focusing on the cardiovascular system, its rhythms, and the pathology associated with its disruption, while emphasizing the importance of the time-of-day as a variable that directly affects outcomes in controlled studies, and how temporal data will inform clinical practice and influence personalized medicine. Finally, we will discuss evidence supporting the existence of sex differences in cardiovascular function and outcomes following an injury, and highlight the need for consistent inclusion of both sexes in studies that aim to understand cardiovascular function and improve cardiovascular health.
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Affiliation(s)
- O. Hecmarie Meléndez-Fernández
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26505, USA; (J.C.W.); (R.J.N.)
| | - James C. Walton
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26505, USA; (J.C.W.); (R.J.N.)
| | - A. Courtney DeVries
- Department of Medicine, Division of Oncology/Hematology, West Virginia University, Morgantown, WV 26505, USA;
- West Virginia University Cancer Institute, West Virginia University, Morgantown, WV 26505, USA
| | - Randy J. Nelson
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26505, USA; (J.C.W.); (R.J.N.)
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25
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Xu J, Chen W. Impact of Water Temperature on Heart Rate Variability during Bathing. Life (Basel) 2021; 11:life11050378. [PMID: 33922202 PMCID: PMC8145520 DOI: 10.3390/life11050378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 02/07/2023] Open
Abstract
Background: Heart rate variability (HRV) is affected by many factors. This paper aims to explore the impact of water temperature (WT) on HRV during bathing. Methods: The bathtub WT was preset at three conditions: i.e., low WT (36–38 °C), medium WT (38–40 °C), and high WT (40–42 °C), respectively. Ten subjects participated in the data collection. Each subject collected five electrocardiogram (ECG) recordings at each preset bathtub WT condition. Each recording was 18 min long with a sampling rate of 200 Hz. In total, 150 ECG recordings and 150 WT recordings were collected. Twenty HRV features were calculated using 1-min ECG segments each time. The k-means clustering analysis method was used to analyze the rough trends based on the preset WT. Analyses of the significant differences were performed using the multivariate analysis of variance of t-tests, and the mean and standard deviation (SD) of each HRV feature based on the WT were calculated. Results: The statistics show that with increasing WT, 11 HRV features are significantly (p < 0.05) and monotonously reduced, four HRV features are significantly (p < 0.05) and monotonously rising, two HRV features are rising first and then reduced, two HRV features (fuzzy and approximate entropy) are almost unchanged, and vLF power is rising. Conclusion: The WT has an important impact on HRV during bathing. The findings in the present work reveal an important physiological factor that affects the dynamic changes of HRV and contribute to better quantitative analyses of HRV in future research works.
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26
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Yang PL, Burr RL, de la Iglesia HO, Buchanan DT, Ward TM, Landis CA, Heitkemper MM. Associations between chronotype, social jetlag, and weekday sleep in women with irritable bowel syndrome. Chronobiol Int 2021; 38:742-752. [PMID: 33612026 DOI: 10.1080/07420528.2021.1885430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Sleep deficiency is well-documented in individuals with irritable bowel syndrome (IBS). Sleep deficiency includes poor sleep quality and an inadequate amount of sleep, and is a modifiable risk factor for IBS symptom exacerbations. Prior studies in other populations have identified chronotype and social jetlag (SJL) as important determinants of sleep outcomes. However, chronotype and SJL have not been examined in women with IBS. We used multiple linear regression analyses to determine whether chronotype and SJL are associated with sleep outcomes during weekdays among women with IBS predominant constipation (IBS-C), IBS with predominant diarrhea (IBS-D), and healthy control (HC) women. This sample included 62 women with IBS (IBS-C = 29, IBS-D = 33) and 58 HC women who completed a 28-day daily diary from two study cohorts. The average age of the participants was 30.1 (SD 7.2) years. Chronotype was estimated from daily diary data with the average mid-sleep time on weekends (MSWwe). SJL was calculated by subtracting the average mid-sleep time on weekdays from MSWwe. Sleep outcomes included diary assessments of sleep quality, sleep need met, and restorative sleep during weekdays. In HCs, later chronotype was predictive of lower sleep quality (β = -0.19, p < .01), a perception of sleep need not met (β = -0.17, p < .001), and a less restorative sleep during weekdays (β = -0.15, p = .073), whereas SJL was not associated with sleep outcomes. Similar to HCs, earlier chronotypes in women with IBS-C reported better sleep quality and more sufficient sleep need met and restorative sleep during weekdays than later chronotypes (all p > .05). Compared to HCs, the relationships of chronotype with weekday sleep outcomes in the women with IBS-D were in the opposite directions (all p < .05). This exploratory study suggests that chronotype expression may reflect the temporal associations of sleep outcomes within IBS bowel pattern predominance subgroups, particularly sleep quality and sleep need met. Additional investigations are warranted to examine whether specific temporal attributes of symptoms and/or symptom severity associated with IBS subgroups contribute to chronotype expression.
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Affiliation(s)
- Pei-Lin Yang
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA.,School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Robert L Burr
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA.,Office of Nursing Research, School of Nursing, University of Washington, Seattle, Washington, USA
| | | | - Diana T Buchanan
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Teresa M Ward
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Carol A Landis
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Margaret M Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
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27
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Feder MA, Baroni A. Just Let Me Sleep in: Identifying and Treating Delayed Sleep Phase Disorder in Adolescents. Child Adolesc Psychiatr Clin N Am 2021; 30:159-174. [PMID: 33223060 DOI: 10.1016/j.chc.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Individuals with delayed sleep phase disorder (DSPD) are unable to naturally fall asleep and awake at conventional times; for this reason, DSPD is often mistaken for insomnia. However, unlike many patients with insomnia, those with DSPD struggle to get up at appropriate times. DSPD is associated with school refusal, academic difficulties, and lower employment rate. DSPD in youth has prevalence as high as 16%, and is often comorbid with other psychiatric disorders. Treatments include appropriate light exposure during the day, melatonin use, developing an evening routine that minimizes arousal-increasing activities, and gradually shifting sleep-wake times toward more functional ones.
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Affiliation(s)
- Michael A Feder
- Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, NYC H+H/Bellevue, New York, NY, USA; Child Study Center, One Park Avenue, 7th Floor, New York, NY 10016, USA
| | - Argelinda Baroni
- Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, NYC H+H/Bellevue, New York, NY, USA; Child Study Center, One Park Avenue, 7th Floor, New York, NY 10016, USA.
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28
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Brandão LEM, Martikainen T, Merikanto I, Holzinger B, Morin CM, Espie CA, Bolstad CJ, Leger D, Chung F, Plazzi G, Dauvilliers Y, Matsui K, De Gennaro L, Sieminski M, Nadorff MR, Chan NY, Wing YK, Mota-Rolim SA, Inoue Y, Partinen M, Benedict C, Bjorvatn B, Cedernaes J. Social Jetlag Changes During the COVID-19 Pandemic as a Predictor of Insomnia - A Multi-National Survey Study. Nat Sci Sleep 2021; 13:1711-1722. [PMID: 34675720 PMCID: PMC8502537 DOI: 10.2147/nss.s327365] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/12/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Lifestyle and work habits have been drastically altered by restrictions due to the COVID-19 pandemic. Whether the associated changes in sleep timing modulate the risk of suffering from symptoms of insomnia, the most prevalent sleep disorder, is however incompletely understood. Here, we evaluate the association between the early pandemic-associated change in 1) the magnitude of social jetlag (SJL) - ie, the difference between sleep timing on working vs free days - and 2) symptoms of insomnia. PATIENTS AND METHODS A total of 14,968 anonymous participants (mean age: 40 years; 64% females) responded to a standardized internet-based survey distributed across 14 countries. Using logistic multivariate regression, we examined the association between the degree of social jetlag and symptoms of insomnia, controlling for important confounders like social restriction extension, country specific COVID-19 severity and psychological distress, for example. RESULTS In response to the pandemic, participants reported later sleep timing, especially during workdays. Most participants (46%) exhibited a reduction in their SJL, whereas 20% increased it; and 34% reported no change in SJL. Notably, we found that both increased and decreased SJL, as a result of the COVID-19 pandemic, were associated with later sleep midpoint (indicating a later chronotype) as well as more recurrent and moderate-to-severe symptoms of insomnia (about 23-54% higher odds ratio than subjects with unchanged SJL). Primarily those with reduced SJL shifted their bedtimes to a later timepoint, compared with those without changes in SJL. CONCLUSION Our findings offer important insights into how self-reported changes to the stability of sleep/wake timing, as reflected by changes in SJL, can be a critical marker of the risk of experiencing insomnia-related symptoms - even when individuals manage to reduce their social jetlag. These findings emphasize the clinical importance of analyzing sleep-wake regularity.
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Affiliation(s)
| | | | - Ilona Merikanto
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Orton Orthopaedic Hospital, Helsinki, Finland
| | - Brigitte Holzinger
- ZK-Schlafcoaching, Medical University Vienna, Vienna, Austria.,Institute for Consciousness and Dream Research, Vienna, Austria
| | - Charles M Morin
- École de Psychologie, Université Laval, Québec, Canada.,Centre d'étude des troubles du sommeil, Université Laval, Québec, Canada.,Centre de recherche CERVO/Brain Research Center, Université Laval, Québec, Canada
| | - Colin A Espie
- Sleep & Circadian Institute, University of Oxford, Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Courtney J Bolstad
- Department of Psychology, Mississippi State University, Starkville, MS, USA
| | - Damien Leger
- APHP, VIFASOM, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Université de Paris, Paris, France
| | - Frances Chung
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, Montpellier, France
| | - Kentaro Matsui
- National Center of Neurology and Psychiatry National Institute of Mental Health, Department of Clinical Laboratory and Department of Sleep-Wake Disorders, Tokyo, Japan.,Tokyo Women's Medical University, Department of Psychiatry, Tokyo, Japan
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Starkville, MS, USA.,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Sérgio Arthuro Mota-Rolim
- Brain Institute, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Physiology and Behaviour Department, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Markku Partinen
- Helsinki Sleep Clinic, Vitalmed Research Center, Terveystalo Biobank and Research, Helsinki, Finland.,Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Christian Benedict
- Sleep Science Laboratory, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Bjorn 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
| | - Jonathan Cedernaes
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Department of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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29
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Franceschini C, Musetti A, Zenesini C, Palagini L, Scarpelli S, Quattropani MC, Lenzo V, Freda MF, Lemmo D, Vegni E, Borghi L, Saita E, Cattivelli R, De Gennaro L, Plazzi G, Riemann D, Castelnuovo G. Poor Sleep Quality and Its Consequences on Mental Health During the COVID-19 Lockdown in Italy. Front Psychol 2020; 11:574475. [PMID: 33304294 PMCID: PMC7693628 DOI: 10.3389/fpsyg.2020.574475] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/15/2020] [Indexed: 02/05/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) seriously affected the whole of Italy. The extreme virulence and the speed of propagation resulted in restrictions and home confinement. This change was immediately perceived by people who found themselves exposed to feelings of uncertainty, fear, anger, stress, and a drastic change in the diurnal but above all nocturnal lifestyle. For these reasons, we aimed to study the quality of sleep and its connection to distress levels and to evaluate how lifestyle changed in the Italian population during the lockdown. Methods By means of an Internet survey we recruited 6,519 adults during the whole of the COVID-19 lockdown (from March 10–1st phase to May 4–2nd phase). We investigated the sociodemographic and COVID-19-related information and assessed sleep quality using the Medical Outcomes Study–sleep scale (MOS-SS) and mental health with the short form of Depression, Anxiety, and Stress Scales–21 Items (DASS-21). Multiple logistic regression model was used to evaluate the multivariate association between the dependent variable (good sleeper vs. poor sleeper) and all the variables that were significant in the univariate analysis. Results A total of 3,562 (55.32%) participants reported poor sleep quality according to the MOS-Sleep Index II score. The multiple binary logistic regression results of poor sleepers revealed several risk factors during the outbreak restrictions: female gender, living in Central Italy, having someone close who died because of COVID-19, markedly changed sleep–wake rhythms characterized by earlier or postponed habitual bedtime, earlier habitual awakening time and reduced number of afternoon naps, and extremely severe levels of stress, anxiety, and depression. Conclusion This is the first study designed to understand sleep quality and sleep habits during the whole of the lockdown period in the Italian population that provides more than 6,000 participants in a survey developed specifically for the health emergency related to COVID-19. Our study found that more than half of the Italian population had impaired sleep quality and sleep habits due to elevated psychological distress during the COVID-19 lockdown containment measures. A multidisciplinary action should be undertaken in order to plan appropriate responses to the current crisis caused by the lockdown for the COVID-19 outbreak.
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Affiliation(s)
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | | | | | - Vittorio Lenzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Roberto Cattivelli
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Verbania, Italy
| | | | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Dieter Riemann
- Medical Center, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Ospedale San Giuseppe, Istituto Auxologico Italiano IRCCS, Verbania, Italy
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30
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Hartley S, Colas des Francs C, Aussert F, Martinot C, Dagneaux S, Londe V, Waldron L, Royant-Parola S. [The effects of quarantine for SARS-CoV-2 on sleep: An online survey]. Encephale 2020; 46:S53-S59. [PMID: 32475692 PMCID: PMC7211567 DOI: 10.1016/j.encep.2020.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/07/2020] [Indexed: 12/17/2022]
Abstract
Objectif Déterminer l’évolution du sommeil chez les Français pendant le confinement motivé par la pandémie du SARS-CoV-2 et définir les facteurs comportementaux associés à un sommeil détérioré. Méthodologie Une enquête en ligne via les réseaux sociaux pendant la période de confinement. Les questions ont ciblé les conditions de confinement, les comportements relatifs au sommeil et les éléments de l’environnement potentiellement perturbateurs du sommeil (exposition à la lumière et activités sportives). Résultats Au total, 1777 participants ont été inclus dont 77 % femmes, 72 % âgés de 25–54 ans. Les conditions de confinement les plus fréquentes étaient en couple avec enfants (36 %) et en maison avec jardin (51 %). Quarante-sept pour cent rapportent une diminution de la qualité du sommeil en confinement. Les facteurs associés à une détérioration du sommeil retenus par l’analyse multivariée sont une diminution de la durée du sommeil (OR 15,52 — p < 0,001), un coucher plus tardif (OR 1,72 — p < 0,001), un lever plus matinal (2,18 — p = 0,01), des horaires plus irréguliers (OR 2,29 — p < 0,001), une diminution de l’exposition à la lumière du jour (OR 1,46 — p = 0,01) et une augmentation de l’utilisation des écrans le soir (OR 1,33 — p = 0,04). Conclusion La mauvaise qualité subjective du sommeil en confinement est associée à une modification des comportements relatifs au sommeil et de l’exposition à la lumière (moins de lumière du jour et plus d’écran le soir). Pour optimiser le sommeil en confinement, des horaires adaptés et réguliers, une exposition de plus d’une heure/jour à la lumière du jour et l’éviction des écrans le soir sont à conseiller.
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Affiliation(s)
- S Hartley
- Réseau Morphée, 2, Grande rue, 92380 Garches, France; Unité du sommeil, EA 4047, université de Versailles Saint-Quentin en Yvelines, hôpital Raymond-Poincaré, AP-HP, 92380 Garches, France.
| | | | - F Aussert
- Réseau Morphée, 2, Grande rue, 92380 Garches, France; Centre des explorations multifonctionnelles, hôpital Antoine-Béclère, AP-HP, Clamart, France
| | - C Martinot
- Réseau Morphée, 2, Grande rue, 92380 Garches, France
| | - S Dagneaux
- Réseau Morphée, 2, Grande rue, 92380 Garches, France
| | - V Londe
- Réseau Morphée, 2, Grande rue, 92380 Garches, France
| | - L Waldron
- Réseau Morphée, 2, Grande rue, 92380 Garches, France
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A Cross-Sectional Study of the Associations between Chronotype, Social Jetlag and Subjective Sleep Quality in Healthy Adults. Clocks Sleep 2019; 2:1-6. [PMID: 33089185 PMCID: PMC7445814 DOI: 10.3390/clockssleep2010001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/10/2019] [Indexed: 02/02/2023] Open
Abstract
Social jetlag, a mismatch between internal biological time and social schedules, and a later timing of the midpoint of sleep on work-free days as an indicator of the circadian phase of entrainment (late chronotype), may be factors associated with poor quality sleep. This study examined the association of social jetlag and chronotype with subjective sleep quality ratings in a healthy young adult cohort and interrogated the moderating effects of sex and age on these associations. A total of 1322 participants aged 18 to 40 completed the Pittsburg Sleep Quality Index (PSQI) and the Munich Chronotype Questionnaire. Later timing of midsleep on "free" days (an indicator of chronotype) had a small-to-medium association with poorer subjective sleep quality, independently of sex and age (rho = 0.212, P < 0.001). Greater social jetlag had a small association with poorer subjective sleep quality ratings (rho = 0.077), and this effect was moderated by sex with there being a relationship between social jetlag and sleep quality only in males. Social jetlag did not mediate the relationship between chronotype and sleep quality. These results indicate differential relationships of the chronotype and social jetlag with subjective sleep quality and indicate that sex is a moderating factor for sleep quality's relationship with social jetlag, but not for the association between sleep quality and chronotype.
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