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Golombek DA, Eyre H, Spiousas I, Casiraghi LP, Hartikainen KM, Partonen T, Pyykkö M, Reynolds CF, Hynes WM, Bassetti CLA, Berk M, Hu K, Ibañez A. Sleep Capital: Linking Brain Health to Wellbeing and Economic Productivity Across the Lifespan. Am J Geriatr Psychiatry 2025; 33:92-106. [PMID: 39117505 DOI: 10.1016/j.jagp.2024.07.011] [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] [Received: 05/18/2024] [Revised: 07/12/2024] [Accepted: 07/13/2024] [Indexed: 08/10/2024]
Abstract
INTRODUCTION AND FRAMEWORK Sleep capital contributes to individual and societal wellbeing, productivity, and economic outcomes and involves a novel aspect of brain capital. It encompasses the quality and quantity of sleep as integral components that influence cognitive abilities, mental and brain health, and physical health, affecting workplace productivity, learning, decision-making, and overall economic performance. Here, we bring a framework to understand the complex relationship between sleep quality, health, wellbeing, and economic productivity. Then we outline the multilevel impact of sleep on cognitive abilities, mental/brain health, and economic indicators, providing evidence for the substantial returns on investment in sleep health initiatives. Moreover, sleep capital is a key factor when considering brain health across the lifespan, especially for the aging population. DISCUSSION We propose specific elements and main variables to develop specific indexes of sleep capital to address its impacts on health, wellbeing and productivity. CONCLUSION Finally, we suggest policy recommendations, workplace interventions, and individual strategies to promote sleep health and brain capital. Investing in sleep capital is essential for fostering a healthier, happier, fairer and more productive society.
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Affiliation(s)
- Diego A Golombek
- Laboratorio Interdisciplinario del Tiempo (LITERA) (DAG, IS, LPC), Universidad de San Andrés/CONICET, Buenos Aires, Argentina.
| | - Harris Eyre
- Baker Institute for Public Policy (HE), Rice University, Houston, TX, USA; Global Brain Health Institute (HE), University of California San Francisco (UCSF), San Francisco, CA, USA; Department of Psychiatry and Behavioral Science (HE), (UCSF), San Francisco, CA, USA; Department of Psychiatry and Behavioral Science (HE), Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry and Behavioral Science (HE), Houston Methodist, Houston, TX, USA; Department of Psychiatry and Behavioral Science (HE), The University of Texas Health Sciences Center at Houston, Houston, TX, USA; Institute for Mental and Physical Health and Clinical Translation (IMPACT) (HE), Deakin University, Geelong, Victoria, Australia; Euro-Mediterranean Economists Association (HE), Barcelona, Spain; Meadows Mental Health Policy Institute (HE), Dallas, TX, USA; Frontier Technology Lab, School of Engineering (HE), Stanford University, Palo Alto, CA, USA
| | - Ignacio Spiousas
- Laboratorio Interdisciplinario del Tiempo (LITERA) (DAG, IS, LPC), Universidad de San Andrés/CONICET, Buenos Aires, Argentina
| | - Leandro P Casiraghi
- Laboratorio Interdisciplinario del Tiempo (LITERA) (DAG, IS, LPC), Universidad de San Andrés/CONICET, Buenos Aires, Argentina
| | - Kaisa M Hartikainen
- Faculty of Medicine and Health Technology (KMH), Tampere University, Tampere, Finland; Behavioral Neurology Research Group (KMH), Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland; National Brain Health Programme (KMH), Helsinki, Finland
| | - Timo Partonen
- Finnish Institute for Health and Welfare (TP), Helsinki, Finland; Department of Psychiatry (TP), University of Helsinki, Helsinki, Finland
| | - Mika Pyykkö
- Finnish Brain Association and Finnish Centre for Health Promotion (MP), Helsinki, Finland
| | - Charles F Reynolds
- Graduate School of Public Health, University of Pittsburgh School of Medicine (CFR), Pittsburgh, PA, USA
| | - William M Hynes
- Institute for Global Prosperity (MH), University College London, London, UK; Santa Fe Institute (MH), Santa Fe, NM, USA; World Bank (MH), Washington, DC, USA
| | - Claudio L A Bassetti
- Neurology Department, Inselspital (CLAB), University of Bern, Bern, Switzerland; Swiss Brain Health Plan (CLAB), Bern, Switzerland
| | - Michael Berk
- School of Medicine (MB), Deakin University and Barwon Health. Institute for Mental and Physical Health and Clinical Translation (IMPACT), Victoria, Australia
| | - Kun Hu
- Division of Sleep Medicine (KH), Harvard Medical School, Boston, MA, USA; Medical Biodynamics Center (KH), Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Agustín Ibañez
- Latin American Brain Health institute (Brainlat) (CSCN) (AI), Universidad Adolfo Ibanez, Santiago, Chile; ChileGlobal Brain Health Institute, Trinity College Dublin, Ireland; Center for Social and Cognitive Neuroscience (CSCN) (AI), Universidad Adolfo Ibanez, Santiago, Chile; Universidad de San Andrés (AI), Buenos Aires, Argentina
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Anauati MV, Gómez Seeber M, Campanario S, Sosa Escudero W, Golombek DA. The economic costs and consequences of (insufficient) sleep: a case study from Latin America. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-024-01733-8. [PMID: 39520588 DOI: 10.1007/s10198-024-01733-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 10/16/2024] [Indexed: 11/16/2024]
Abstract
Sleep, an essential physiological process, has long been recognized for its critical role in human health and well-being. Beyond its biological significance, recent research has highlighted the intricate interplay between sleep and economic outcomes. By constructing meticulous economic models that account for diverse factors and refining them based on empirical data and local characteristics, this study aims to provide an in-depth understanding of the significant economic toll stemming from inadequate sleep and its ramifications on various aspects of society. Here we calculated the effect of insufficient sleep on economic loss in Argentina, according to an Overlapping Generations (OLG) model that considers average sleeping length in terms of the recommended minimum and its effect on productivity and health outcomes. We considered different scenarios in which the population sleeps from six to nine hours every night. Our results indicate that if the whole adult population achieved the recommended sleep duration of at least 7 h/night, it would be associated with a 1.27% higher GDP compared to the baseline scenario, representing the most optimistic outcome. This equals about 3.7 times the total annual budget in science, and is approximately the same percentage as the actually implemented national budget for education. In summary, by bridging the usually distant realms of biology and economics, this study offers a comprehensive analysis that not only deepens our understanding of the mechanisms underlying these costs but also provides potential avenues for intervention and policy-making.
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Affiliation(s)
| | - Matías Gómez Seeber
- Department of Economics, Universidad de San Andrés-CIAS, Victoria, Argentina
| | - Sebastián Campanario
- Economist. Innovation and Wellbeing reporter, La Nación Newspaper, Vicente López, Argentina
| | - Walter Sosa Escudero
- Department of Economics, Universidad de San Andrés-CONICET, Victoria, Argentina.
| | - Diego A Golombek
- Laboratorio Interdisciplinario del Tiempo, Universidad de San Andrés-CONICET, Vito Dumas 284, Victoria, 1644, Argentina.
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Putilov AA. Reaction of the endogenous regulatory mechanisms to early weekday wakeups: a review of its popular explanations in light of model-based simulations. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1285658. [PMID: 38169971 PMCID: PMC10760451 DOI: 10.3389/fnetp.2023.1285658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/09/2023] [Indexed: 01/05/2024]
Abstract
Introduction: Several widely held explanations of the mechanisms underlying the responses of endogenous sleep-wake-regulating processes to early weekday wakeups have been proposed. Here, they were briefly reviewed and validated against simulations based on the rhythmostatic version of a two-process model of sleep-wake regulation. Methods: Simulated sleep times on weekdays and weekends were compared with the times averaged over 1,048 samples with either earlier or later weekday risetimes. In total, 74 paired samples were collected before and during lockdown, and 93 paired samples were collected during early and later school start times. Results: The counterintuitive predictions of the simulations included the following: 1) only one night of ad lib sleep is sufficient to restore the endogenously determined sleep times after 1 day/5 days of larger/smaller reduction/extension of the sleep/wake phase of the circadian sleep-wake cycle; 2) sleep loss on weekdays is irrecoverable; 3) irrespective of the amount of such deadweight loss, sleep on weekends is not prolonged; and 4) the control of the circadian clocks over the sleep-wake cyclicity is not disrupted throughout the week. Discussion: The following popular explanations of the gaps between weekends and weekdays in sleep timing and duration were not supported by these simulations: 1) early weekday wakeups cause "social jetlag," viewed as the weekend and weekday (back and forth) shifts of the sleep phase relative to the unchanged phase of the circadian clocks, and 2) early weekday wakeups cause an accumulation of "sleep debt paid back" on weekends, or, in other terms, people can "catch-up" or "compensate" sleep on weekends.
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Affiliation(s)
- Arcady A. Putilov
- Laboratory of Nanobiotechnology and Biophysics, North-Caucasus Federal University, Stavropol, Russia
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
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Sletten TL, Weaver MD, Foster RG, Gozal D, Klerman EB, Rajaratnam SMW, Roenneberg T, Takahashi JS, Turek FW, Vitiello MV, Young MW, Czeisler CA. The importance of sleep regularity: a consensus statement of the National Sleep Foundation sleep timing and variability panel. Sleep Health 2023; 9:801-820. [PMID: 37684151 DOI: 10.1016/j.sleh.2023.07.016] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To develop and present consensus findings of the National Sleep Foundation sleep timing and variability panel regarding the impact of sleep timing variability on health and performance. METHODS The National Sleep Foundation assembled a panel of sleep and circadian experts to evaluate the scientific evidence and conduct a formal consensus and voting procedure. A systematic literature review was conducted using the NIH National Library of Medicine PubMed database, and panelists voted on the appropriateness of 3 questions using a modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting. RESULTS The literature search and panel review identified 63 full text publications to inform consensus voting. Panelists achieved consensus on each question: (1) is daily regularity in sleep timing important for (a) health or (b) performance? and (2) when sleep is of insufficient duration during the week (or work days), is catch-up sleep on weekends (or non-work days) important for health? Based on the evidence currently available, panelists agreed to an affirmative response to all 3 questions. CONCLUSIONS Consistency of sleep onset and offset timing is important for health, safety, and performance. Nonetheless, when insufficient sleep is obtained during the week/work days, weekend/non-work day catch-up sleep may be beneficial.
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Affiliation(s)
- Tracey L Sletten
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Russell G Foster
- Sleep & Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - David Gozal
- Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Till Roenneberg
- Institutes for Occupational, Social, and Environmental Medicine and Medical Psychology, LMU Munich, Munich, Germany
| | - Joseph S Takahashi
- Department of Neuroscience, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Howard Hughes Medical Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Fred W Turek
- Center for Sleep and Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, Illinois, USA
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Michael W Young
- Laboratory of Genetics, The Rockefeller University, New York City, New York, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
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Juda M, Pater J, Mistlberger RE, Schütz CG. Sleep and Rest-Activity Rhythms in Recovering Patients with Severe Concurrent Mental and Substance Use Disorder: A Pilot Study. J Dual Diagn 2023; 19:26-39. [PMID: 36580397 DOI: 10.1080/15504263.2022.2157694] [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] [Indexed: 12/30/2022]
Abstract
Objective: Mental health and substance use disorders are commonly associated with disrupted sleep and circadian rest-activity rhythms. How these disorders in combination relate to sleep and circadian organization is not well studied. We provide here the first quantitative assessment of sleep and rest-activity rhythms in inpatients with complex concurrent disorders, taking into account categories of substance use (stimulant vs. stimulant and opioid use) and psychiatric diagnosis (psychotic disorder and mood disorder). We also explore how sleep and rest-activity rhythms relate to psychiatric functioning. Methods: A total of 44 participants (10 female) between the age of 20-60 years (median = 29 years) wore wrist accelerometers over 5-70 days and completed standardized questionnaires assessing chronotype and psychiatric functioning (fatigue, psychiatric symptom severity, and impulsiveness). To examine potential influences from treatment, we computed (1) length of stay; (2) days of abstinence from stimulants and opioids as a measure of withdrawal; and (3) a sedative load based on prescribed medications. Results: Participants exhibited a sustained excessive sleep duration, frequent nighttime awakenings, and advanced rest-activity phase related to sedative load. Sleep disruptions were elevated in participants with a history of opioid use. Patients with a psychotic disorder showed the longest sleep and most fragmented and irregular rest-activity patterns. Non-parametric circadian rhythm analysis revealed a high rhythm amplitude by comparison with population norms, and this was associated with greater psychiatric symptom severity. Psychiatric symptom severity was also associated with greater fatigue and later MCTQ chronotype. Conclusions: This pilot study provides initial information on the prevalence and severity of sleep and circadian rhythm disturbances in individuals with severe concurrent disorders. The results underline the need for further studies to start to understand the role of sleep in the disease and recovery process in this understudied population.
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Affiliation(s)
- Myriam Juda
- Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada.,Behavioral Reward Affect + Impulsivity Neuroscience (BRAIN) Lab, Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.,Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Joanna Pater
- Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada.,Behavioral Reward Affect + Impulsivity Neuroscience (BRAIN) Lab, Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.,School of Medicine, St. George's University, St. George's, Grenada
| | - Ralph E Mistlberger
- Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Christian G Schütz
- Behavioral Reward Affect + Impulsivity Neuroscience (BRAIN) Lab, Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.,Provincial Health Services Authority, Red Fish Healing Centre for Mental Health and Addiction, Coquitlam, Canada
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Barbato G. REM Sleep: An Unknown Indicator of Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12976. [PMID: 34948586 PMCID: PMC8702162 DOI: 10.3390/ijerph182412976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
Standard polysomnographic analysis of sleep has not provided evidence of an objective measure of sleep quality; however, factors such as sleep duration and sleep efficiency are those more consistently associated with the subjective perception of sleep quality. Sleep reduction as currently occurs in our 24/7 society has had a profound impact on sleep quality; the habitual sleep period should fit within what is a limited nighttime window and may not be sufficient to satisfy the whole sleep process; moreover, the use of artificial light during the evening and early night hours can delay and disturb the circadian rhythms, especially affecting REM sleep. The correct phase relationship of the sleep period with the circadian pacemaker is an important factor to guarantee adequate restorative sleep duration and sleep continuity, thus providing the necessary background for a good night's sleep. Due to the fact that REM sleep is controlled by the circadian clock, it can provide a window-like mechanism that defines the termination of the sleep period when there is still the necessity to complete the sleep process (not only wake-related homeostasis) and to meet the circadian end of sleep timing. An adequate amount of REM sleep appears necessary to guarantee sleep continuity, while periodically activating the brain and preparing it for the return to consciousness.
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Affiliation(s)
- Giuseppe Barbato
- Department of Psychology, Università degli Studi della Campania Luigi Vanvitelli, 80122 Caserta, Italy
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