1
|
Perrault AA, Kebets V, Kuek NMY, Cross NE, Tesfaye R, Pomares FB, Li J, Chee MW, Dang-Vu TT, Thomas Yeo B. A multidimensional investigation of sleep and biopsychosocialprofiles with associated neural signatures. bioRxiv 2024:2024.02.15.580583. [PMID: 38559143 PMCID: PMC10979931 DOI: 10.1101/2024.02.15.580583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Sleep is essential for optimal functioning and health. Interconnected to multiple biological, psychological and socio-environmental factors (i.e., biopsychosocial factors), the multidimensional nature of sleep is rarely capitalized on in research. Here, we deployed a data-driven approach to identify sleep-biopsychosocial profiles that linked self-reported sleep patterns to inter-individual variability in health, cognition, and lifestyle factors in 770 healthy young adults. We uncovered five profiles, including two profiles reflecting general psychopathology associated with either reports of general poor sleep or an absence of sleep complaints (i.e., sleep resilience) respectively. The three other profiles were driven by sedative-hypnotics-use and social satisfaction, sleep duration and cognitive performance, and sleep disturbance linked to cognition and mental health. Furthermore, identified sleep-biopsychosocial profiles displayed unique patterns of brain network organization. In particular, somatomotor network connectivity alterations were involved in the relationships between sleep and biopsychosocial factors. These profiles can potentially untangle the interplay between individuals' variability in sleep, health, cognition and lifestyle - equipping research and clinical settings to better support individual's well-being.
Collapse
Affiliation(s)
- Aurore A. Perrault
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l’Ile-de-Montréal, QC, Canada
- Sleep & Circadian Research Group, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW, Australia
| | - Valeria Kebets
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- McConnell Brain Imaging Centre (BIC), Montreal Neurological Institute (MNI), McGill University, Montreal, QC, Canada
- McGill University, Montreal, QC, Canada
| | - Nicole M. Y. Kuek
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
| | - Nathan E. Cross
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l’Ile-de-Montréal, QC, Canada
- School of Psychology, University of Sydney, NSW, Australia
| | | | - Florence B. Pomares
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l’Ile-de-Montréal, QC, Canada
| | - Jingwei Li
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Institute of Neuroscience and Medicine (INM-7: Brain and Behavior), Research Center Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany
| | - Michael W.L. Chee
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Thien Thanh Dang-Vu
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l’Ile-de-Montréal, QC, Canada
| | - B.T. Thomas Yeo
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore
- Martinos Center for Biomedical Imaging, Massachussetts General Hospital, Charlestown, MA, USA
| |
Collapse
|
2
|
Maltezos A, Perrault AA, Walsh NA, Phillips EM, Gong K, Tarelli L, Smith D, Cross NE, Pomares FB, Gouin JP, Dang-Vu TT. Methodological approach to sleep state misperception in insomnia disorder: Comparison between multiple nights of actigraphy recordings and a single night of polysomnography recording. Sleep Med 2024; 115:21-29. [PMID: 38325157 DOI: 10.1016/j.sleep.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/11/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
STUDY OBJECTIVE To provide a comprehensive assessment of sleep state misperception in insomnia disorder (INS) and good sleepers (GS) by comparing recordings performed for one night in-lab (PSG and night review) and during several nights at-home (actigraphy and sleep diaries). METHODS Fifty-seven INS and 29 GS wore an actigraphy device and filled a sleep diary for two weeks at-home. They subsequently completed a PSG recording and filled a night review in-lab. Sleep perception index (subjective/objective × 100) of sleep onset latency (SOL), sleep duration (TST) and wake duration (TST) were computed and compared between methods and groups. RESULTS GS displayed a tendency to overestimate TST and WASO but correctly perceived SOL. The degree of misperception was similar across methods within the GS group. In contrast, INS underestimated their TST and overestimated their SOL both in-lab and at-home, yet the severity of misperception of SOL was larger at-home than in-lab. Finally, INS overestimated WASO only in-lab while correctly perceiving it at-home. While only the degree of TST misperception was stable across methods in INS, misperception of SOL and WASO were dependent on the method used. CONCLUSIONS We found that GS and INS exhibit opposite patterns and severity of sleep misperception. While the degree of misperception in GS was similar across methods, only sleep duration misperception was reliably detected by both in-lab and at-home methods in INS. Our results highlight that, when assessing sleep misperception in insomnia disorder, the environment and method of data collection should be carefully considered.
Collapse
Affiliation(s)
- Antonia Maltezos
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Neuroscience, Université de Montreal, Montreal, QC, Canada
| | - Aurore A Perrault
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada.
| | - Nyissa A Walsh
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Psychology & Centre for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Emma-Maria Phillips
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Neuroscience, Université de Montreal, Montreal, QC, Canada
| | - Kirsten Gong
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Psychology & Centre for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Lukia Tarelli
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Psychology & Centre for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Dylan Smith
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada
| | - Nathan E Cross
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada
| | - Florence B Pomares
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada
| | - Jean-Philippe Gouin
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Psychology & Centre for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Thien Thanh Dang-Vu
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Neuroscience, Université de Montreal, Montreal, QC, Canada.
| |
Collapse
|
3
|
Weiner OM, O'Byrne J, Cross NE, Giraud J, Tarelli L, Yue V, Homer L, Walker K, Carbone R, Dang-Vu TT. Slow oscillation-spindle cross-frequency coupling predicts overnight declarative memory consolidation in older adults. Eur J Neurosci 2024; 59:662-685. [PMID: 37002805 DOI: 10.1111/ejn.15980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/06/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023]
Abstract
Cross-frequency coupling (CFC) between brain oscillations during non-rapid-eye-movement (NREM) sleep (e.g. slow oscillations [SO] and spindles) may be a neural mechanism of overnight memory consolidation. Declines in CFC across the lifespan might accompany coinciding memory problems with ageing. However, there are few reports of CFC changes during sleep after learning in older adults, controlling for baseline effects. Our objective was to examine NREM CFC in healthy older adults, with an emphasis on spindle activity and SOs from frontal electroencephalogram (EEG), during a learning night after a declarative learning task, as compared to a baseline night without learning. Twenty-five older adults (M [SD] age = 69.12 [5.53] years; 64% female) completed a two-night study, with a pre- and post-sleep word-pair associates task completed on the second night. SO-spindle coupling strength and a measure of coupling phase distance from the SO up-state were both examined for between-night differences and associations with memory consolidation. Coupling strength and phase distance from the up-state peak were both stable between nights. Change in coupling strength between nights was not associated with memory consolidation, but a shift in coupling phase towards (vs. away from) the up-state peak after learning predicted better memory consolidation. Also, an exploratory interaction model suggested that associations between coupling phase closer to the up-state peak and memory consolidation may be moderated by higher (vs. lower) coupling strength. This study supports a role for NREM CFC in sleep-related memory consolidation in older adults.
Collapse
Affiliation(s)
- Oren M Weiner
- PERFORM Centre and Center for Studies in Behavioural Neurobiology, Department of Psychology and Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'île-de-Montréal, Montréal, Quebec, Canada
| | - Jordan O'Byrne
- PERFORM Centre and Center for Studies in Behavioural Neurobiology, Department of Psychology and Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montréal, Quebec, Canada
| | - Nathan E Cross
- PERFORM Centre and Center for Studies in Behavioural Neurobiology, Department of Psychology and Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'île-de-Montréal, Montréal, Quebec, Canada
| | - Julia Giraud
- Department of Neurosciences, Université de Montréal, Montréal, Quebec, Canada
| | - Lukia Tarelli
- PERFORM Centre and Center for Studies in Behavioural Neurobiology, Department of Psychology and Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'île-de-Montréal, Montréal, Quebec, Canada
| | - Victoria Yue
- PERFORM Centre and Center for Studies in Behavioural Neurobiology, Department of Psychology and Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Quebec, Canada
| | - Léa Homer
- PERFORM Centre and Center for Studies in Behavioural Neurobiology, Department of Psychology and Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Quebec, Canada
| | - Katherine Walker
- PERFORM Centre and Center for Studies in Behavioural Neurobiology, Department of Psychology and Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Quebec, Canada
| | - Roxanne Carbone
- PERFORM Centre and Center for Studies in Behavioural Neurobiology, Department of Psychology and Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Quebec, Canada
| | - Thien Thanh Dang-Vu
- PERFORM Centre and Center for Studies in Behavioural Neurobiology, Department of Psychology and Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Quebec, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'île-de-Montréal, Montréal, Quebec, Canada
- Department of Neurosciences, Université de Montréal, Montréal, Quebec, Canada
| |
Collapse
|
4
|
Teh JZ, Grummitt L, Haroutonian C, Cross NE, Skinner B, Bartlett DJ, Yee B, Grunstein RR, Naismith SL, D’Rozario AL. Overnight declarative memory consolidation and non-rapid eye movement sleep electroencephalographic oscillations in older adults with obstructive sleep apnea. Sleep 2023; 46:zsad087. [PMID: 37052122 PMCID: PMC10666962 DOI: 10.1093/sleep/zsad087] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 03/01/2023] [Indexed: 04/14/2023] Open
Abstract
STUDY OBJECTIVES To compare overnight declarative memory consolidation and non-rapid eye movement (NREM) sleep electroencephalogram (EEG) oscillations in older adults with obstructive sleep apnea (OSA) to a control group and assess slow-wave activity (SWA) and sleep spindles as correlates of memory consolidation. METHODS Forty-six older adults (24 without OSA and 22 with OSA) completed a word-pair associate's declarative memory task before and after polysomnography. Recall and recognition were expressed as a percentage of the morning relative to evening scores. Power spectral analysis was performed on EEG recorded at frontal (F3-M2, F4-M1) and central (C3-M2, C4-M1) sites. We calculated NREM absolute slow oscillation (0.25-1 Hz) and delta (0.5-4.5 Hz) EEG power, and slow (11-13 Hz) spindle density (number of events per minute of N2 sleep) and fast (13-16 Hz) spindle density. RESULTS There were no significant differences in overnight recall and recognition between OSA (mean age 58.7 ± 7.1 years, apnea-hypopnea index (AHI) 41.9 ± 29.7 events/hour) and non-OSA (age 61.1 ± 10.3 years, AHI 6.6 ± 4.2 events/hour) groups. The OSA group had lower fast spindle density in the frontal region (p = 0.007). No between-group differences in SWA were observed. In the Control group, overnight recognition positively correlated with slow spindle density in frontal (rho = 0.555, p = 0.020) and central regions (rho = 0.490, p = 0.046). Overnight recall was not related to SWA or spindle measures in either group. CONCLUSIONS Older adults with OSA had deficits in fast sleep spindles but showed preserved overnight declarative memory consolidation. It is possible that compensatory mechanisms are being recruited by OSA patients to preserve declarative memory consolidation despite the presence of sleep spindle deficits.
Collapse
Affiliation(s)
- Jun Z Teh
- School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW, Australia
- NHMRC Centre of Research Excellence to Optimise Sleep in Brain Ageing and Neurodegeneration (CogSleep CRE), Sydney, NSW, Australia
| | - Lucinda Grummitt
- School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Carla Haroutonian
- School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW, Australia
| | - Nathan E Cross
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW, Australia
| | - Bradley Skinner
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW, Australia
| | - Delwyn J Bartlett
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW, Australia
- NHMRC Centre of Research Excellence to Optimise Sleep in Brain Ageing and Neurodegeneration (CogSleep CRE), Sydney, NSW, Australia
| | - Brendon Yee
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia
| | - Ronald R Grunstein
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW, Australia
- NHMRC Centre of Research Excellence to Optimise Sleep in Brain Ageing and Neurodegeneration (CogSleep CRE), Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia
| | - Sharon L Naismith
- School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- NHMRC Centre of Research Excellence to Optimise Sleep in Brain Ageing and Neurodegeneration (CogSleep CRE), Sydney, NSW, Australia
| | - Angela L D’Rozario
- School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, NSW, Australia
- NHMRC Centre of Research Excellence to Optimise Sleep in Brain Ageing and Neurodegeneration (CogSleep CRE), Sydney, NSW, Australia
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| |
Collapse
|
5
|
Hoyos CM, Cross NE, Terpening Z, D'Rozario AL, Yee BJ, LaMonica H, Marshall NS, Grunstein RR, Naismith SL. CPAP for Cognition in Sleep Apnea and Mild Cognitive Impairment: A Pilot Randomised Cross-Over Trial. Am J Respir Crit Care Med 2022; 205:1479-1482. [PMID: 35584294 DOI: 10.1164/rccm.202111-2646le] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Camilla M Hoyos
- The University of Sydney, 4334, Faculty of Science, School of Psychology, Sydney NSW, Australia, Sydney, New South Wales, Australia.,The University of Sydney, 4334, Healthy Brain Ageing Program, Brain and Mind Centre, Sydney, New South Wales, Australia.,Woolcock Institute of Medical Research, 104349, Centre for Sleep and Chronobiology, Glebe, New South Wales, Australia;
| | - Nathan E Cross
- The University of Sydney, 4334, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.,The University of Sydney, 4334, Healthy Brain Ageing Program, Brain and Mind Centre, Sydney, New South Wales, Australia.,Woolcock Institute of Medical Research, 104349, Centre for Sleep and Chronobiology, Glebe, New South Wales, Australia.,Concordia University, 5618, Center for Studies in Behavioural Neurobiology; Department of Health, Kinesiology and Applied Physiology, Montreal, Quebec, Canada
| | - Zoe Terpening
- The University of Sydney, 4334, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.,University of New South Wales, 7800, Faculty of Medicine, Sydney, New South Wales, Australia
| | - Angela L D'Rozario
- The University of Sydney, 4334, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.,The University of Sydney, 4334, Healthy Brain Ageing Program, Brain and Mind Centre, Sydney, New South Wales, Australia.,Woolcock Institute of Medical Research, 104349, Centre for Sleep and Chronobiology, Glebe, New South Wales, Australia
| | - Brendon J Yee
- Woolcock Institute of Medical Research, 104349, Centre for Sleep and Chronobiology, Glebe, New South Wales, Australia.,Royal Prince Alfred Hospital, 2205, Department of Respiratory and Sleep Medicine, Camperdown, New South Wales, Australia
| | - Haley LaMonica
- The University of Sydney, 4334, Healthy Brain Ageing Program, Brain and Mind Centre, Sydney, New South Wales, Australia.,The University of Sydney, 4334, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Nathaniel S Marshall
- The University of Sydney, 4334, Faculty of Medicine and Health Sciences, Sydney, New South Wales, Australia.,Woolcock Institute of Medical Research, 104349, Centre for Sleep and Chronobiology, Glebe, New South Wales, Australia
| | - Ronald R Grunstein
- Woolcock Institute of Medical Research, 104349, Centre for Sleep and Chronobiology, Glebe, New South Wales, Australia.,Royal Prince Alfred Hospital, 2205, Department of Respiratory and Sleep Medicine, Camperdown, New South Wales, Australia.,The University of Sydney, 4334, Faculty of Medicine and Health Sciences, Sydney, New South Wales, Australia
| | - Sharon L Naismith
- The University of Sydney, 4334, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.,The University of Sydney, 4334, Healthy Brain Ageing Program, Brain and Mind Centre, Sydney, New South Wales, Australia
| |
Collapse
|
6
|
Cross NE, Pomares FB, Nguyen A, Perrault AA, Jegou A, Uji M, Lee K, Razavipour F, Ali OBK, Aydin U, Benali H, Grova C, Dang-Vu TT. An altered balance of integrated and segregated brain activity is a marker of cognitive deficits following sleep deprivation. PLoS Biol 2021; 19:e3001232. [PMID: 34735431 PMCID: PMC8568176 DOI: 10.1371/journal.pbio.3001232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/28/2021] [Indexed: 11/19/2022] Open
Abstract
Sleep deprivation (SD) leads to impairments in cognitive function. Here, we tested the hypothesis that cognitive changes in the sleep-deprived brain can be explained by information processing within and between large-scale cortical networks. We acquired functional magnetic resonance imaging (fMRI) scans of 20 healthy volunteers during attention and executive tasks following a regular night of sleep, a night of SD, and a recovery nap containing nonrapid eye movement (NREM) sleep. Overall, SD was associated with increased cortex-wide functional integration, driven by a rise of integration within cortical networks. The ratio of within versus between network integration in the cortex increased further in the recovery nap, suggesting that prolonged wakefulness drives the cortex towards a state resembling sleep. This balance of integration and segregation in the sleep-deprived state was tightly associated with deficits in cognitive performance. This was a distinct and better marker of cognitive impairment than conventional indicators of homeostatic sleep pressure, as well as the pronounced thalamocortical connectivity changes that occurs towards falling asleep. Importantly, restoration of the balance between segregation and integration of cortical activity was also related to performance recovery after the nap, demonstrating a bidirectional effect. These results demonstrate that intra- and interindividual differences in cortical network integration and segregation during task performance may play a critical role in vulnerability to cognitive impairment in the sleep-deprived state.
Collapse
Affiliation(s)
- Nathan E. Cross
- PERFORM Centre, Concordia University, Montreal, Canada
- Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
- Institut Universitaire de Gériatrie de Montréal and CRIUGM, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - Florence B. Pomares
- PERFORM Centre, Concordia University, Montreal, Canada
- Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
- Institut Universitaire de Gériatrie de Montréal and CRIUGM, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - Alex Nguyen
- PERFORM Centre, Concordia University, Montreal, Canada
- Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Department of Physics, Concordia University, Montreal, Canada
| | - Aurore A. Perrault
- PERFORM Centre, Concordia University, Montreal, Canada
- Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
- Institut Universitaire de Gériatrie de Montréal and CRIUGM, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - Aude Jegou
- PERFORM Centre, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Department of Physics, Concordia University, Montreal, Canada
| | - Makoto Uji
- PERFORM Centre, Concordia University, Montreal, Canada
- Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Department of Physics, Concordia University, Montreal, Canada
| | - Kangjoo Lee
- Multimodal Functional Imaging Lab, Department of Physics, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Biomedical Engineering Department, Neurology and Neurosurgery Department, McGill University, Montreal, Quebec, Canada
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Fatemeh Razavipour
- PERFORM Centre, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Department of Physics, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Biomedical Engineering Department, Neurology and Neurosurgery Department, McGill University, Montreal, Quebec, Canada
| | - Obaï Bin Ka’b Ali
- PERFORM Centre, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Department of Physics, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Biomedical Engineering Department, Neurology and Neurosurgery Department, McGill University, Montreal, Quebec, Canada
| | - Umit Aydin
- PERFORM Centre, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Department of Physics, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Biomedical Engineering Department, Neurology and Neurosurgery Department, McGill University, Montreal, Quebec, Canada
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Habib Benali
- PERFORM Centre, Concordia University, Montreal, Canada
| | - Christophe Grova
- PERFORM Centre, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Department of Physics, Concordia University, Montreal, Canada
- Multimodal Functional Imaging Lab, Biomedical Engineering Department, Neurology and Neurosurgery Department, McGill University, Montreal, Quebec, Canada
| | - Thien Thanh Dang-Vu
- PERFORM Centre, Concordia University, Montreal, Canada
- Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
- Institut Universitaire de Gériatrie de Montréal and CRIUGM, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| |
Collapse
|
7
|
Machado FV, Louzada LL, Cross NE, Camargos EF, Dang-Vu TT, Nóbrega OT. More than a quarter century of the most prescribed sleeping pill: Systematic review of zolpidem use by older adults. Exp Gerontol 2020; 136:110962. [PMID: 32360985 DOI: 10.1016/j.exger.2020.110962] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/14/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022]
Abstract
Zolpidem is widely used to treat insomnia of older adults despite that few randomized controlled studies were conducted in this group. We systematically reviewed the relevant literature on efficacy/effectiveness and safety of zolpidem use by elderly individuals in relevant databases completed with a manual search of key journals. Studies were required to include individuals aged ≥60 years under intervention with zolpidem compared to placebo or other hypnosedatives. Outcomes were either objectively- or subjectively-assessed improvements in specific sleep parameters and safety for clinical use. The 31 reports selected for review were mostly of low-quality. The evidence suggests that zolpidem is useful typically by reducing sleep latency and episodes of wake after sleep onset, and increasing total sleep time and sleep efficiency. Regarding safety and tolerability, analyses suggest a low risk of daytime sleepiness and of deleterious effects on memory or psychomotor performance, provided that recommended dosage and precautions are followed. Few retrospective studies associate zolpidem use with risk of falls, fractures, dementia, cancer, and stroke. Zolpidem appears effective at lower doses and for short-term treatment among the elderly. Rigorous, new clinical trials are warranted to further document the specific effects of zolpidem in older individuals.
Collapse
Affiliation(s)
- Flávio V Machado
- Graduation Program in Medical Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil
| | - Luciana L Louzada
- Graduation Program in Medical Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil; Geriatric Medical Centre, Brasilia University Hospital, SGAN 605 Av. L2 Norte, Brasilia, DF 70840-901, Brazil
| | - Nathan E Cross
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 chemin Queen-Mary, Montreal, Qc H3W 1W5, Canada; Center for Studies in Behavioral Neurobiology and PERFORM Center, Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, Qc H4B 1R6, Canada
| | - Einstein F Camargos
- Graduation Program in Medical Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil; Geriatric Medical Centre, Brasilia University Hospital, SGAN 605 Av. L2 Norte, Brasilia, DF 70840-901, Brazil
| | - Thien Thanh Dang-Vu
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 chemin Queen-Mary, Montreal, Qc H3W 1W5, Canada; Center for Studies in Behavioral Neurobiology and PERFORM Center, Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montreal, Qc H4B 1R6, Canada
| | - Otávio T Nóbrega
- Graduation Program in Medical Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 chemin Queen-Mary, Montreal, Qc H3W 1W5, Canada.
| |
Collapse
|
8
|
Cross NE, Carrier J, Postuma RB, Gosselin N, Kakinami L, Thompson C, Chouchou F, Dang-Vu TT. Association between insomnia disorder and cognitive function in middle-aged and older adults: a cross-sectional analysis of the Canadian Longitudinal Study on Aging. Sleep 2020; 42:5488740. [PMID: 31089710 DOI: 10.1093/sleep/zsz114] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/27/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES This study examined the differences in cognitive function between middle-aged and older adults with insomnia disorder, insomnia symptoms only (ISO) or no insomnia symptoms (NIS), in the context of other health and lifestyle factors. METHODS Twenty-eight thousand four hundred eighty-five participants >45 years completed questionnaires, physical examinations, and neuropsychological testing across domains of processing speed, memory, and executive functions. An eight-question instrument assessed participants' sleep, defining subjects with insomnia symptoms, probable insomnia disorder (PID), or NIS. The associations between these three groups and cognitive performance were examined with linear regression models adjusted for lifestyle and clinical factors. RESULTS PID was identified in 1,068 participants (3.7% of the sample) while 7,813 (27.5%) experienced ISO. Participants with PID exhibited greater proportions of adverse medical and lifestyle features such as anxiety, depression, and diabetes than both other groups. Analyses adjusting for age, sex, education, as well as medical and lifestyle factors demonstrated that adults with PID exhibited declarative memory deficits (Rey Auditory Verbal Learning Test) compared with ISO or NIS. Adults with insomnia symptoms exhibited better performance on a task of mental flexibility than both other groups. CONCLUSIONS These findings suggest that insomnia disorder in middle-aged and older adults is associated with poorer health outcomes and worse memory performance than adults with insomnia symptoms alone or without any sleep complaints, even after adjustment for comorbidities. The assessment of longitudinal data within this cohort will be critical to understand if insomnia disorder may increase the risk of further cognitive decline.
Collapse
Affiliation(s)
- Nathan E Cross
- Institut Universitaire de Geriatrie de Montreal and CRIUGM, CIUSSS du Centre-Sud-de-l'Ile-de-Montreal, Montreal, Canada.,PERFORM Centre, Concordia University, Montreal, Canada.,Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada.,Canadian Sleep and Circadian Network, Montreal, Canada
| | - Julie Carrier
- Institut Universitaire de Geriatrie de Montreal and CRIUGM, CIUSSS du Centre-Sud-de-l'Ile-de-Montreal, Montreal, Canada.,Canadian Sleep and Circadian Network, Montreal, Canada.,Center for Advanced Research in Sleep Medicine, Hopital du Sacre- Coeur de Montreal, CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, Canada
| | - Ronald B Postuma
- Canadian Sleep and Circadian Network, Montreal, Canada.,Center for Advanced Research in Sleep Medicine, Hopital du Sacre- Coeur de Montreal, CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, Canada.,Department of Neurology, McGill University - Montreal General Hospital, Montreal, Canada
| | - Nadia Gosselin
- Canadian Sleep and Circadian Network, Montreal, Canada.,Center for Advanced Research in Sleep Medicine, Hopital du Sacre- Coeur de Montreal, CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, Canada.,Department of Psychology, Universite de Montreal, Montreal, Canada
| | - Lisa Kakinami
- PERFORM Centre, Concordia University, Montreal, Canada.,Department of Mathematics and Statistics, Concordia University
| | - Cynthia Thompson
- Center for Advanced Research in Sleep Medicine, Hopital du Sacre- Coeur de Montreal, CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, Canada
| | - Florian Chouchou
- Institut Universitaire de Geriatrie de Montreal and CRIUGM, CIUSSS du Centre-Sud-de-l'Ile-de-Montreal, Montreal, Canada.,PERFORM Centre, Concordia University, Montreal, Canada.,IRISSE Laboratory, UFR SHE, University of La Réunion, Le Tampon, France
| | - Thien Thanh Dang-Vu
- Institut Universitaire de Geriatrie de Montreal and CRIUGM, CIUSSS du Centre-Sud-de-l'Ile-de-Montreal, Montreal, Canada.,PERFORM Centre, Concordia University, Montreal, Canada.,Center for Studies in Behavioral Neurobiology, Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada.,Canadian Sleep and Circadian Network, Montreal, Canada
| |
Collapse
|
9
|
Cross NE, Memarian N, Duffy SL, Paquola C, LaMonica H, D'Rozario A, Lewis SJG, Hickie IB, Grunstein RR, Naismith SL. Structural brain correlates of obstructive sleep apnoea in older adults at risk for dementia. Eur Respir J 2018; 52:13993003.00740-2018. [PMID: 29973356 DOI: 10.1183/13993003.00740-2018] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 05/04/2018] [Indexed: 11/05/2022]
Abstract
This study aimed to investigate associations between obstructive sleep apnoea (OSA) and cortical thickness in older adults with subjective and objective cognitive difficulties, who are considered "at-risk" for dementia.83 middle-aged to older adults (51-88 years) underwent neuropsychological testing, polysomnography assessment of OSA and a structural magnetic resonance imaging brain scan. A principal components analysis was performed on OSA measures. Cortical thickness and subcortical volumes were compared to extracted components of "oxygen desaturation" and "sleep disturbance".Oxygen desaturation was significantly related to reduced cortical thickness in the bilateral temporal lobes (left: r=-0.44, p<0.001; right: r=-0.39, p=0.003). Conversely, sleep disturbance was associated with increased thickness in the right postcentral gyrus (r=0.48, p<0.001), pericalcarine (r=0.50, p=0.005) and pars opercularis (r=0.46, p=0.009) and increased volume of the hippocampus and amygdala. Decreased thickness in the bilateral temporal regions was associated with reduced verbal encoding (r=0.28, p=0.010).Given the clinical significance of this sample in terms of dementia prevention, these changes in grey matter reveal how OSA might contribute to neurodegenerative processes in older adults.
Collapse
Affiliation(s)
- Nathan E Cross
- School of Psychology, The University of Sydney, Camperdown, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Camperdown, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Neurosleep, NHMRC Centre of Research Excellence, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Negar Memarian
- Woolcock Institute of Medical Research, The University of Sydney, Camperdown, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Neurosleep, NHMRC Centre of Research Excellence, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Shantel L Duffy
- Woolcock Institute of Medical Research, The University of Sydney, Camperdown, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Neurosleep, NHMRC Centre of Research Excellence, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Casey Paquola
- Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Haley LaMonica
- School of Psychology, The University of Sydney, Camperdown, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Angela D'Rozario
- School of Psychology, The University of Sydney, Camperdown, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Camperdown, Australia.,Neurosleep, NHMRC Centre of Research Excellence, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Simon J G Lewis
- Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Neurosleep, NHMRC Centre of Research Excellence, The University of Sydney, Camperdown, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, Australia
| | - Ronald R Grunstein
- Woolcock Institute of Medical Research, The University of Sydney, Camperdown, Australia.,Neurosleep, NHMRC Centre of Research Excellence, The University of Sydney, Camperdown, Australia.,Sydney Health Partners, The University of Sydney, Camperdown, Australia
| | - Sharon L Naismith
- School of Psychology, The University of Sydney, Camperdown, Australia.,Brain and Mind Centre, The University of Sydney, Camperdown, Australia.,Neurosleep, NHMRC Centre of Research Excellence, The University of Sydney, Camperdown, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| |
Collapse
|
10
|
Miller CB, Valenti L, Harrison CM, Bartlett DJ, Glozier N, Cross NE, Grunstein RR, Britt HC, Marshall NS. Time Trends in the Family Physician Management of Insomnia: The Australian Experience (2000-2015). J Clin Sleep Med 2017; 13:785-790. [PMID: 28454597 DOI: 10.5664/jcsm.6616] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/14/2017] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To evaluate changes in rates of family physician (FP) management of insomnia in Australia from 2000-2015. METHODS The Bettering the Evaluation And Care of Health (BEACH) program is a nationally representative cross-sectional survey of 1,000 newly randomly sampled family physicians' activity in Australia per year, who each record details of 100 consecutive patient encounters. This provided records of approximately 100,000 encounters each year. We identified all encounters with patients older than 15 years where insomnia or difficulty sleeping was managed and assessed trends in these encounters from 2000-2015. RESULTS There was no change in the management rate of insomnia from 2000-2007 (1.54 per 100 encounters [95% confidence interval [CI]: 1.49-1.58]). This rate was lower from 2008-2015 (1.31 per 100 encounters [95% CI: 1.27-1.35]). There was no change in FP management: pharmacotherapy was used in approximately 90% of encounters; nonpharmacological advice was given at approximately 20%; and onward referral at approximately 1% of encounters. Prescription of temazepam changed from 54.6 [95% CI: 51.4-57.9] per 100 insomnia problems in 2000-2001 to 43.6 [95% CI: 40.1-47.0] in 2014-2015, whereas zolpidem increased steadily from introduction in 2000 to 14.6 [95% CI: 12.2-17.1] per 100 insomnia problems in 2006-2007, and then decreased to 7.3 [95% CI: 5.4-9.2] by 2014-2015. CONCLUSIONS Insomnia management frequency decreased after 2007 in conjunction with ecologically associated Australian media reporting of adverse effects linked to zolpidem use. Australian FPs remain reliant on pharmacotherapy for the management of insomnia.
Collapse
Affiliation(s)
- Christopher B Miller
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia
| | - Lisa Valenti
- Family Medicine Research Centre, School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Christopher M Harrison
- Family Medicine Research Centre, School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Delwyn J Bartlett
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Nick Glozier
- Brain and Mind Centre, The University of Sydney, New South Wales, Australia
| | - Nathan E Cross
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, RPAH, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Helena C Britt
- Family Medicine Research Centre, School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Nathaniel S Marshall
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, New South Wales, Australia.,Sydney Nursing School, The University of Sydney, New South Wales, Australia
| |
Collapse
|
11
|
D’Rozario AL, Grummitt L, Cross NE, Bartlett DJ, Grunstein RR, Naismith S. 0848 CLINICAL, POLYSOMNOGRAPHIC AND NEUROPHYSIOLOGICAL CORRELATES OF
SLEEP-DEPENDENT MEMORY WITH AGING. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
12
|
Miller CB, Valenti L, Harrison C, Bartlett DJ, Glozier N, Cross NE, Grunstein RR, Britt HC, Marshall NS. 0319 FAMILY PHYSICIAN MANAGEMENT OF INSOMNIA IN AUSTRALIA: THE BEACH STUDY (2000–15). Sleep 2017. [DOI: 10.1093/sleepj/zsx050.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
13
|
McKinnon AC, Duffy SL, Cross NE, Terpening Z, Grunstein RR, Lagopoulos J, Batchelor J, Hickie IB, Lewis SJ, Shine JM, Naismith SL. Functional Connectivity in the Default Mode Network is Reduced in Association with Nocturnal Awakening in Mild Cognitive Impairment. J Alzheimers Dis 2017; 56:1373-1384. [DOI: 10.3233/jad-160922] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Andrew C. McKinnon
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
- Department of Psychology, Macquarie University, Sydney NSW, Australia
| | - Shantel L. Duffy
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
- Charles Perkins Centre and Brain and Mind Centre, The University of Sydney, Camperdown NSW, Australia
| | - Nathan E. Cross
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
- Woolcock Institute of Medical Research, Glebe NSW, Australia
| | - Zoe Terpening
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | | | - Jim Lagopoulos
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | | | - Ian B. Hickie
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | - Simon J.G. Lewis
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | - James M. Shine
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
| | - Sharon L. Naismith
- Healthy Brain Ageing Program, The University of Sydney, Camperdown NSW, Australia
- School of Psychology, The University of Sydney, Camperdown NSW, Australia
- Charles Perkins Centre and Brain and Mind Centre, The University of Sydney, Camperdown NSW, Australia
| |
Collapse
|
14
|
D'Rozario AL, Cross NE, Vakulin A, Bartlett DJ, Wong KKH, Wang D, Grunstein RR. Quantitative electroencephalogram measures in adult obstructive sleep apnea - Potential biomarkers of neurobehavioural functioning. Sleep Med Rev 2016; 36:29-42. [PMID: 28385478 DOI: 10.1016/j.smrv.2016.10.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/15/2016] [Accepted: 10/08/2016] [Indexed: 10/20/2022]
Abstract
Obstructive sleep apnea (OSA) results in significantly impaired cognitive functioning and increased daytime sleepiness in some patients leading to increased risk of motor vehicle and workplace accidents and reduced productivity. Clinicians often face difficulty in identifying which patients are at risk of neurobehavioural dysfunction due to wide inter-individual variability, and disparity between symptoms and conventional metrics of disease severity such as the apnea hypopnea index. Quantitative electroencephalogram (EEG) measures are determinants of awake neurobehavioural function in healthy subjects. However, the potential value of quantitative EEG (qEEG) measurements as biomarkers of neurobehavioural function in patients with OSA has not been examined. This review summarises the existing literature examining qEEG in OSA patients including changes in brain activity during wake and sleep states, in relation to daytime sleepiness, cognitive impairment and OSA treatment. It will speculate on the mechanisms which may underlie changes in EEG activity and discuss the potential utility of qEEG as a clinically useful predictor of neurobehavioural function in OSA.
Collapse
Affiliation(s)
- Angela L D'Rozario
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia; School of Psychology, Faculty of Science, Brain and Mind Centre and Charles Perkins Centre, The University of Sydney, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital & Sydney Local Health District, Sydney, NSW, Australia.
| | - Nathan E Cross
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Andrew Vakulin
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia; Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Delwyn J Bartlett
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, NSW, Australia
| | - Keith K H Wong
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital & Sydney Local Health District, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, NSW, Australia
| | - David Wang
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital & Sydney Local Health District, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, NSW, Australia
| | - Ronald R Grunstein
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia; Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital & Sydney Local Health District, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, NSW, Australia
| |
Collapse
|
15
|
Cross NE, Harrison CM, Yee BJ, Grunstein RR, Wong KKH, Britt HC, Marshall NS. Management of Snoring and Sleep Apnea in Australian Primary Care: The BEACH Study (2000-2014). J Clin Sleep Med 2016; 12:1167-73. [PMID: 27397666 DOI: 10.5664/jcsm.6060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 03/24/2016] [Indexed: 01/26/2023]
Abstract
STUDY OBJECTIVES To characterize the changes in management of snoring and obstructive sleep apnea (OSA) in general practice in Australia. METHODS The Bettering the Evaluation And Care of Health (BEACH) study is a nationally representative rolling cross-sectional survey of general practice activity in Australia. We analyzed all adult (age 18+ y) encounters for OSA or snoring, annually from 2000 to 2014 (approximately 1,000 general practitioners (GPs) per year recording approximately 100,000 patient encounters per year). RESULTS The management rate of OSA rose from 94 to 296 per 100,000 encounters, whereas management rate of snoring remained steady at approximately 15 to 25 per 100,000 encounters. The majority of patients managed for OSA were: middle-aged (25-64 y; 71.3% of all patients); overweight (90%); male (62%), although there was a trend for an increase in the proportion being female over the study period (21 to 37 per 100 encounters). Referral rates were high for both OSA (59 per 100 problems managed) and snoring (69 per 100), although medical referrals (to a sleep clinic or respiratory physician) were significantly higher for patients managed for OSA than for snoring (90% vs. 60% of all referrals). Surgical referrals were higher for snoring than for OSA (37% vs. 3% of all referrals). CONCLUSIONS The management rate for OSA tripled from 2000 to 2014, while the rate for snoring remained steady. GPs significantly relied on the advice of other health professionals to manage OSA; however, their referral patterns aligned with what most specialists would recommend. COMMENTARY A commentary on this article appears in this issue on page 1081.
Collapse
Affiliation(s)
- Nathan E Cross
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, NSW, Australia
| | - Christopher M Harrison
- Family Medicine Research Centre of the School of Public Health, The University of Sydney, Sydney, Australia
| | - Brendon J Yee
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Keith K H Wong
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - Helena C Britt
- Family Medicine Research Centre of the School of Public Health, The University of Sydney, Sydney, Australia
| | - Nathaniel S Marshall
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, NSW, Australia.,Sydney Nursing School, The University of Sydney, Sydney, Australia
| |
Collapse
|
16
|
Cross NE, Lagopoulos J, Duffy SL, Cockayne NL, Hickie IB, Lewis SJG, Naismith SL. Sleep quality in healthy older people: relationship with ¹H magnetic resonance spectroscopy markers of glial and neuronal integrity. Behav Neurosci 2014; 127:803-10. [PMID: 24128367 DOI: 10.1037/a0034154] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The hippocampus and thalamus assume a significant role in the overnight consolidation of memories, a process that is negatively impacted by sleep disruption. Emerging evidence suggests that disturbances of sleep in older people may co-occur with underlying neurobiological changes. This study sought to assess glial and neuronal integrity in these regions in relation to subjective sleep disturbance in a healthy older sample. Forty-three healthy older people (mean age = 70, SD = 5.0) were assessed clinically and medically and screened for cognitive and depressive symptoms, as well as sleep disturbance. Single voxel hippocampal and thalamus metabolite ratios of N-acetyl aspartate (NAA) and myo-inositol (mI) with total creatine (Cr + PCr) were measured using magnetic resonance spectroscopy at 3-Tesla. Higher hippocampal mI/Cr + PCr ratios were significantly correlated with poorer self-reported sleep quality (r = .42, p < .01) and less sleep efficiency (r = -0.42, p < .01) as recorded by the Pittsburgh Sleep Quality Index (Buysse, Reynolds, Monk, Berman, & Kupfer, 1989). No other significant correlations were observed within the hippocampus or within the thalamus. These results indicate that in healthy older people, subjective sleep disturbance may be associated with glial alterations in the hippocampus. Future research is now needed to examine these associations with respect to objective sleep measures and overnight memory consolidation.
Collapse
|
17
|
Sternberg TL, Cross NE. Adverse reactions to nonindicated medications. Anesthesiology 1997; 86:1212-3. [PMID: 9158372 DOI: 10.1097/00000542-199705000-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|