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Royant-Parola S, Hartley S, Reynaud E, Brion A, Crouigneau B, Rabeyron T, Batissou A, Schlesser T, Schröder CM, Sarfati Y. [Sleep in a performance artist: Eight days and seven nights sitting inside a metal sculpture]. Encephale 2024; 50:185-191. [PMID: 37604714 DOI: 10.1016/j.encep.2023.05.005] [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] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/08/2023] [Indexed: 08/23/2023]
Abstract
Sleep in extreme situations has been little studied. The artist Abraham Poincheval (AP) is known for his performances in confined spaces. For his show at the Perrotin Gallery in Paris, he was enclosed for 8days and 7nights in a metal sculpture of his body in a seated position, with his head facing a work by Hans Hartung at the end of a cone system placed in front of his eyes which occluded all other visual stimuli. The interior of the metal structure was not padded and there was no head support. His sleep and internal temperature were continuously recorded using polysomnography (Grael, Compumedics) and an orally swallowed temperature sensitive capsule (Bodycap) with temperature sampling every 2min. AP slept an average of 355.1min/24h, composed of light slow-wave sleep (N1: 47.1min, N2: 192.2min), deep slow-wave sleep (N3: 100.4min), and REM sleep 4,3 % (15.4min). Sleep, although mostly nocturnal, was split into periods of no more than 20min. Deep sleep was therefore remarkably resistant to the uncomfortable experimental conditions, while REM sleep was markedly impaired, lasting only a few short minutes and followed by rapid awakening. This is probably due to the head position within the sculpture which was unsupported, so REM sleep with its inherent muscle atonia led to involuntary head flexion and was impossible to sustain for long. The thermal minimum was between 5:17 a.m. and 6:35 a.m. The amplitude of the core temperature decreased by more than 30 % between the beginning and the end of the protocol. Despite the immobility induced by the confined experimental conditions, there was no desynchronization of circadian rhythms. The sleep time was surprisingly long given the conditions, and slow-wave sleep was relatively preserved with an amount typically found in normal subjects while REM sleep was markedly impaired. Slow-wave sleep is clearly preserved underlying its central role in physical and mental homeostasis. REM sleep is clearly more fragile. The reduction in REM sleep linked to position has been found in a study of sleep in the sitting position in airplanes where loss of muscle tonus in the neck fragments REM sleep. Techniques for selective REM sleep deprivation also use muscle atonia: one of the initial techniques of selective REM sleep deprivation relied on muscle atonia in REM causing a cat to fall from a small perch into water. In man, the lack of head support is clearly a source of REM fragmentation. However in the case of this study, we cannot exclude an effect of other factors, notably the meditative techniques used by the performer to maintain attention on the painting, described as a dream state punctuated by visual hallucinations. Surprisingly, despite physical isolation within the sculpture, AP's biological rhythms remained stable. However, the conditions were not those of complete isolation: noise, the presence of the public in the gallery who occasionally talked to AP through the sculpture, and variations in light during the day were all temporal cues. In addition, a heatwave during the performance raised the temperature in the room with reduced total sleep time on the hottest night. Although the phase of the circadian rhythm measured by the internal temperature did not change, the amplitude fell which is compatible with reduced physical activity. In conclusion, under physically constraining and uncomfortable sleep conditions, deep sleep is maintained while REM sleep is starkly reduced. From a homeostatic point of view, this means that over a short period of time, in a survival situation, energy recovery through deep slow-wave sleep takes priority over REM sleep.
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Affiliation(s)
| | - Sarah Hartley
- Réseau Morphée, 2, grande rue, 92380 Garches, France
| | - Eve Reynaud
- CNRS UPR 3212, Institut des neurosciences cellulaires et intégratives, université de Strasbourg, 67200 Strasbourg, France
| | - Agnès Brion
- Réseau Morphée, 2, grande rue, 92380 Garches, France
| | | | - Thomas Rabeyron
- Université de Lorraine, Interpsy, EA4432, Nancy, France; Institut universitaire de France, 54000 Nancy, France
| | | | - Thomas Schlesser
- Fondation Hartung Bergman, 173, chemin du Valbosquet, 06600 Antibes, France
| | - Carmen M Schröder
- CNRS UPR 3212, Institut des neurosciences cellulaires et intégratives, université de Strasbourg, 67200 Strasbourg, France; Département de psychiatrie de l'enfant et de l'adolescent, hôpitaux universitaires de Strasbourg, 67200 Strasbourg, France; CIRCSom (Centre international de recherche en chronosomnologie), hôpitaux universitaires de Strasbourg, 67200 Strasbourg, France
| | - Yves Sarfati
- 123, boulevard du Montparnasse, 75006 Paris, France
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Pitrat B, Turpin A, Peyret E, Hamonniere T, Drain A, Maatoug R, Le Roux E. Mobile app measuring sleep and behaviors: A trial in adolescents with addiction. Encephale 2024:S0013-7006(23)00214-2. [PMID: 38311486 DOI: 10.1016/j.encep.2023.11.007] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/08/2023] [Accepted: 11/02/2023] [Indexed: 02/06/2024]
Abstract
INTRODUCTION The smartphones generalisation allows the development of attractive "real-life" monitoring tools for care and research enabling the measurement of addictive behaviours and comorbidities such as sleep disorders. The study objective was to assess the interest of a mobile app collecting such information among adolescents with addictive behaviours in order to enhance the availability of behavioural data in consultation. METHODS An open label randomised pilot study was held along two parallel arms. The patients randomised to the intervention group (n=18) used a mobile app to provide daily data for 15 days relating to their sleep and their behaviour (addictive behaviours with or without substances). The patients in the control group (n=18) used a paper diary allowing the collection of the same data, only the medium differed. RESULTS The patients' median age was 16 years [15.0-16.5]. A median of 67% and 10% of the expected information was completed respectively in the intervention and control groups during the 15 days of follow-up and could be used in consultation (P=0.08). The patient's knowledge, attitudes, intentions to change, behaviour change and seeking help related to the use of the diaries appeared higher in the intervention group (20.5/30) than in the control group (11/20). CONCLUSION This study described the high patient compliance with the data collection by means of the app. The diary app seems to have been more impactful for patients than the paper diary. This app could represent an important tool to improve the therapeutic alliance and care due to a better knowledge of the behaviours on the part of the clinician but also a better awareness of the patients themselves.
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Affiliation(s)
- Benjamin Pitrat
- Child and Adolescent Psychiatry Department, Robert-Debré Hospital, AP-HP Nord-université de Paris, 75019 Paris, France
| | - Agathe Turpin
- Clinical Epidemiology Unit, Robert-Debré Hospital, AP-HP Nord-université de Paris, Inserm, CIC 1426, Paris, France
| | - Emmanuelle Peyret
- Child and Adolescent Psychiatry Department, Robert-Debré Hospital, AP-HP Nord-université de Paris, 75019 Paris, France
| | - Tristan Hamonniere
- LPPS, université de Paris, 92100 Boulogne-Billancourt, France; Clinique médicale et pédagogique Dupré, Fondation santé des étudiants de France, Sceaux, France
| | | | - Redwan Maatoug
- Service de psychiatrie adulte de la Pitié-Salpêtrière, institut du cerveau (ICM), AP-HP, Sorbonne université, 75013 Paris, France
| | - Enora Le Roux
- Clinical Epidemiology Unit, Robert-Debré Hospital, AP-HP Nord-université de Paris, Inserm, CIC 1426, Paris, France; ECEVE UMR 1123, Inserm, université de Paris, Paris, France.
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Remadi M, Dinis S, Bernard L, Defontaine D, Boussaud M, Chennaoui M, Saguin E. Evaluation of sleep and therapeutic education needs of military with PTSD. Encephale 2024; 50:48-53. [PMID: 36907668 DOI: 10.1016/j.encep.2023.01.004] [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] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/11/2022] [Accepted: 01/10/2023] [Indexed: 03/12/2023]
Abstract
Sleep disorders in post-traumatic stress disorder (PTSD) are both diagnostic (nocturnal reliving) and prognostic. Poor sleep worsens the daytime symptomatology of PTSD and makes it resistant to treatment. However, no specific treatment is codified in France to treat these sleep disorders although sleep therapies (cognitive behavioural therapy for insomnia, psychoeducation and relaxation) have proven for years to be effective in treating insomnia. Therapeutic sessions can be part of a therapeutic patient education program, which is a model for the management of chronic pathologies. It allows for an improvement in a patient's quality of life and enhanced medication compliance. We therefore carried out an inventory of sleep disorders of patients with PTSD. First, we collected data by means of sleep diaries concerning the population's sleep disorders at home. Then we assessed the population's expectations and needs regarding its management of sleep, thanks to a semi-qualitative interview. The data from sleep diaries, which was consistent with the literature, showed that our patients suffered from severe sleep disorders that strongly impact their daily lives, with 87% of patients having an increased sleep onset latency, and 88% having nightmares. We observed a strong demand from patients for specific support for these symptoms, 91% expressing an interest in a TPE program targeting sleep disorders. Thanks to the data collected, the emerging themes for a future therapeutic patient education program targeting sleep disorders of soldiers with PTSD are: sleep hygiene; management of nocturnal awakenings, including nightmares; and psychotropic drugs.
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Affiliation(s)
- M Remadi
- Service de psychiatrie, HIA Bégin, 94160 Saint-Mandé, France.
| | - S Dinis
- Service de psychiatrie, HIA Bégin, 94160 Saint-Mandé, France
| | - L Bernard
- Service de psychiatrie, HIA Bégin, 94160 Saint-Mandé, France
| | - D Defontaine
- Service de psychiatrie, HIA Percy, 92140 Clamart, France
| | - M Boussaud
- Service de psychiatrie, HIA Percy, 92140 Clamart, France
| | - M Chennaoui
- VIFASOM (vigilance fatigue sommeil et santé publique) EA 7330, université de Paris, 75005 Paris, France; Institut de recherche biomédicale des Armées, 91220 Brétigny-sur-Orge, France
| | - E Saguin
- Service de psychiatrie, HIA Bégin, 94160 Saint-Mandé, France; VIFASOM (vigilance fatigue sommeil et santé publique) EA 7330, université de Paris, 75005 Paris, France
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Methorst C, Perrin J, Faix A, Huyghe E. [Male infertility, environment and lifestyle]. Prog Urol 2023; 33:613-623. [PMID: 38012907 DOI: 10.1016/j.purol.2023.09.014] [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] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Since the 1970s, there has been a quantitative and qualitative decline in sperm parameters. The main hypothesis to explain such a rapid evolution is the involvement of environmental and behavioral phenomena. METHODS A bibliographic search limited to English and French literature in men published before 7/2023 was carried out on the links between fertility and pollution, xenobiotics, tobacco, narcotics, cannabis, alcohol, weight, sport, sedentary lifestyle, sleep and anabolics. RESULTS Profound changes in lifestyle have occurred over the past 50 years: reduced sleep time, sedentary lifestyle, dietary changes, tobacco consumption, use of narcotics and anabolics. These changes have a proven impact on spermogram parameters, and should be corrected in an effort to optimize reproductive health. Other environmental parameters: pollution, exposure to heavy metals, exposure to xenobiotics, phthalates and pesticides… will be more difficult to exclude from patients' daily lives, but deserve to be taken more into account. CONCLUSION This review should help the urologist to assess and counsel patients in order to improve their reproductive health. These factors should be routinely investigated in infertile men.
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Affiliation(s)
- C Methorst
- Service de médecine de la reproduction, hôpital des 4 villes, Saint-Cloud, France
| | - J Perrin
- Biologie et médecine de la reproduction et du développement, CHU de Marseille, UMR 7263 IMBE, Marseille, France
| | - A Faix
- Clinique Saint-Roch, 560, avenue du Colonel-Pavelet-dit-Villars, 34000 Montpellier, France
| | - E Huyghe
- Département d'urologie, hôpital de Rangueil, CHU de Toulouse, Toulouse, France; Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; UMR DEFE, Inserm 1203, université de Toulouse, université de Montpellier, Toulouse, France.
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Ouchene R, El Habchi N, Demina A, Petit B, Trojak B. The effectiveness of lucid dreaming therapy in patients with nightmares: A systematic review. L'Encéphale 2023; 49:525-531. [PMID: 37005191 DOI: 10.1016/j.encep.2023.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVES Nightmares can be defined as "an unpleasant dream with anxiety and oppression". They represent a symptom possibly leading to serious psychiatric and physical consequences. It occurs to 2% to 8% of the general population. Lucid dreaming therapy (LDT) is an interesting upcoming psychotherapy for the treatment of nightmares. The aim of this study was to evaluate the efficacy of LDT in the treatment of nightmares in adults and children. METHODS We performed a systematic review of the literature, based on the Cochrane organisation's methodology. We explored the PubMed, Cochrane library, PsycINFO via Ovid and Embase databases and clinical trial registries (CTR), namely clinicaltrials.gov, EU clinical trials and the WHO clinical trials registry platform. RESULTS Four randomized controlled trials (RCT), 2 case series and 5 case reports were included. Most of the included studies found LDT effective in reducing nightmare frequency among adults with chronic and recurring nightmares. We did not identify any reports in children. CONCLUSIONS Despite a limited internal validity for the included studies, these first results are encouraging. Nonetheless, larger and more rigorous studies would allow to better assess the utility of LDT for nightmares.
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Affiliation(s)
- R Ouchene
- Centre Hospitalier La Chartreuse, 21000 Dijon, France.
| | - N El Habchi
- CHU Dijon Bourgogne, Université Bourgogne Franche-Comté, Bourgogne Franche-Comté, France
| | - A Demina
- CHU Dijon Bourgogne, Université Bourgogne Franche-Comté, Bourgogne Franche-Comté, France
| | - B Petit
- CHU Dijon Bourgogne, Université Bourgogne Franche-Comté, Bourgogne Franche-Comté, France
| | - B Trojak
- CHU Dijon Bourgogne, Université Bourgogne Franche-Comté, Bourgogne Franche-Comté, France; Université de Bourgogne Franche-Comté, UMR Inserm 1093, CAPS, Dijon, France
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Denis I, Turcotte S, Morin CM, Belleville G, Foldes-Busque G. A preliminary validation of the pediatric adaptation of the Insomnia Severity Index. Encephale 2023; 49:474-480. [PMID: 36244838 DOI: 10.1016/j.encep.2022.05.008] [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] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/03/2022] [Accepted: 05/12/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The prevalence of insomnia in children aged 5 to 12 years old is 20% to 31%. Currently, there is no well-validated questionnaire assessing all the components of insomnia in school-aged children. The present study aims to introduce an adaptation of the Insomnia Severity Index for this purpose. METHOD Fifty-nine children aged 8- to 12-years-old with at least one anxiety disorder were recruited from youth mental health care settings. Their parents completed the pediatric adaptation of the Insomnia Severity Index which includes two scales used to report insomnia symptoms in children and their impact on the child (ISI-Child) and parents (ISI-Parent), My Child's Sleep Habits questionnaire, and the Child Behavior Checklist. RESULTS Both the ISI-Child and the ISI-Parent scales presented adequate factorial structure (RMSEA ≤ 0.05) and internal consistency (ISI-Child: α=0.87; ISI-Parent: α=0.88). Furthermore, the results of the two scales were strongly correlated (r=0.91, P<0.001). The convergent validity was assessed using the Waking During the Night scale of the My Child's Sleep Habits questionnaire and was adequate for the ISI-Child (r=0.52, P<0.001) and the ISI-Parent (r=0.53, P<0.001). Finally, the Rule-Breaking Behavior (r ≤ 0.26, P ≥ 0.05) and Aggressive Behavior (r ≤ 0.19, P ≥ 0.19) scales of the Child Behavior Checklist showed small correlations with both subscales, indicating good divergent validity. CONCLUSION The pediatric adaptation of the Insomnia Severity Index is a potentially reliable and valid measure for screening and assessing insomnia in children.
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Affiliation(s)
- I Denis
- School of Psychology, Université Laval, G1V 0A6 Québec City, Canada; Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada; Centre de recherche universitaire sur les jeunes familles, G1C 3S2 Québec City, Canada.
| | - S Turcotte
- Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada
| | - C M Morin
- Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada; Centre d'étude des troubles du sommeil, centre de recherche, institut universitaire en santé mentale, G1J 2G3 Québec City, Canada
| | - G Belleville
- Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada
| | - G Foldes-Busque
- School of Psychology, Université Laval, G1V 0A6 Québec City, Canada; Research Centre, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, G6V 3Z1 Lévis, Canada; Research Centre, Quebec Heart and Lung Institute, G1V 4G5 Québec City, Canada
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Geoffroy PA, Schroder CM, Bourgin P, Maruani J, Lejoyeux M, d'Ortho MP, Couffignal C. Validation of a data collection set for the psychiatric, addiction, sleep and chronobiological assessments of patients with depression: A Delphi study for the SoPsy-depression French national cohort. Encephale 2023; 49:117-123. [PMID: 36257850 DOI: 10.1016/j.encep.2022.07.004] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/08/2022] [Accepted: 07/15/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Despite international efforts to identify biomarkers of depression, none has been transferred to clinical practice, neither for diagnosis, evolution, nor therapeutic response. This led us to build a French national cohort (through the clinical and research network named SoPsy within the French biological psychiatry society (AFPBN) and sleep society (SFRMS)), to better identify markers of sleep and biological rhythms and validate more homogeneous subgroups of patients, but also to specify the manifestations and pathogeneses of depressive disorders. Before inclusions, we sought to provide a predefined, standardized, and robust set of data to be collected in all centers. METHODS A Delphi process was performed to achieve consensus through the independent rating of invited experts, the SoPsy-depression co-investigators (n=34). The initial set open for vote included 94 questionnaires targeting adult and child psychiatry, sleep and addiction. RESULTS Two questionnaire rounds were completed with 94% participation in the first round and 100% participation in the second round. The results of the Delphi survey incorporated the consensus opinion of the 32 members who completed both rounds. Nineteen of the 94 questionnaires achieved consensus at the first round and seventy of 75 at the second round. The five remaining questionnaires were submitted to three experts involved in the steering committee during a dedicated meeting. At the end, 24 questionnaires were retained in the mandatory and 26 in the optional questionnaire set. CONCLUSIONS A validated data collection set of questionnaires is now available to assess psychiatry, addiction, sleep and chronobiology dimensions of depressive disorders.
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Affiliation(s)
- P A Geoffroy
- Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France; GHU Paris - psychiatry & neurosciences, 1, rue Cabanis, 75014 Paris, France; NeuroDiderot, Inserm, FHU I2-D2, université Paris Cité, 75019 Paris, France; CNRS UPR 3212, Institute for cellular and integrative neurosciences, 67000 Strasbourg, France.
| | - C M Schroder
- CNRS UPR 3212, Institute for cellular and integrative neurosciences, 67000 Strasbourg, France; Department of child and adolescent psychiatry, Strasbourg university and Strasbourg university hospitals, Strasbourg, France; Sleep disorders center & CIRCSom (International Research Center for ChronoSomnology), CHRU, Strasbourg, France
| | - P Bourgin
- CNRS UPR 3212, Institute for cellular and integrative neurosciences, 67000 Strasbourg, France; Sleep disorders center & CIRCSom (International Research Center for ChronoSomnology), CHRU, Strasbourg, France
| | - J Maruani
- Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France; GHU Paris - psychiatry & neurosciences, 1, rue Cabanis, 75014 Paris, France; NeuroDiderot, Inserm, FHU I2-D2, université Paris Cité, 75019 Paris, France
| | - M Lejoyeux
- Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France; GHU Paris - psychiatry & neurosciences, 1, rue Cabanis, 75014 Paris, France; NeuroDiderot, Inserm, FHU I2-D2, université Paris Cité, 75019 Paris, France
| | - M-P d'Ortho
- NeuroDiderot, Inserm, FHU I2-D2, université Paris Cité, 75019 Paris, France; Service de physiologie - explorations fonctionnelles, centre du sommeil, hôpital Bichat, AP-HP, 75018 Paris, France
| | - C Couffignal
- Département de biostatistique, épidémiologie et recherche clinique, Hôpital Bichat, université Paris Cité, AP-HP, 75018 Paris, France
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Christodoulou N, Maruani J, d'Ortho MP, Lejoyeux M, Geoffroy PA. Sleep quality of medical students and relationships with academic performances. Encephale 2023; 49:9-14. [PMID: 34876277 DOI: 10.1016/j.encep.2021.09.006] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Sleep health is a major public health concern because of its correlation with physical and mental health, and it may be particularly altered in medical students. This study aims: i) to examine the sleep characteristics of French medical students and their knowledge about basic sleep hygiene rules and; ii) to examine the correlations between sleep quality and academic performances, as well as between sleep quality and sleep knowledge. METHODS Students from 4th, 5th and 6th years of medicine, of the Faculty of Paris Diderot, voluntarily responded to an online questionnaire including PSQI and multiple-choice quizzes (MCQ) about basic sleep hygiene rules. RESULTS From the 177 participants, 49.7% had a poor sleep (PSQI>5). Regarding sleep latency, 44.6% needed>30min to fall asleep at least once a week, 26.5% slept 6 hours or less by night, 42.4% of them qualified their sleep quality as bad or very bad. A serious lack of knowledge about basic sleep hygiene rules was observed, with an average score at the MCQ of 6.61/10, and only 31% of medical students were aware of basic good sleep habits. Significant correlations were observed between sleep efficiency and all academic mean scores (both regarding the morning, afternoon, and pooled mean scores), and between sleep disturbances and the morning mean score. CONCLUSIONS French medical students have a poor sleep quality, correlating with academic performances, and present a poor knowledge of basic sleep rules. These findings are a call to improve medical training schedules and to develop prevention and training programs.
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Affiliation(s)
- N Christodoulou
- Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France; Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France.
| | - J Maruani
- Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France; Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France
| | - M-P d'Ortho
- Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France; Inserm U1141, université de Paris, NeuroDiderot, 75019 Paris, France; Explorations fonctionnelles et centre du sommeil, département de physiologie clinique, GHU Paris Nord, DMU DREAM, hôpital Bichat, AP-HP, 75018 Paris, France
| | - M Lejoyeux
- Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France; Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France; GHU Paris - psychiatry & neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - P A Geoffroy
- Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France; Département de psychiatrie et d'addictologie, GHU Paris Nord, DMU neurosciences, hôpital Bichat - Claude Bernard, AP-HP, 75018 Paris, France; GHU Paris - psychiatry & neurosciences, 1, rue Cabanis, 75014 Paris, France.
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Julian M, Camart N, de Kernier N, Verlhiac JF. [Quantitative survey on French teenagers' sleep: Insomnia, anxiety-depression and circadian rhythms]. Encephale 2023; 49:41-49. [PMID: 34865847 DOI: 10.1016/j.encep.2021.08.010] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/29/2021] [Accepted: 08/20/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Insomnia is a sleep disorder that particularly affects teenagers. Its psychic and physical consequences are major and make it a public health priority. The main purpose of the study was to provide contemporary data on adolescent sleep and to explore the intrications between insomnia and mood disorders while investigating the chronotype responsibility. METHOD A battery of questionnaires was offered to 1,036 French teenagers, enrolled in secondary school, aged between 12 and 20 years old and living in urban areas for middle school students and in rural areas for high school students. It was mainly composed of the Insomnia Severity Index (ISI), the Hospital Anxiety and Depression Scale (HADS) and the - Morningness-Eveningness Questionnaire (MEQ). The authorities responsible for ethics and professional conduct have issued a favorable opinion. RESULTS This study demonstrated that anxiety, depression, gender and age were factors linked to insomnia, reaffirming a female predisposition and asserting a high school entry effect (especially at 15 years old). The results also indicated that a tendency to vesperality increased the risk and the level of insomnia, thus evoking the responsibility of circadian typologies in this sleep disorder. CONCLUSION This study underlines the importance of prevention and screening for insomnia when entering high school, as well as the need, in sleep disorder clinics and in psychotherapy, to deal with individual circadian rhythms, their consequences and organizational choices in the sleep/wakefulness articulation.
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Affiliation(s)
- M Julian
- Université de Caen Normandie (LPCN/EA 7452), esplanade de la paix, 14035 Caen.
| | - N Camart
- Université Paris Nanterre (CLIPSYD/EA 4430), 200, avenue de la République, 92001 Nanterre
| | - N de Kernier
- Université Paris Nanterre (CLIPSYD/EA 4430), 200, avenue de la République, 92001 Nanterre
| | - J-F Verlhiac
- Université Paris Nanterre (CLIPSYD/EA 4430), 200, avenue de la République, 92001 Nanterre
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Challamel MJ, Beydon N, Coutier L, Launois S, Seailles T, Vecchierini MF, Franco P. [Diagnostic criteria for obstructive sleep apnea syndrome in adolescent]. Rev Mal Respir 2021; 38:829-39. [PMID: 34565640 DOI: 10.1016/j.rmr.2021.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/13/2021] [Indexed: 11/20/2022]
Abstract
The obstructive sleep apnoea syndrome (OSAS) affects 1-4% of adolescents. It represents a transitional stage between paediatric and adult OSA and is characterized by specific symptoms. BACKGROUND: The persistence of childhood OSAS during adolescence is not frequent. Risk factors are male sex, obesity and a history of tonsillectomy or adenoidectomy. Symptoms may be misleading such as tiredness and depressive disorders. In adolescence, untreated OSAS may result in neuro-behavioural and cognitive deficits, systemic inflammation, cardiovascular and metabolic disorders. The French Society of Research and Sleep Medicine organized a meeting on OSAS in adolescents. A multidisciplinary group of specialists (pulmonologists, pediatricians, ENT and maxillo-facial surgeons, dentofacial orthopedists/orthodontists, myofunctional therapists and sleep specialists) exchanged their experience, discussed publications and drew up a consensus document on the diagnosis and polysomnographic criteria for OSAS in adolescents. They proposed a practical diagnostic guideline and follow-up for these adolescents. OUTLOOK AND CONCLUSION: A good knowledge of the particularities of this pathology by the physician will lead to an early diagnosis, propose adapted multifactorial treatments and avoid the deleterious consequences of this pathology at adult age.
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Zarzour M, Hachem C, Kerbage H, Richa S, Choueifaty DE, Saliba G, Haddad E, Melki E, Sleilaty G, Saliby R, Sabbagh C, Choucair J. Anxiety and sleep quality in a sample of Lebanese healthcare workers during the COVID-19 outbreak. Encephale 2021; 48:496-503. [PMID: 34728067 PMCID: PMC8457956 DOI: 10.1016/j.encep.2021.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/22/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022]
Abstract
A cross-sectional, survey based study was conducted in order to assess mental health outcomes among healthcare workers in a private university hospital involved in the COVID-19 response in Lebanon. The main objective was to quantify symptoms of anxiety and sleep quality using self-rating scales (the State-Trait Anxiety Inventory (STAI) and Pittsburgh Sleep Quality Index (PSQI) respectively), while identifying factors that might affect those symptoms. A total of 628 healthcare workers completed the survey; 409 (66.2%) were younger than 40 years, and 441 (71.4%) were women. Of all participants, 503 (81.4%) were nurses, 52 (8.4%) were physicians and 63 (10.2%) were residents. Registered nurses, residents, women, and younger participants presented higher scores on both scales than other categories of participants. Among factors related with COVID-19, those associated with higher scores were having relatives affected by the virus (22.2%), being excessively exposed to media (12.9%), and increasing the consumption of substances/alcohol (31.2%) during this period. Factors associated with higher risk of anxiety symptoms after multivariable logistic regression analysis were: female sex, young age, poor sleep quality, and living with elderly. Our findings contribute to the understanding of the psychological wellbeing of health care workers involved in the acute COVID-19 outbreak in Lebanon.
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Affiliation(s)
- M Zarzour
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon.
| | - C Hachem
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - H Kerbage
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - S Richa
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - D El Choueifaty
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Nursing, Damas Rd, Beirut, 1104 2020, Lebanon
| | - G Saliba
- Department of Infectious Disease, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - E Haddad
- Department of Infectious Disease, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - E Melki
- Emergency Department, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - G Sleilaty
- Clinical Research Centre, Hôtel-Dieu de France, Alfred Naccache, Beirut, 1104 2020, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - R Saliby
- Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - C Sabbagh
- Emergency Department, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - J Choucair
- Department of Infectious Disease, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
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Veyrier M, Ariouat I, Jacob A, Trout H, Bloch V, Delavest M, Bellivier F, Geoffroy PA. Use of immediate release melatonin in psychiatry: BMI impacts the daily-dose. Encephale 2020; 47:96-101. [PMID: 33349460 DOI: 10.1016/j.encep.2020.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/01/2020] [Revised: 07/28/2020] [Accepted: 08/08/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE There is a growing interest in psychiatry regarding melatonin use both for its soporific and chronobiotic effects. This study aimed to evaluate factors impacting the daily-dose. METHODS In a university department of psychiatry in Paris (France), we conducted a posteriori naturalistic observational study from April 03, 2017 to January 31, 2018. We assessed links between sociodemographic and clinical characteristics and daily dose of melatonin (the daily-dose of melatonin initiation and the daily-dose at Hospital discharge). A survey of drug interactions was performed regarding metabolic inducers and inhibitors of the cytochrome P450 1A2. RESULTS Forty patients were included and treated with immediate-release melatonin. For patients with no history of melatonin use, the initiation dose of was 2 or 4mg, with no effects of age, weight, BMI, melatonin indication, cause of hospitalization. We found that higher discharge dose was associated with higher BMI (P=0.036) and more reevaluations of melatonin dose (P=0.00019). All patients with a moderate inducer (n=3, here lansoprazole) were significantly more associated with the discontinuation melatonin group (P=0.002). CONCLUSION The BMI and the number of reevaluations impact the daily dose of melatonin. Two mechanisms may explain that BMI may need higher doses: (i) melatonin diffuses into the fat mass, (ii) the variant 24E on melatonin receptor MT2, more frequent in obese patients, leads to a decrease of the receptor signal.
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Affiliation(s)
- M Veyrier
- Service Pharmacie, AP-HP, GH Saint-Louis-Lariboisière-F. Widal, 75475 Paris cedex 10, France.
| | - I Ariouat
- Service Pharmacie, AP-HP, GH Saint-Louis-Lariboisière-F. Widal, 75475 Paris cedex 10, France
| | - A Jacob
- Service Pharmacie, AP-HP, GH Saint-Louis-Lariboisière-F. Widal, 75475 Paris cedex 10, France; Iserm U1144 optimisation thérapeutique en neuropsychopharmacologie, université Paris Descartes, université Paris Diderot, université Sorbonne Paris Cité, Paris, France
| | - H Trout
- Service Pharmacie, AP-HP, GH Saint-Louis-Lariboisière-F. Widal, 75475 Paris cedex 10, France
| | - V Bloch
- Service Pharmacie, AP-HP, GH Saint-Louis-Lariboisière-F. Widal, 75475 Paris cedex 10, France; Iserm U1144 optimisation thérapeutique en neuropsychopharmacologie, université Paris Descartes, université Paris Diderot, université Sorbonne Paris Cité, Paris, France
| | - M Delavest
- Département de Psychiatrie et de Médecine Addictologique, AP-HP, GH Saint-Louis-Lariboisière-F. Widal, 75475 Paris cedex 10, France
| | - F Bellivier
- Iserm U1144 optimisation thérapeutique en neuropsychopharmacologie, université Paris Descartes, université Paris Diderot, université Sorbonne Paris Cité, Paris, France; Département de Psychiatrie et de Médecine Addictologique, AP-HP, GH Saint-Louis-Lariboisière-F. Widal, 75475 Paris cedex 10, France
| | - P A Geoffroy
- Iserm U1144 optimisation thérapeutique en neuropsychopharmacologie, université Paris Descartes, université Paris Diderot, université Sorbonne Paris Cité, Paris, France; Département de Psychiatrie et de Médecine Addictologique, AP-HP, GH Saint-Louis-Lariboisière-F. Widal, 75475 Paris cedex 10, France.
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Broussard M, Leveziel N, Lii M, Tonnerre D, Flausse R. Assessment of physiological upper eyelid laxity. J Fr Ophtalmol 2019; 42:471-6. [PMID: 30979557 DOI: 10.1016/j.jfo.2018.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/17/2018] [Accepted: 10/16/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate overall upper eyelid laxity according to age and sleep position. METHODS This single-center prospective study was conducted on healthy subjects between 20 and 89 years of age and was approved by the institutional review board and the ethics committee. Data collected were age, sex, weight and height, ophthalmological history, general history (diabetes, hypertension, smoking) and preferred sleep position (lateral, ventral, dorsal decubitus or no preference). Overall upper eyelid laxity was measured using the McNab technique. RESULTS In total, 280 patients were included in the study - 40 per 10-year age bracket. Mean overall right eyelid laxity was measured at 5.35mm (5.38mm on the left) between 20 and 29 years old and 8.28mm (8.43mm on the left) between 80 and 89 years old. 161 patients slept in a lateral decubitus position. Median overall upper eyelid laxity for the sleep side was 8mm vs. 7mm for the non-sleep side. CONCLUSION Overall upper eyelid laxity increased significantly with age (P<0.001) and compared to the contralateral side (P<0.001). Overall upper eyelid hyperlaxity can be defined as a measurement (by the McNab technique) greater than: 7mm between 20 and 29 years, 8mm between 30 and 39 years, 9mm between 40 and 69 years and 10mm between 70 and 89 years. This study provides new data on normal eyelid laxity in the general population according to age and sleep position.
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Suter PM. [Thoughts about Light and Sleep]. Praxis (Bern 1994) 2019; 108:139-143. [PMID: 30722742 DOI: 10.1024/1661-8157/a003175] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Thoughts about Light and Sleep Abstract. Many aspects of health and disease are mainly determined by the constant change between light and darkness during a solar day. The resulting physiological rhythms correspond to the circadian rhythm, which was one of the most central drivers in the evolution of humans. However, over the last 20-30 years, these natural rhythms of the change of light and darkness are being increasingly ignored by modern societies. It is well known that these rhythms are modulators of many physiological pathways and any desynchronization or misalignment will activate different pathophysiological pathways, which contribute to the risk of chronic diseases. Light pollution by widespread illumination of our environment and the night sky and uncontrolled man-made use of any light source plays a key role in the pathogenesis of sleep disturbances. Blue light exposure in the evening from any artificial light source (especially from electronic device screens) is of special relevance in this context. In this article a few key facts concerning light, sleep and diseases are presented. We should by all means account for the effects of light and darkness and stop any further light pollution.
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Affiliation(s)
- Paolo M Suter
- 1 Medizinische Poliklinik, Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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Abstract
Sleep Disorders in Old Age Abstract. Sleep disorders increase with age. Older patients rarely complain about sleep disorders, therefore it is important to ask about sleep problems. Insomnias, sleep-disordered breathing and restless legs syndrome tend to increase with older age. It is important to consider that sleep disorders may be the first symptom of a depression, anxiety disorder or neurodegenerative disorders such as dementias. Many factors can influence sleep in old age: it is important to inquire after sleeping habits including naps during the day, medication and comorbidity. Treatment depends on the causes. Insomnias should be treated mainly with non-pharmacological means such as cognitive behaviour therapy.
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Pöpel A. [Evidence-Based Treatment of Insomnia]. Praxis (Bern 1994) 2018; 107:1339-1343. [PMID: 30482125 DOI: 10.1024/1661-8157/a003160] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Evidence-Based Treatment of Insomnia Abstract. This review article presents current evidence on the diagnosis and efficacy of treatment methods for non-organic insomnia. In diagnostics, it is particularly important to examine differential diagnoses individually and, if available, to treat them. Regarding the actual insomnia treatment, it should be emphasized that drug treatment provides proof of efficacy only in short-term treatments lasting less than four weeks. The most effective treatment for insomnia is disorder-specific cognitive-behavioral psychotherapy (CBT-I). CBT-I should therefore be accessible to every patient with insomnia.
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Bat-Pitault F, Viorrain M, Da Fonseca D, Charvin I, Guignard-Perret A, Putois B, Herbillon V, Gérard D, Franco P. [Adolescent sleep disorders associated with school absenteeism: The child and adolescent psychiatrist is often crucial for effective management in sleep consultation]. Encephale 2019; 45:82-9. [PMID: 30122297 DOI: 10.1016/j.encep.2018.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/09/2018] [Accepted: 06/13/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Adolescent sleep is characterized by a physiological delayed sleep phase disorder frequently exacerbated by the intensive use of information and communication technologies. The sleep restriction thus induced during schooling has consequences on the physical and psychological health of the adolescent. On the other hand, the sleep complaint may correspond to psychiatric disorders in the adolescent. Thus, when this complaint is associated with school absenteeism, the management of sleep alone is often insufficient. In order to understand the reason for this inefficiency, we wanted to better characterize the profile of these adolescents. METHOD We have developed a somnological and psychiatric "screening kit" resulting in a management decision tree. This kit was tested in 2017 as part of joint consultations at the Lyon Sleep Center in adolescents who presented a complaint of sleepiness or insomnia associated with school absenteeism. RESULTS These preliminary results on 11 patients show the predominance of a delayed sleep phase syndrome or an absence of sleep diagnosis associated in more than 90 % of cases with anxiety-depressive difficulties ranging from the mood depressive disorder to the school refusal behavior and underlying anxiety disorders. Somatization is also common. CONCLUSION These first data seem to confirm the need for a child and adolescent psychiatric assessment to deal with the psychological difficulties of these adolescents in parallel with their sleep complaint so as to offer them the best chances of improvement, re-schooling and social insertion.
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Hafsa K, Ben Saad H. [Sleep between Koran and science]. Rev Pneumol Clin 2017; 73:158-161. [PMID: 28396141 DOI: 10.1016/j.pneumo.2017.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 01/12/2017] [Accepted: 01/13/2017] [Indexed: 06/07/2023]
Affiliation(s)
- K Hafsa
- Certificat d'études complémentaires en physiologie et physiopathologie respiratoire appliquée, faculté de médecine de Sousse, université de Sousse, Sousse, Tunisie
| | - H Ben Saad
- Certificat d'études complémentaires en physiologie et physiopathologie respiratoire appliquée, faculté de médecine de Sousse, université de Sousse, Sousse, Tunisie; Laboratoire de recherche n(o) LR14ES05 : interactions du système cardiopulmonaire, faculté de médecine de Sousse, université de Sousse, Sousse, Tunisie; Laboratoire de physiologie, faculté de médecine « Ibn Eljazzar » de Sousse, université de Sousse, avenue Mohamed Karoui, 4000 Sousse, Tunisie; Service de physiologie et explorations fonctionnelles, EPS Farhat HACHED, Sousse, Tunisie.
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Abstract
Cancer-related fatigue (CRF) is a commonly reported and debilitating side effect of cancer and/or cancer treatment. Sleep disorders are also highly reported in the cancer population; however it is unknown if sleep is associated with fatigue. In the general population, exercise has been shown to improve sleep, however in the cancer population this idea is under investigation. The primary purposes of this review were to: (i) review the prevalence and causes of sleep disorders in cancer patients and survivors, (ii) examine the relationship between sleep and CRF and (iii) review the impact of exercise interventions on sleep in cancer patients and survivors. A scoping review of the literature was conducted regarding exercise interventions in cancer patients and survivors with sleep as at least one outcome measure. A search of the literature revealed limited studies (n=21) assessing the effect of exercise on sleep disorders in the cancer population. Methodological issues are evident because assessing sleep is often not the main outcome of interest. The reviewed studies revealed that exercise positively impacts sleep quality and quantity. There seems to be possible relationship between sleep disorders, exercise and CRF. Further investigation of this relationship is necessary, specifically using objective measurement tools, in large, controlled studies, focusing on sleep as the primary outcome.
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Affiliation(s)
- Mary E Medysky
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - John Temesi
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Susan Nicole Culos-Reed
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada; Department of Oncology, Cumming School of Medicine, Calgary, Canada; Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Canada
| | - Guillaume Y Millet
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
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21
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Lopez R, Evangelista E, Dauvilliers Y. [Not Available]. Rev Prat 2016; 66:1001-1006. [PMID: 30512371] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Violent behaviors during sleep. Violent behaviors during sleep are probably underdiagnosed but frequent and disabling complaints. They refer to behaviors ranging from simple dream enactment to complex behaviors that may have serious or even lethal consequences for oneself or other individuals. After awakening, the subjects are often unaware of their actions and had partial or complete amnesia of the episode. The violent behaviors during sleep may have multiple aetiologies. The parasomnias, including the disorders of arousal and the rapid eye movement sleep behavior disorder are mainly involved. A carefully clinical interview may help the clinician to rule out the differential diagnoses (i.e. nocturnal frontal lobe epilepsy, sleep related dissociative disorder) and to address the patient for further investigations. This article provides a brief overview of the epidemiology, the diagnosis, the prognosis and the treatment of the main causes of violent behaviors during sleep.
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Affiliation(s)
- Régis Lopez
- Centre national de référence narcolepsiehypersomnies, unité des troubles du sommeil, service de neurologie, hôpital Guide- Chauliac
- Inserm U1061
- Université de Montpellier, Montpellier, France
| | - Elisa Evangelista
- Centre national de référence narcolepsiehypersomnies, unité des troubles du sommeil, service de neurologie, hôpital Guide- Chauliac
- Université de Montpellier, Montpellier, France
| | - Yves Dauvilliers
- Centre national de référence narcolepsiehypersomnies, unité des troubles du sommeil, service de neurologie, hôpital Guide- Chauliac
- Inserm U1061
- Université de Montpellier, Montpellier, France
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Bat-Pitault F, Da Fonseca D, Flori S, Porcher-Guinet V, Stagnara C, Patural H, Franco P, Deruelle C. [Recognition of facial expressions of emotions by 3-year-olds depending on sleep and risk of depression]. Encephale 2016; 43:416-422. [PMID: 27623119 DOI: 10.1016/j.encep.2016.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/03/2016] [Accepted: 03/08/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The emotional process is characterized by a negative bias in depression, thus it was legitimate to establish if they same is true in very young at-risk children. Furthermore, sleep, also proposed as a marker of the depression risk, is closely linked in adults and adolescents with emotions. That is why we wanted first to better describe the characteristics of emotional recognition by 3-year-olds and their links with sleep. Secondly we observed, if found at this young age, an emotional recognition pattern indicating a vulnerability to depression. MATERIAL AND METHOD We studied, in 133 children aged 36 months from the AuBE cohort, the number of correct answers to the task of recognition of facial emotions (joy, anger and sadness). Cognitive functions were also assessed by the WPPSI III at 3 years old, and the different sleep parameters (time of light off and light on, sleep times, difficulty to go to sleep and number of parents' awakes per night) were described by questionnaires filled out by mothers at 6, 12, 18, 24 and 36 months after birth. Of these 133 children, 21 children whose mothers had at least one history of depression (13 boys) were the high-risk group and 19 children (8 boys) born to women with no history of depression were the low-risk group (or control group). RESULTS Overall, 133 children by the age of 36 months recognize significantly better happiness than other emotions (P=0.000) with a better global recognition higher in girls (M=8.8) than boys (M=7.8) (P=0.013) and a positive correlation between global recognition ability and verbal IQ (P=0.000). Children who have less daytime sleep at 18 months and those who sleep less at 24 months show a better recognition of sadness (P=0.043 and P=0.042); those with difficulties at bedtime at 18 months recognize less happiness (P=0.043), and those who awaken earlier at 24 months have a better global recognition of emotions (P=0.015). Finally, the boys of the high-risk group recognize sadness better than boys in the control group (P=0.015). CONCLUSION This study confirms that the recognition of emotion is related to development with a female advantage and a link with the language skills at 36 months of life. More importantly, we found a relationship between sleep characteristics and emotional recognition ability and a negative bias in emotional recognition in young males at risk for depression.
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Affiliation(s)
- F Bat-Pitault
- Institut de neurosciences de la Timone, CNRS, Aix-Marseille université, 249, boulevard Sainte-Marguerite, 13009 Marseille, France; Service de pédopsychiatrie, hôpital Salvator, Assistance publique-hôpitaux de Marseille, Aix-Marseille université, 249, boulevard Sainte-Marguerite, 13009 Marseille, France.
| | - D Da Fonseca
- Institut de neurosciences de la Timone, CNRS, Aix-Marseille université, 249, boulevard Sainte-Marguerite, 13009 Marseille, France; Service de pédopsychiatrie, hôpital Salvator, Assistance publique-hôpitaux de Marseille, Aix-Marseille université, 249, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - S Flori
- Service de réanimation pédiatrique et néonatale, pôle mère et enfant, hôpital Nord, 42270 Saint-Priest-en-Jarez, France; EA SNA-EPIS 4607, université Jean-Monnet, 42023 Saint-Étienne, France
| | - V Porcher-Guinet
- Unité de sommeil pédiatrique, hôpital Mère-Enfant, université Lyon 1, 69500 Bron, France; Integrative Physiology of Brain Arousal System, CRNL, Inserm-U1028, CNRS UMR5292, université Lyon 1, 69675 Bron, France
| | - C Stagnara
- EA SNA-EPIS 4607, université Jean-Monnet, 42023 Saint-Étienne, France
| | - H Patural
- Service de réanimation pédiatrique et néonatale, pôle mère et enfant, hôpital Nord, 42270 Saint-Priest-en-Jarez, France; EA SNA-EPIS 4607, université Jean-Monnet, 42023 Saint-Étienne, France
| | - P Franco
- Unité de sommeil pédiatrique, hôpital Mère-Enfant, université Lyon 1, 69500 Bron, France; Integrative Physiology of Brain Arousal System, CRNL, Inserm-U1028, CNRS UMR5292, université Lyon 1, 69675 Bron, France
| | - C Deruelle
- Institut de neurosciences de la Timone, CNRS, Aix-Marseille université, 249, boulevard Sainte-Marguerite, 13009 Marseille, France
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Zakhem E, El Hage R, Pezé T, Hurdiel R, Zunquin G, Theunynck D. [Factors associated with eating disorders in students of the University of Littoral Côte d'Opale]. Rev Epidemiol Sante Publique 2015; 63:259-65. [PMID: 26143089 DOI: 10.1016/j.respe.2015.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 09/18/2013] [Revised: 02/16/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022] Open
Abstract
AIMS Our study aimed to observe the rate of eating disorders in first year public health students (allied medical and sports) of the University of the Littoral Opal Coast (ULCO) using the SCOFF-F (Sick, Control, One, stone, Fat, Food; French version) questionnaire and to compare morphological characteristics, level of physical condition, level of physical activity and sleep quality. METHODS Overall 642 subjects (459 women and 183 men) aged 22years (20.9±4.9years) participated in this study (Universanté-CEMHaVi). Weight, height, and fat mass were measured, and waist-to-hip ratio and body mass index (BMI) were calculated. The level of physical condition was evaluated using several physical tests: Leger and Boucher (20m) and shuttle run (4×10m), Sargent-test and handgrip strength. The SCOFF-F questionnaire followed by a clinical maintenance conducted by a professional was used to detect eating disorders. Several other questionnaires were used to evaluate the physical activity level; General Practice Assessment Questionnaire (GPAQ) and wellness. Sleep quality index was evaluated using Pittsburgh Sleep Quality Index (PSQI). RESULTS SCOFF-F was positive in 24.2% of women and 10.2% of men. In women, there were no significant differences between those who had a positive SCOFF-F screening and those who had a negative SCOFF-F screening regarding age, height, waist-to-hip ratio, level of physical condition measured and level of physical activity evaluated. However, significant differences were found between women who had a positive SCOFF-F screening and women who had a negative SCOFF-F screening regarding sleep quality, well-being score, BMI and fat mass. In men, significant differences were found between those who had a positive SCOFF-F screening and those who had a negative SCOFF-F screening regarding BMI and fat mass. CONCLUSION This study suggests that in both sexes, having a positive SCOFF-F screening is associated with higher BMI. In women, the increase in BMI and the perturbations in sleep quality and well-being score may indicate bulimia nervosa. The definition of a panel of possible factors associated with eating disorders can help in screening and early detection of eating disorders.
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Affiliation(s)
- E Zakhem
- Département d'éducation physique, faculté des lettres et des sciences humaines, université de Balamand, El-Koura, P.O. Box 100, Tripoli, Liban; URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - R El Hage
- Département d'éducation physique, faculté des lettres et des sciences humaines, université de Balamand, El-Koura, P.O. Box 100, Tripoli, Liban.
| | - T Pezé
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - R Hurdiel
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - G Zunquin
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - D Theunynck
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
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24
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Antone E, Gilbert M, Bironneau V, Meurice JC. [Continuous positive airways pressure treatment for obstructive sleep apnoea]. Rev Mal Respir 2015; 32:447-60. [PMID: 25823935 DOI: 10.1016/j.rmr.2014.11.072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 10/10/2013] [Accepted: 11/07/2014] [Indexed: 11/16/2022]
Abstract
Continuous positive airway pressure (CPAP) still remains the most frequently used and the most efficient treatment for obstructive sleep apnea syndrome. However, its efficiency is conditioned by healthcare quality depending on many factors such as medical specificities of the patients as well as the severity of sleep-related breathing disorders. In order to optimize CPAP efficiency, it is necessary to be aware of the functional abilities of the different devices, and to perform a close monitoring of the patients, particularly during the first weeks of treatment, by maximally using the data provided by the CPAP apparatus. Some questions remain unsolved, such as the impact of nasal CPAP on glucose metabolism or cardiovascular prognosis. Furthermore, the strategy of CPAP use should be improved according to future results of studies dedicated to the interest of home telemonitoring and taking into account the validated mode of CPAP initiation.
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Affiliation(s)
- E Antone
- Service de pneumologie, CHU de Poitiers, université de Poitiers, 2, rue de la Miletrie, 86000 Poitiers, France.
| | - M Gilbert
- Service de pneumologie, CHU de Poitiers, université de Poitiers, 2, rue de la Miletrie, 86000 Poitiers, France
| | - V Bironneau
- Service de pneumologie, CHU de Poitiers, université de Poitiers, 2, rue de la Miletrie, 86000 Poitiers, France
| | - J C Meurice
- Service de pneumologie, CHU de Poitiers, université de Poitiers, 2, rue de la Miletrie, 86000 Poitiers, France
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25
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Lord C, Sekerovic Z, Carrier J. Sleep regulation and sex hormones exposure in men and women across adulthood. ACTA ACUST UNITED AC 2014; 62:302-10. [PMID: 25218407 DOI: 10.1016/j.patbio.2014.07.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 03/01/2014] [Accepted: 07/11/2014] [Indexed: 02/02/2023]
Abstract
This review aims to discuss how endogenous and exogenous testosterone exposures in men and estrogens/progesterone exposures in women interact with sleep regulation. In young men, testosterone secretion peaks during sleep and is linked to sleep architecture. Animal and human studies support the notion that sleep loss suppresses testosterone secretion. Testosterone levels decline slowly throughout the aging process, but relatively few studies investigate its impact on age-related sleep modifications. Results suggest that poorer sleep quality is associated with lower testosterone concentrations and that sleep loss may have a more prominent effect on testosterone levels in older individuals. In women, sex steroid levels are characterized by a marked monthly cycle and reproductive milestones such as pregnancy and menopause. Animal models indicate that estrogens and progesterone influence sleep. Most studies do not show any clear effects of the menstrual cycle on sleep, but sample sizes are too low, and research designs often inhibit definitive conclusions. The effects of hormonal contraceptives on sleep are currently unknown. Pregnancy and the postpartum period are associated with increased sleep disturbances, but their relation to the hormonal milieu still needs to be determined. Finally, studies suggest that menopausal transition and the hormonal changes associated with it are linked to lower subjective sleep quality, but results concerning objective sleep measures are less conclusive. More research is necessary to unravel the effects of vasomotor symptoms on sleep. Hormone therapy seems to induce positive effects on sleep, but key concerns are still unresolved, including the long-term effects and efficacy of different hormonal regimens.
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Affiliation(s)
- C Lord
- Département de psychologie, université de Montréal, Pavillon Marie-Victorin, 90, avenue Vincent-d'Indy, H2V 2S9 Montréal, Québec, Canada
| | - Z Sekerovic
- Département de psychologie, université de Montréal, Pavillon Marie-Victorin, 90, avenue Vincent-d'Indy, H2V 2S9 Montréal, Québec, Canada
| | - J Carrier
- Département de psychologie, université de Montréal, Pavillon Marie-Victorin, 90, avenue Vincent-d'Indy, H2V 2S9 Montréal, Québec, Canada; Center for advanced research in sleep medicine, hôpital du Sacré-Cœur de Montréal, 5400, boulevard Gouin-Ouest, H4J 1C5 Montréal, Québec, Canada; Institut universitaire de gériatrie de Montréal, université de Montréal, Pavillon Côte des neiges, 4565, chemin Queen-Mary, H3W1W5 Montréal, Québec, Canada.
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26
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Abstract
State-of-the-art neuroimaging techniques have accelerated progress in the study and understanding of sleep in humans. Neuroimaging studies in primary insomnia remain relatively few, considering the important prevalence of this disorder in the general population. This review examines the contribution of functional and structural neuroimaging to our current understanding of primary insomnia. Functional studies during sleep provided support for the hyperarousal theory of insomnia. Functional neuroimaging also revealed abnormalities in cognitive and emotional processing in primary insomnia. Results from structural studies suggest neuroanatomical alterations in primary insomnia, mostly in the hippocampus, anterior cingulate cortex and orbitofrontal cortex. However, these results are not well replicated across studies. A few magnetic resonance spectroscopy studies revealed abnormalities in neurotransmitter concentrations and bioenergetics in primary insomnia. The inconsistencies among neuroimaging findings on insomnia are likely due to clinical heterogeneity, differences in imaging and overall diversity of techniques and designs employed. Larger samples, replication, as well as innovative methodologies are necessary for the progression of this perplexing, yet promising area of research.
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Affiliation(s)
- J N O'Byrne
- Department of Exercise Science, Concordia University, 7141 Sherbrooke St W, Montreal, Quebec, H4B 1R6 Canada; Center for Studies in Behavioral Neurobiology, Concordia University, 7141 Sherbrooke St W, Montreal, Quebec, H4B 1R6 Canada
| | - M Berman Rosa
- Department of Psychology, Concordia University, 7141 Sherbrooke St W, Montreal, Quebec, H4B 1R6 Canada
| | - J-P Gouin
- Department of Psychology, Concordia University, 7141 Sherbrooke St W, Montreal, Quebec, H4B 1R6 Canada
| | - T T Dang-Vu
- Department of Exercise Science, Concordia University, 7141 Sherbrooke St W, Montreal, Quebec, H4B 1R6 Canada; Center for Studies in Behavioral Neurobiology, Concordia University, 7141 Sherbrooke St W, Montreal, Quebec, H4B 1R6 Canada; Institut Universitaire de Gériatrie de Montréal, Université de Montréal, 4565, chemin Queen-Mary, Montreal, Quebec, H3W 1W5 Canada.
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27
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Abstract
The placebo response is a psychobiological phenomenon for clinical benefits following the administration of an inert substance whatever its form. This phenomenon can be attributed to a wide range of neurobiological processes, such as expectations of relief, the Pavlovian conditioning and learning, emotional regulation, and reward mechanisms, which are themselves under the influence of processes that take place during sleep. The study of placebo analgesia in healthy from a placebo conditioning associated with analgesic suggestions has highlighted a relationship between sleep, expectations of relief and placebo analgesia: when the induction is persuasive before sleep, expectations of relief modulate placebo response the next morning and paradoxical sleep correlates negatively with both expectations and the placebo response. When the analgesic experience before sleep is less persuasive, expectations of relief are still present but no longer interact with placebo analgesia while paradoxical sleep no longer correlates with the analgesic placebo response. Sleep-processes especially during paradoxical sleep seem to influence the relationship between expectations of relief and placebo analgesia. In this review, we describe the relationship between sleep and placebo analgesia, the mechanisms involved in the placebo response (e.g., conditioning, learning, memory, reward) and their potential link with sleep that could make it a special time for the building placebo response.
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Affiliation(s)
- F Chouchou
- Facultés de médecine dentaire et de médecine, université de Montréal, pavillon Roger-Gaudry - entrée B-1, 2900, boulevard Édouard-Montpetit, Montréal, Québec, Canada; Centre de recherche avancée en médecine du sommeil, hôpital du Sacré-Cœur de Montréal, 5400, boulevard Gouin Ouest, Montréal H4J 1C5, Québec, Canada; Inserm U1028 - CNRS UMR 5292, unité NeuroPain, intégration centrale de la douleur chez l'homme, centre de recherche en neurosciences de Lyon, hôpital neurologique unité hypnologie, RdJ, 59, boulevard Pinel, 69677 Bron cedex, France.
| | - G-J Lavigne
- Facultés de médecine dentaire et de médecine, université de Montréal, pavillon Roger-Gaudry - entrée B-1, 2900, boulevard Édouard-Montpetit, Montréal, Québec, Canada; Centre de recherche avancée en médecine du sommeil, hôpital du Sacré-Cœur de Montréal, 5400, boulevard Gouin Ouest, Montréal H4J 1C5, Québec, Canada.
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Larouche M, Côté G, Bélisle D, Lorrain D. Kind attention and non-judgment in mindfulness-based cognitive therapy applied to the treatment of insomnia: state of knowledge. ACTA ACUST UNITED AC 2014; 62:284-91. [PMID: 25104242 DOI: 10.1016/j.patbio.2014.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 01/08/2014] [Accepted: 07/10/2014] [Indexed: 12/12/2022]
Abstract
Psychophysiological insomnia is characterized by acquired sleep difficulties and/or a state of hypervigilance when going to bed. This mental and physiological condition prevents sleep onset regardless of the presence of anxious or depressive disorders. Despite the fact that cognitive behavioural therapies have been shown to be effective for this disorder, some people are not responding to this treatment. It is therefore important to explore new ways of increasing the effectiveness of current treatments. Approaches based on mindfulness, which promote a non-judgemental acceptance of the living experience, are increasingly reported in the literature to be effective in the treatment of various physical and psychological health conditions, being particularly efficient in reducing the stress and discomfort associated with these problems. This article focuses on some cognitive factors associated with maintaining insomnia and suggests that approaches based on mindfulness, through certain action mechanisms, may help to improve sleep. A review of recent studies on the application of mindfulness-based approaches to treat insomnia is hereby presented. Avenues for future research to improve insomnia treatment protocols based on mindfulness are suggested.
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Affiliation(s)
- M Larouche
- Department of psychology, faculty of letters and human sciences, university of Sherbrooke, 2500, boulevard de l'université, J1K 2R1 Sherbrooke (QC), Canada
| | - G Côté
- Department of psychology, faculty of letters and human sciences, university of Sherbrooke, 2500, boulevard de l'université, J1K 2R1 Sherbrooke (QC), Canada
| | - D Bélisle
- Department of letters and communication, faculty of letters and human sciences, university of Sherbrooke, 2500, boulevard de l'université, J1K 2R1 Sherbrooke (QC), Canada
| | - D Lorrain
- Department of psychology, faculty of letters and human sciences, university of Sherbrooke, 2500, boulevard de l'université, J1K 2R1 Sherbrooke (QC), Canada; Research center on aging (Sherbrooke geriatric university institute-health and social services center), 1036, Belvedere street South, J1H 4C4 Sherbrooke (QC), Canada.
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Abstract
This article describes the two-process model of sleep regulation. The 24-hour sleep-wake cycle is regulated by a homeostatic process and an endogenous, 2 oscillators, circadian process, under the influence of external synchronisers. These two processes are partially independent but influence each other, as shown in the two-sleep-process auto-regulation model. A reciprocal inhibition model of two interconnected neuronal groups, "SP on" and "SP off", explains the regular recurrence of paradoxical sleep. Sleep studies have primarily depended on observation of the subject and have determined the optimal conditions for sleep (position, external conditions, sleep duration and need) and have studied the consequences of sleep deprivation or modifications of sleep schedules. Then, electrophysiological recordings permitted the classification of sleep stages according to the observed EEG patterns. The course of a night's sleep is reported on a "hypnogram". The adult subject falls asleep in non-REM sleep (N1), then sleep deepens progressively to stages N2 and N3 with the appearance of spindles and slow waves (N2). Slow waves become more numerous in stage N3. Every 90minutes REM sleep recurs, with muscle atonia and rapid eye movements. These adult sleep patterns develop progressively during the 2 first years of life as total sleep duration decreases, with the reduction of diurnal sleep and of REM sleep. Around 2 to 4 months, spindles and K complexes appear on the EEG, with the differentiation of light and deep sleep with, however, a predominance of slow wave sleep.
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Affiliation(s)
- M-F Vecchierini
- Centre du sommeil et de la vigilance, Hôtel-Dieu, 1, place du Parvis-Notre-Dame, 75181 Paris cedex 04, France.
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30
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Fetter D, Lefaucheur R, Borden A, Maltête D. Parkinson's patients cope with daylight saving time. Rev Neurol (Paris) 2013; 170:124-7. [PMID: 24239344 DOI: 10.1016/j.neurol.2013.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/23/2013] [Revised: 07/23/2013] [Accepted: 08/27/2013] [Indexed: 11/27/2022]
Abstract
Disturbances of the circadian timing system following daylight saving time (DST) may influence the symptoms of Parkinson's disease (PD). To address this question, we compared the severity of motor fluctuations and non-motor symptoms both before and after the time change. Total daily "off-time" based on diaries, excessive daytime sleepiness (Epworth Sleepiness Scale), depressive symptoms (Beck Depression Inventory), and psychosis associated with PD were assessed both before and after the DST. Eighty-three PD patients (mean age, 67±7.7years; mean disease duration, 10.4±6.4years) were included. Thirty-six patients had motor fluctuations (mean daily "off-time", 4.8±2.4h/day). There was no significant variation of the total daily "off-time" (2.5±2.6h/day versus 2.5±2.7h/day), ESS (8.3±4.8 versus 8.1±4.9), BDI (10.4±6.2 versus 10.0±6.9), or PAPD (1.4±1.6 versus 1.1±1.6) scores (P>0.05) after DST. Our results suggest that PD patients cope relatively well with DST.
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Affiliation(s)
- D Fetter
- Department of neurology, Rouen university hospital and university of Rouen, 1, rue de Germont, 76031 Rouen cedex, France
| | - R Lefaucheur
- Department of neurology, Rouen university hospital and university of Rouen, 1, rue de Germont, 76031 Rouen cedex, France
| | - A Borden
- Department of neurology, Rouen university hospital and university of Rouen, 1, rue de Germont, 76031 Rouen cedex, France
| | - D Maltête
- Department of neurology, Rouen university hospital and university of Rouen, 1, rue de Germont, 76031 Rouen cedex, France; Inserm U1079, Rouen faculty of medicine, 22, boulevard Gambetta, 76183 Rouen cedex, France.
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31
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Beck F, Richard JB, Léger D. [Insomnia and total sleep time in France: prevalence and associated socio-demographic factors in a general population survey]. Rev Neurol (Paris) 2013; 169:956-64. [PMID: 24140281 DOI: 10.1016/j.neurol.2013.02.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 02/04/2013] [Accepted: 02/26/2013] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Sleep is considered as a major protective factor for good health and quality of life. The epidemiology of chronic insomnia and other sleep disorders has recently been developed in France. The aim of this study was to evaluate total sleep time and the prevalence of chronic insomnia in the general population aged 15 to 85 years. It was also to investigate factors associated with sleep disorders. METHODS Within the framework of the Health Barometer 2010, a French general population survey, 27,653 15 to 85-year-old individuals were questioned about their health behaviors and attitudes, in particular about their sleeping time and habits. RESULTS The average sleeping time of the 15 to 85-year-old was 7 hours 13 minutes. It was higher for women than for men (7 hours 18 minutes vs 7 hours 07 minutes; P<0.001), whereas 15.8 % of the population presented criteria for chronic insomnia, 19.3 % of women and 11.9 % of men (P<0.001). The prevalence of chronic insomnia was stable with age among women, around 19 %, whereas it increased for men from 3 % in the 15-19-year age range to 18 % in the 45-54-year age range, before decreasing to 8 % beyond 65 years. Chronic insomnia was also found to be related to precarious situations and to several difficult events of life such as violence or chronic alcohol abuse, whereas the relationship observed with tobacco smoking was no longer found after logistic regression adjustment for socio-demographic characteristics. Since the beginning of 1990s, a single-question inquiry on "sleeping problems present during the last 8 days" has been asked in the Health Barometer. The rate of subjects concerned increased from 1995, with a prevalence stabilized at a high level since 2000. CONCLUSIONS Based on these data, we think that the surveillance of sleep disorders is an important public health issue and that prevention and health educational initiatives should be launched in the general population to promote a better quality of sleep.
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