1
|
Yang TH, Lin HH, Hsu HL, Chiou AF. Factors associated with sleep quality in patients undergoing cardiac surgery: A longitudinal study. Nurs Crit Care 2024; 29:477-485. [PMID: 38410051 DOI: 10.1111/nicc.13055] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/03/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Poor sleep quality is associated with multiple factors in cardiac surgery patients. AIM To examine the trajectory of sleep quality and its associated factors over 3 months in Taiwanese patients undergoing cardiac surgery. STUDY DESIGN A longitudinal study. This study enrolled 95 patients undergoing cardiac surgery in northern Taiwan. Sleep quality was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale before surgery, at discharge, and at 1 month and 3 months postsurgery. RESULTS The majority of participants reported poor sleep quality before cardiac surgery (76.8%) and at discharge (81.6%), and they showed significant improvements in sleep quality at 1 month (B = -0.93, p = .023) and 3 months postsurgery (B = -1.50, p < .001). Significant daytime sleepiness was reported by 25.3% of patients before cardiac surgery, and this proportion significantly decreased at 3 months postsurgery (B = -2.59, p < .001). The significant predictors of sleep quality in cardiac surgery patients were symptom distress, sleep medications, occupation, left ventricular ejection fraction, ACE-I drugs and potassium ions, which explained 53.7% of the total variance in sleep quality. Having a nap habit was an independent predictor of daytime sleepiness in cardiac surgery patients, which could explain 3.7% of the total variation. CONCLUSION Poor sleep quality was common in patients undergoing cardiac surgery and was associated with multiple factors, including symptom distress, cardiac function, medications, and psychosocial and environmental factors. RELEVANCE TO CLINICAL PRACTICE Poor sleep quality was observed in cardiac surgical patients before surgery and at discharge postsurgery. Patient education on symptom management, medication adherence and sleep hygiene are suggested to improve sleep quality in patients undergoing cardiac surgery.
Collapse
Affiliation(s)
- Ting-Hui Yang
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hsuan-Hua Lin
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hung-Lung Hsu
- Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Biotechnology, Ming Chuan University, Taipei, Taiwan
| | - Ai-Fu Chiou
- College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
2
|
Djupedal ILR, Harris A, Svensen E, Pallesen S, Waage S, Nielsen MB, Sunde E, Bjorvatn B, Holmelid Ø, Vedaa Ø. Effects of a work schedule with abated quick returns on insomnia, sleepiness and work-related fatigue: Results from a large-scale cluster randomized controlled trial. Sleep 2024:zsae086. [PMID: 38581363 DOI: 10.1093/sleep/zsae086] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Indexed: 04/08/2024] Open
Abstract
STUDY OBJECTIVES To investigate the effect of a work schedule with abated quick returns (i.e., >11 hours between two shifts) on insomnia, daytime sleepiness, and work-related fatigue compared to a shift schedule maintaining the usual number of quick returns. METHODS A two-armed cluster randomized controlled trial including 66 units was conducted at a university hospital in Norway. Units with healthcare workers on rotating shift schedules were randomly assigned to a shift schedule with abated quick returns (intervention) or to continue with a schedule including quick returns as usual (control) for six months. Questionnaires assessed symptoms of insomnia (Bergen Insomnia Scale), daytime sleepiness (Epworth Sleepiness Scale), and work-related fatigue (Revised Swedish Occupational Fatigue Inventory) at baseline and towards the end of the intervention. Data was analyzed using multilevel linear mixed-effects models, and Cohen's d was used to calculate the effect size between groups. RESULTS Overall, 1314 healthcare workers (85.2% female) completed the baseline questionnaire (response rate 49.1%), and 552 completed the follow-up questionnaire. The intervention reduced quick returns from an average of 13.2 (SD=8.7) to 6.7 (SD=6.0), while the control group's average remained relatively unchanged from 13.2 (SD=8.7) to 12.0 (SD=9.3). Results showed a small improvement in symptoms of insomnia (BIS; d=-0.13, p=0.022) and daytime sleepiness (ESS; d=-0.14, p=0.013) in favor of the intervention. No effects were observed on work-related fatigue. CONCLUSIONS Reducing the number of quick returns resulted in improvements in insomnia and daytime sleepiness. The findings highlight the importance of sufficient rest time in the work schedule of healthcare workers.
Collapse
Affiliation(s)
- Ingebjørg Louise Rockwell Djupedal
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Norway
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Erling Svensen
- Department of Human Resources, Haukeland University Hospital, Bergen
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Siri Waage
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Morten Birkeland Nielsen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Erlend Sunde
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Bjørn Bjorvatn
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Øystein Holmelid
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Øystein Vedaa
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Norway
| |
Collapse
|
3
|
Xiong X, Xiao CQ, Yang YC, Li YJ, Cheng QY, Wang XY, Liu Y. Temporomandibular disorder patients with excessive daytime sleepiness present greater pain intensity and reduced jaw function. J Oral Rehabil 2024; 51:639-647. [PMID: 38100233 DOI: 10.1111/joor.13639] [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: 04/03/2023] [Revised: 09/20/2023] [Accepted: 12/07/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Sleep disorders are associated with temporomandibular disorders (TMDs). Limited studies have focused on excessive daytime sleepiness (EDS) and its impact on jaw functions in TMD patients. OBJECTIVE The aim of the present investigation was to identify the impact of EDS on pain and jaw function in TMD patients. METHODS A total of 338 TMD patients (50 males and 288 females) was included. The Epworth Sleepiness Scale (ESS) was used to classify patients into EDS group (score ≥ 10) and non-EDS group (score < 10). The Jaw Functional Limitation Scale 8-item (JFLS-8) was used to assess the severity of jaw dysfunction. Pain intensity was evaluated using the Visual Analogue Scale (VAS). Anxiety and depression were evaluated using the Generalised Anxiety Disorder 7-item (GAD-7) and the Patient Health Questionnaire 9-item (PHQ-9). All included patients were diagnosed with pain-related TMD (PT), intra-articular TMD (IT) or combined TMD (CT). RESULTS Compared with non-EDS patients, EDS patients exhibited more severe jaw dysfunction, greater pain intensity and higher PHQ-9 scores (p < .05). Multivariate analyses showed that EDS (B = 3.69), female gender (B = 3.69), and elevated GAD-7 score (B = 0.73) were significantly associated with an increased score on the JFLS-8 (p < .05). Moreover, bivariate logistic regression analysis indicated a significant relationship between EDS and PT (OR = 2.70, p = .007). CONCLUSION The presence of EDS was more closely related to PT, but the causal relationship between them needs to be further confirmed. More concern and intervention to alleviate poor sleep quality might be highlighted during the treatment of TMD, especially PT subtype.
Collapse
Affiliation(s)
- Xin Xiong
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chu-Qiao Xiao
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yi-Chun Yang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yi-Jun Li
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Qiao-Yu Cheng
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiao-Yi Wang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yang Liu
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
4
|
Chen PY, Lin SY, Wu CS, Hung SH, Chen DHK, Liu WT, Lin YC. An expedited model for identifying potential patients with periodic leg movements. J Sleep Res 2024:e14198. [PMID: 38500205 DOI: 10.1111/jsr.14198] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/19/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024]
Abstract
Periodic leg movements during sleep (PLMS) may have crucial consequences in adults. This study aimed to identify baseline characteristics, symptoms, or questionnaires that could help to identify sleep-disordered breathing patients with significant PLMS. Patients aged 20-80 years who underwent polysomnography for assessing sleep disturbance were included. Various factors such as sex, age, body measurements, symptoms, apnea-hypopnea index (AHI), and sleep quality scales were analysed to determine the presence of PLMS. The study included 1480 patients with a mean age of 46.4 ± 13.4 years, among whom 110 (7.4%) had significant PLMS with a PLM index of 15 or higher. There were no significant differences observed in terms of sex or BMI between patients with and without significant PLMS. However, the odds ratios (OR) for PLMS were 4.33, 4.41, and 4.23 in patients who were aged over 50 years, had insomnia, or had an ESS score of less than 10, respectively. Notably, the OR increased up to 67.89 times in patients who presented with all three risk factors. Our analysis identified significant risk factors for PLMS: age over 50, self-reported insomnia, and lower daytime sleepiness levels. These findings aid in identifying potential PLMS patients, facilitating confirmatory examinations and managing associated comorbidities.
Collapse
Affiliation(s)
- Po-Yueh Chen
- Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shang-Yang Lin
- Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan
| | - Chung-Sheng Wu
- Department of Primary Care Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shih-Han Hung
- Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - David Hsin-Kuang Chen
- Department of Medical Education, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Wen-Te Liu
- Department of Chest Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yi-Chih Lin
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
5
|
Tao M, Dong X, Tu J, Fang Q, Shao C. Symptom and comorbidity burden in hypertensive patients with obstructive sleep apnea. Front Endocrinol (Lausanne) 2024; 15:1361466. [PMID: 38501097 PMCID: PMC10944929 DOI: 10.3389/fendo.2024.1361466] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/19/2024] [Indexed: 03/20/2024] Open
Abstract
Background Obstructive sleep apnea (OSA) is an important but frequently overlooked risk factor for hypertension (HTN). The prevalence of hypertension is high in patients with OSA, but the differences in clinical symptoms and comorbidities between patients with OSA with hypertension and those with normal blood pressure have not been fully defined. Methods This study retrospectively analyzed OSA patients diagnosed for the first time in Lihuili Hospital Affiliated to Ningbo University from 2016 to 2020. Patients were divided into an OSA group with hypertension and an OSA group without hypertension. The sociodemographic information, clinical symptoms, comorbidities, and polysomnography results of the two groups were compared. The independent risk factors associated with hypertension in patients with OSA were explored. Results A total of 1108 patients with OSA initially diagnosed were included in the study, including 387 with hypertension and 721 without. Compared with OSA patients without hypertension, OSA patients with hypertension were older; had a higher body mass index (BMI) and Epworth sleepiness score (ESS); a higher incidence of nocturia; and a higher proportion of diabetes mellitus, coronary heart disease, and cerebrovascular disease. Multivariate analysis showed age (odds ratio [OR]:1.06, 95% confidence interval [CI]:1.04-1.08), BMI (OR:1.17, 95% CI:1.11-1.23), ESS score (OR:0.97, 95%CI: 0.94-1.00) and nocturia symptoms (OR:1.64, 95% CI:1.19-2.27) was independently associated with hypertension in OSA patients, and comorbid diabetes (OR: 3.86, 95% CI: 2.31-6.45), coronary heart disease (OR: 1.90, 95% CI:1.15-3.16), and ischemic stroke (OR: 3.69,95% CI:1.31-10.40) was independently associated with hypertension in OSA patients. Conclusion Compared to OSA patients with normal blood pressure, OSA patients with hypertension had more significant daytime sleepiness, more frequent nocturnal urination, and a higher risk of diabetes, coronary heart disease, and cerebrovascular disease.
Collapse
Affiliation(s)
- MengShi Tao
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- Health Science Center, Ningbo University, Ningbo, China
| | - Xiaoqi Dong
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
| | - Jinjing Tu
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
| | - Qing Fang
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
| | - Chuan Shao
- Department of Respiratory and Critical Care Medicine, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- Health Science Center, Ningbo University, Ningbo, China
| |
Collapse
|
6
|
Chen C, Hsu NW, Chen HC. The differential pattern of associations between nighttime sleep disturbances with dimensions of daytime sleepiness in community-dwelling older adults, the Yilan study, Taiwan. Psychogeriatrics 2024; 24:212-222. [PMID: 38111149 DOI: 10.1111/psyg.13063] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The association between nighttime sleep disturbance and daytime sleepiness remains unclear. This study aimed to examine the relationships between various domains of nighttime sleep disturbance, daytime sleepiness, and their specific dimensions. METHODS This was a community-based cross-sectional study. The participants were adults aged 65 years and older from Yilan City, Taiwan. Daytime sleepiness (DS) was defined using the Epworth Sleepiness Scale (ESS) with scores ≥ 11. The ESS dimensions were further examined using exploratory factor analysis. The highest 15% factor scores for each factor were defined as factor-specific DS. Various domains of nighttime sleep disturbance were assessed using the Pittsburgh Sleep Quality Index. Logistic regression analysis was used to examine the independent relationships among various nighttime sleep disturbances, ESS, and its dimensions. RESULTS Of the 2585 participants, a total of 59.0% were women. Two factors were identified by exploratory factor analysis and were designated as 'passive factor' and 'active factor'. Multiple logistic regression analyses elucidated that short sleep duration was a common risk indicator for ESS-defined (odds ratio (OR): 2.01; 95% confidence interval (CI): 1.43-2.83), passive factor-defined (OR: 2.23, 95% CI: 1.65-3.00), and active factor-defined DS (OR: 1.47, 95% CI: 1.07-2.00). Hypnotic use was associated with a lower risk of both ESS-defined (OR: 0.66, 95% CI: 0.47-0.92) and passive factor-defined DS (OR:0.69, 95% CI: 0.52-0.92). Bathroom use (OR: 1.41, 95% CI: 1.04-1.91), coughing or snoring (OR: 2.14, 95% CI: 1.01-4.56), and sleep efficiency (OR: 0.42; 95% CI: 0.31-0.57) were uniquely associated with active factor-defined DS. CONCLUSION Two factors were identified in the ESS, revealing factor-specific correlates of DS. Specifically, ESS- and passive factor-defined DS shared similar correlates. In contrast, some correlates seem unique to active-factor-defined DS.
Collapse
Affiliation(s)
- Ching Chen
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Nai-Wei Hsu
- Division of Cardiology, Department of Internal Medicine & Community Medicine Center, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Public Health Bureau, Yilan, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
7
|
Gandhi K, Ferdous S. Tetrad of Narcolepsy Type 1: Treatment and Management. Cureus 2024; 16:e55331. [PMID: 38562323 PMCID: PMC10982127 DOI: 10.7759/cureus.55331] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Narcolepsy is a chronic condition that brings about excessive daytime sleepiness. It can be classified into two types: narcolepsy type 1 (presence of cataplexy, which is marked by weakness of muscles) and narcolepsy type 2 (without cataplexy). It is generally underdiagnosed, which results in delayed diagnosis of the condition. It has more prevalence in the United States of America as compared to India. The narcoleptic tetrad consists of excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, and hypnagogic hallucinations. Rapid eye movement (REM) sleep behavior disorder is another characteristic feature. Research about narcolepsy has been carried out for about 145-150 years, but it is only in the last 18-20 years that there has been advancement in the underlying pathophysiology, diagnosis, and, thus, availability of better treatment. Both pharmacological and non-pharmacological methods are preferred in treating narcolepsy, yet there is no cure for it. Since the knowledge regarding this condition is very limited, it is often misunderstood, and dealing with it is mentally and socially draining, often causing anxiety in the patients, feeling of social isolation, and other significant impacts on the quality of living. Raising awareness about narcolepsy is vital to prevent further medical attention delays.
Collapse
Affiliation(s)
- Kanishka Gandhi
- Physiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Suraiya Ferdous
- Physiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| |
Collapse
|
8
|
San L, Arranz B. The Night and Day Challenge of Sleep Disorders and Insomnia: A Narrative Review. Actas Esp Psiquiatr 2024; 52:45-56. [PMID: 38454895 PMCID: PMC10926017] [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] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
This is a narrative review of sleep disorders, especially chronic insomnia, as a primary diagnosis or as a comorbid diagnosis associated with different psychiatric and organic diseases. The epidemiological evidence is reviewed, the diagnostic criteria most frequently used in clinical practice are examined, and a series of therapeutic recommendations for the correct treatment of this pathology is presented. Sleep disorders are very prevalent in the general population (one-third experiences difficulty with sleep initiation/maintenance at least once a week, and about 6-15% meet the criteria for insomnia disorders), but remain relatively poorly understood and frequently overlooked by healthcare professionals. Prevalence estimates of insomnia disorder vary between 5% and 20%. Sleep disorders co-exist with psychiatric and medical conditions with an interactive and bidirectional relationship. About 70-80% of psychiatric patients show some sleep disturbance and there is a correlation between the severity of the sleep disturbance and the severity of the psychopathology. Untreated sleep disorders increase the risk of cardiovascular events, cognitive impairment, motor vehicle accidents, obesity, diabetes, and efficiency and safety at work, leading to increased all-cause healthcare utilization and being a strong predictor of sick leave or disability pension and poor quality of life. Sleep disorders can cause drowsiness or excessive daytime sleepiness, which can lead to functional impairment in 15% of the general adult population. Sleep quality should be a routine target in the evaluation of patients with psychiatric and non-psychiatric diseases to ensure sleep health based on early diagnosis and adequate therapeutic approaches.
Collapse
Affiliation(s)
- Luis San
- Parc Sanitari Sant Joan de Déu, Camí Veil de la Colonia 25, E-08830 Sant Boi de Llobregat, Barcelona, Spain
- CIBERSAM, Centro de Investigación Biomédica en Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Belén Arranz
- Parc Sanitari Sant Joan de Déu, Camí Veil de la Colonia 25, E-08830 Sant Boi de Llobregat, Barcelona, Spain
- CIBERSAM, Centro de Investigación Biomédica en Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
9
|
Hou XZ, Li YS, Wu Q, Lv QY, Yang YT, Li LL, Ye XJ, Yang CY, Wang MS, Lv YF, Cao LL, Wang SH. Association of sleep characteristics with cardiovascular disease risk in adults over 40 years of age: a cross-sectional survey. Front Cardiovasc Med 2024; 11:1308592. [PMID: 38327493 PMCID: PMC10847268 DOI: 10.3389/fcvm.2024.1308592] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024] Open
Abstract
Background The relationship between sleep characteristics and cardiovascular disease (CVD) risk has yet to reach a consistent conclusion, and more research needs to be carried out. This study aimed to explore the relationship between snoring, daytime sleepiness, bedtime, sleep duration, and high-risk sleep patterns with CVD risk. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2015-2018 were collected and analyzed. Multivariable logistic regression was used to evaluate the relationship between snoring, daytime sleepiness, bedtime, sleep duration, high-risk sleep patterns, and CVD risk. Stratified analysis and interaction tests were carried out according to hypertension, diabetes and age. Results The final analysis contained 6,830 participants, including 1,001 with CVD. Multivariable logistic regression suggested that the relationship between snoring [OR = 7.37,95%CI = (6.06,8.96)], daytime sleepiness [OR = 11.21,95%CI = (9.60,13.08)], sleep duration shorter than 7 h [OR = 9.50,95%CI = (7.65,11.79)] or longer than 8 h [OR = 6.61,95%CI = (5.33,8.19)], bedtime after 0:00 [OR = 13.20,95%CI = (9.78,17.80)] compared to 22:00-22:59, high-risk sleep patterns [OR = 47.73,95%CI = (36.73,62.04)] and CVD risk were statistically significant. Hypertension and diabetes interacted with high-risk sleep patterns, but age did not. Conclusions Snoring, daytime sleepiness, excessive or short sleep duration, inappropriate bedtime, and high-risk sleep patterns composed of these factors are associated with the CVD risk. High-risk sleep patterns have a more significant impact on patients with hypertension and diabetes.
Collapse
Affiliation(s)
- Xin-Zheng Hou
- Department of Cardiovascular Diseases, Guang anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Yu-Shan Li
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Qian Wu
- Department of Cardiovascular Diseases, Guang anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Qian-Yu Lv
- Department of Cardiovascular Diseases, Guang anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Ying-Tian Yang
- Department of Cardiovascular Diseases, Guang anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Lan-Lan Li
- Department of Cardiovascular Diseases, Guang anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Xue-Jiao Ye
- Department of Cardiovascular Diseases, Guang anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Chen-Yan Yang
- Department of Cardiovascular Diseases, Guang anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Man-Shi Wang
- Department of Cardiovascular Diseases, Guangwai Hospital, Beijing, China
| | - Yan-Fei Lv
- Shanghai Qianhe Technology Co., Ltd., Shanghai, China
| | - Lin-Lin Cao
- Department of Cardiovascular Diseases, Guang anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Shi-Han Wang
- Department of Cardiovascular Diseases, Guang anmen Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
10
|
Godos J, Ferri R, Lanza G, Caraci F, Vistorte AOR, Yelamos Torres V, Grosso G, Castellano S. Mediterranean Diet and Sleep Features: A Systematic Review of Current Evidence. Nutrients 2024; 16:282. [PMID: 38257175 PMCID: PMC10821402 DOI: 10.3390/nu16020282] [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: 12/27/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
The prevalence of sleep disorders, characterized by issues with quality, timing, and sleep duration is increasing globally. Among modifiable risk factors, diet quality has been suggested to influence sleep features. The Mediterranean diet is considered a landmark dietary pattern in terms of quality and effects on human health. However, dietary habits characterized by this cultural heritage should also be considered in the context of overall lifestyle behaviors, including sleep habits. This study aimed to systematically revise the literature relating to adherence to the Mediterranean diet and sleep features in observational studies. The systematic review comprised 23 reports describing the relation between adherence to the Mediterranean diet and different sleep features, including sleep quality, sleep duration, daytime sleepiness, and insomnia symptoms. The majority of the included studies were conducted in the Mediterranean basin and reported a significant association between a higher adherence to the Mediterranean diet and a lower likelihood of having poor sleep quality, inadequate sleep duration, excessive daytime sleepiness or symptoms of insomnia. Interestingly, additional studies conducted outside the Mediterranean basin showed a relationship between the adoption of a Mediterranean-type diet and sleep quality, suggesting that biological mechanisms sustaining such an association may exist. In conclusion, current evidence suggests a relationship between adhering to the Mediterranean diet and overall sleep quality and different sleep parameters. The plausible bidirectional association should be further investigated to understand whether the promotion of a healthy diet could be used as a tool to improve sleep quality.
Collapse
Affiliation(s)
- Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute-IRCCS, 94018 Troina, Italy;
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy;
- Clinical Neurophysiology Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy;
- Neuropharmacology and Translational Neurosciences Research Unit, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Angel Olider Rojas Vistorte
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.O.R.V.); (V.Y.T.)
- Universidad Internacional Iberoamericana, Arecibo, PR 00613, USA
- Universidade Internacional do Cuanza, Cuito EN250, Angola
| | - Vanessa Yelamos Torres
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.O.R.V.); (V.Y.T.)
- Universidad Internacional Iberoamericana, Campeche 24560, Mexico
- Universidad de La Romana, La Romana 22000, Dominican Republic
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
- Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, 95123 Catania, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, 95124 Catania, Italy;
| |
Collapse
|
11
|
Verhoef VTR, Smolders KCHJ, Remmelswaal L, Peeters G, Overeem S, de Kort YAW. Match and Mismatch between Lived Experiences of Daytime Sleepiness and Diagnostic Instruments: A Qualitative Study amongst Patients with Sleep Disorders. Clocks Sleep 2024; 6:24-39. [PMID: 38247883 PMCID: PMC10801535 DOI: 10.3390/clockssleep6010003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Excessive daytime sleepiness is a common symptom of sleep disorders. Despite its prevalence, it remains difficult to define, detect, and address. The difficulties surrounding sleepiness have been linked to an ambiguous conceptualization, a large variety of scales and measures, and the overlap with other constructs, such as fatigue. The present study aims to investigate patients' descriptions of sleepiness-related daytime complaints and their phenomenology. We performed semi-directed interviews with patients diagnosed with obstructive sleep apnea (N = 15) or narcolepsy (N = 5). The interviewers took care of utilizing the participants' terminology when describing daytime complaints related to their sleep disorder. Various aspects of the daytime complaints were investigated, such as their description and temporality. The transcribed content was thematically analyzed using an eclectic coding system, yielding five themes. The participants used different interchangeable descriptors (tired, sleepy, fatigued, exhausted) to express their daytime complaints. They enriched their description with indexes of magnitude (ranging from 'not especially' to 'most gigantic, extreme'), oppositions to other states (using antipodes like energy, alertness, wakefulness, or rest), and indications of fluctuations over the day. Interestingly, the participants often used metaphors to express their experiences and their struggles. The lived experiences of the patients were found to not always align with common self-reported monitoring tools of sleepiness and to relate only in part with current conceptions. In practice, it is important to probe daytime complaints, such as daytime sleepiness, with a broader consideration, for example, by exploring antipodes, consequences, and time-of-day fluctuations.
Collapse
Affiliation(s)
- Vaida T. R. Verhoef
- Human-Technology Interaction, Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands; (K.C.H.J.S.)
| | - Karin C. H. J. Smolders
- Human-Technology Interaction, Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands; (K.C.H.J.S.)
| | - Lysanne Remmelswaal
- Human-Technology Interaction, Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands; (K.C.H.J.S.)
| | - Geert Peeters
- Center for Sleep Medicine Kempenhaeghe, 5591 VE Heeze, The Netherlands; (G.P.); (S.O.)
| | - Sebastiaan Overeem
- Center for Sleep Medicine Kempenhaeghe, 5591 VE Heeze, The Netherlands; (G.P.); (S.O.)
- Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands
| | - Yvonne A. W. de Kort
- Human-Technology Interaction, Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands; (K.C.H.J.S.)
| |
Collapse
|
12
|
Doğan S, Bayram GA. Evaluating the effect of daytime sleepiness and sleep quality on balance, fatigue and life quality of shift workers. Work 2024; 77:789-797. [PMID: 37742678 DOI: 10.3233/wor-220700] [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] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Changes in the sleep-wake cycle in shift workers can cause many health problems. OBJECTIVE The aim of this study was to investigate the relationship between daytime sleepiness and sleep quality on balance, physical activity level, fatigue and quality of life in shift and non-shift workers. METHOD A total of 58 employees, 29 shifts and 29 non-shifts, were included in the study. Data were collected using the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the Tandem Posture Test, the One-Foot Stand Test, the Ten-Step Tandem Walking Test, the International Physical Activity Questionnaire-Short Form, the Fatigue Severity Scale, and the Nottingham Health Profile. RESULTS Individuals working in shifts had higher fatigue severity and daytime sleepiness levels (p < 0.05), while physical activity levels and sleep quality were lower than those working without shifts (p < 0.05). It was determined that as the daytime sleepiness of individuals working in shifts and non-shifts increased, their quality of life decreased (p < 0.05). CONCLUSION According to the data obtained from the study, individuals working in shifts compared to individuals working without shifts experienced higher levels of daytime sleepiness and fatigue severity level while sleep quality and physical activity level were lower.
Collapse
Affiliation(s)
- Semanur Doğan
- Institute of Health Sciences, Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey
| | - Gulay Aras Bayram
- Faculty of Health Sciences, Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey
| |
Collapse
|
13
|
Quach HQ, Warner ND, Ovsyannikova IG, Covassin N, Poland GA, Somers V, Kennedy RB. Excessive daytime sleepiness is associated with impaired antibody response to influenza vaccination in older male adults. Front Cell Infect Microbiol 2023; 13:1229035. [PMID: 38149010 PMCID: PMC10749933 DOI: 10.3389/fcimb.2023.1229035] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/27/2023] [Indexed: 12/28/2023] Open
Abstract
Background The reduced effectiveness of standard-dose influenza vaccines in persons ≥65 years of age led to the preferential recommendation to use high-dose (HDFlu) or MF59-adjuvanted (MF59Flu) vaccines for this age group. Sleep is an important modulator of immune responses to vaccines and poor sleep health is common in older adults. However, potential effects of poor sleep health on immune responses to influenza vaccination in older adults remain largely unknown. Methods We conducted a cohort study of 210 healthy participants age ≥65 years, who received either seasonal high-dose (HDFlu) or MF59-adjuvanted (MF59Flu) influenza vaccine. We assessed sleep characteristics in this cohort by standardized questionnaires and measured the antibody titer against influenza A/H3N2 virus in serum of study participants by hemagglutination inhibition assay on the day of immunization and 28 days thereafter. We then assessed the association between sleep characteristics and antibody titers. Results Our results demonstrated that male, but not female, study participants with excessive daytime sleepiness had an impaired influenza A/H3N2-specific antibody response at Day 28 post-vaccination. No other associations were found between antibody titer and other sleep characteristics, including sleep quality and obstructive sleep apnea. Conclusion Our results provide an additional and easily measured variable explaining poor vaccine effectiveness in older adults. Our results support that gaining sufficient sleep is a simple non-vaccine interventional approach to improve influenza immune responses in older adults. Our findings extend the literature on the negative influence of excessive daytime sleepiness on immune responses to influenza vaccination in older male adults.
Collapse
Affiliation(s)
- Huy Quang Quach
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States
| | - Nathaniel D. Warner
- Department of Quantitative Health Services, Mayo Clinic, Rochester, MN, United States
| | | | - Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Gregory A. Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States
| | - Virend K. Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Richard B. Kennedy
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States
| |
Collapse
|
14
|
Canever JB, Cândido LM, Moreira BDS, Danielewicz AL, Cimarosti HI, Lima-Costa MF, Avelar NCPD. A nationwide study on sleep complaints and associated factors in older adults: ELSI-Brazil. CAD SAUDE PUBLICA 2023; 39:e00061923. [PMID: 38018640 PMCID: PMC10642241 DOI: 10.1590/0102-311xen061923] [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: 04/10/2023] [Revised: 06/13/2023] [Accepted: 07/13/2023] [Indexed: 11/30/2023] Open
Abstract
Sleep problems, such as difficulty falling asleep, staying asleep, early awakening with failure to continue sleep, and altered sleep-wake cycle, are common in the general population. This cross-sectional study with 6,929 older adults (≥ 60 years) aimed to estimate the prevalence of different types of sleep problems, their associated factors, and the population-attributable fraction of associated factors among older adults. The outcome variables consisted of self-reported sleep problems: insomnia (initial, intermediate, late, and any type of insomnia), poor sleep quality, and daytime sleepiness. The independent variables were sociodemographic and behavioral characteristics and health conditions. The prevalence proportions were initial insomnia (49.1%), intermediate insomnia (49.2%), late insomnia (45.9%), any type of insomnia (58.6%), poor sleep quality (15.6%), and daytime sleepiness (38.4%). Female sex, presence of two or more chronic diseases, not eating the recommended amount of fruits and vegetables, and regular and bad/very bad self-rated health were positively associated with the sleep problems investigated. Consuming alcohol once a month or more was inversely associated with initial insomnia. Population attributable fraction estimates ranged from 3% to 19% considering two or more chronic diseases, not eating the recommended amount of fruits and vegetables, and regular and bad/very bad self-rated health. High prevalence of self-reported sleep problems was evinced in older adults. These results can be useful to guide public health services in the creation of informational, evaluative, and screening strategies for sleep problems in older Brazilian adults.
Collapse
Affiliation(s)
- Jaquelini Betta Canever
- Centro de Ciências, Tecnologias e Saúde do Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, Brasil
| | - Letícia Martins Cândido
- Centro de Ciências, Tecnologias e Saúde do Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, Brasil
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Ana Lúcia Danielewicz
- Centro de Ciências, Tecnologias e Saúde do Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, Brasil
| | | | - Maria Fernanda Lima-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | | |
Collapse
|
15
|
Zhang Y, Zhao W, Liu K, Chen Z, Fei Q, Ahmad N, Yi M. The causal associations of altered inflammatory proteins with sleep duration, insomnia and daytime sleepiness. Sleep 2023; 46:zsad207. [PMID: 37535878 DOI: 10.1093/sleep/zsad207] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/27/2023] [Indexed: 08/05/2023] Open
Abstract
STUDY OBJECTIVES Growing evidence linked inflammation with sleep. This study aimed to evaluate the associations and causal effects of sleep traits including insomnia, excessive daytime sleepiness (EDS), and sleep duration (short: <7 h; normal: 7-9 h; long: ≥9 h), with levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukins. METHODS Standard procedures of quantitative analysis were applied to estimate the expression differences for each protein in compared groups. Then, a two-sample Mendelian randomization (MR) analysis was performed to explore their causal relationships with published genome-wide association study summary statistics. The inverse-variance weighted was used as the primary method, followed by several complementary approaches as sensitivity analyses. RESULTS A total of 44 publications with 51 879 participants were included in the quantitative analysis. Our results showed that the levels of CRP, interleukin-1β (IL-1β), IL-6, and TNF-α were higher from 0.36 to 0.58 (after standardization) in insomnia compared with controls, while there was no significant difference between participants with EDS and controls. Besides, there was a U/J-shaped expression of CRP and IL-6 with sleep durations. In MR analysis, the primary results demonstrated the causal effects of CRP on sleep duration (estimate: 0.017; 95% confidence intervals [CI], [0.003, 0.031]) and short sleep duration (estimate: -0.006; 95% CI, [-0.011, -0.001]). Also, IL-6 was found to be associated with long sleep duration (estimate: 0.006; 95% CI, [0.000, 0.013]). These results were consistent in sensitivity analyses. CONCLUSIONS There are high inflammatory profiles in insomnia and extremes of sleep duration. Meanwhile, elevated CRP and IL-6 have causal effects on longer sleep duration. Further studies can focus on related upstream and downstream mechanisms.
Collapse
Affiliation(s)
- Yuan Zhang
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Wangcheng Zhao
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Kun Liu
- School of Life Sciences, Central South University, Changsha, China
| | - Ziliang Chen
- School of Life Sciences, Central South University, Changsha, China
| | - Quanming Fei
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Namra Ahmad
- School of Life Sciences, Central South University, Changsha, China
| | - Minhan Yi
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- School of Life Sciences, Central South University, Changsha, China
| |
Collapse
|
16
|
Chen S, Li H, Wen D. Social Support and Daytime Sleepiness Among Chinese Medical Students: Mediating Roles of Loneliness and Problematic Smartphone Use. Psychol Res Behav Manag 2023; 16:4083-4093. [PMID: 37817912 PMCID: PMC10561758 DOI: 10.2147/prbm.s432400] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023] Open
Abstract
Background Sleep problems have become a serious threat to public health worldwide. Daytime sleepiness is an important indicator of many sleep problems, which have a significant impact on academic performance, physical and mental health, and wellbeing among medical students. We aimed to explore the factors associated with daytime sleepiness among medical students. Methods We conducted a cross-sectional survey of 466 medical students recruited via convenience sampling. Self-rated psychometric scales, including the Social Support Rate Scale, the Epworth Sleepiness Scale, the Chinese version of the UCLA loneliness scale, and the Mobile Phone Addiction Index (MPAI), were utilized to evaluate social support, daytime sleepiness, loneliness, and problematic smartphone use. A sequential mediation model was constructed with daytime sleepiness as the dependent variable, social support as the independent variable, and loneliness and problematic smartphone use as mediating variables. Age, gender, and grade were taken as covariates. Results Social support among medical students was negatively associated with loneliness, problematic smartphone use, and daytime sleepiness (p < 0.01). A sequential mediation analysis showed that loneliness (the first mediator) and problematic smartphone use (the second mediator) sequentially mediated the path from social support to daytime sleepiness among medical students (β = -0.008; 95% CI = -0.016, -0.002). Moreover, there were also significant mediating roles observed in the relationship between social support and daytime sleepiness via loneliness only (β = -0.037; 95% CI = -0.062, -0.015) and problematic smartphone use only (β = -0.022; 95% CI = -0.041, -0.008). Conclusion Social support, loneliness, and problematic smartphone use among medical students influenced their daytime sleepiness. Interventions targeting medical student loneliness and problematic smartphone use behaviors might attenuate the effects from low levels of social support and further improve daytime sleepiness.
Collapse
Affiliation(s)
- Sijian Chen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
- School of Nursing, China Medical University, Shenyang, People’s Republic of China
| | - Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
| | - Deliang Wen
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, People’s Republic of China
| |
Collapse
|
17
|
Zakharov IM, Ismatullina VI, Kolyasnikov PV, Marakshina JA, Malykh AS, Tabueva AO, Adamovich TV, Lobaskova MM, Malykh SB. An Independent Evaluation of the Psychometric Properties of the Russian Version of the Pediatric Daytime Sleepiness Scale (PDSS). Psychol Russ 2023; 16:206-221. [PMID: 38024570 PMCID: PMC10659232 DOI: 10.11621/pir.2023.0314] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background The quality of sleep significantly impacts children's day-to-day performance, with at least 20% reporting issues with sleepiness. Valid tools for assessing the quality of sleep are needed. Objective In this study, we assessed the psychometric properties of the Russian version of the Pediatric Daytime Sleepiness Scale (PDSS). The initial adaptation of the PDSS was conducted on a sample from the Arctic regions of Russia. This location may have influenced the scale's generalizability due to variations in natural daylight across different areas of the country. Design To rectify this, we gathered a comprehensive, geographically diverse sample from Russia. This combined dataset comprised 3772 participants between 10 to 18 years of age, from nine different regions of Russia. Results We confirmed the unifactorial structure of the PDSS, which showed no regional effects. The psychometric analysis indicated that one item from the 8item PDSS could be removed, thereby improving the scale's model fit. We also observed gender and age impacts on sleep quality: boys reported fewer sleep-related issues than girls, and younger children reported fewer problems than older children. Conclusion This study validates the usefulness and reliability of the Russian version of the PDSS, thereby enhancing its general applicability. Furthermore, we replicated previously reported age and sex effects on the sleep quality of school-aged children.
Collapse
Affiliation(s)
- Ilya M Zakharov
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | | | - Pavel V Kolyasnikov
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | | | - Artem S Malykh
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Anna O Tabueva
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | | | - Marina M Lobaskova
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Sergey B Malykh
- Psychological Institute of Russian Academy of Education, Moscow, Russia
- Lomonosov Moscow State University, Russia
| |
Collapse
|
18
|
Vael VEC, Bijlenga D, Schinkelshoek MS, van der Sluiszen NNJJM, Remmerswaal A, Overeem S, Ramaekers JG, Vermeeren A, Lammers GJ, Fronczek R. Skin temperature as a predictor of on-the-road driving performance in people with central disorders of hypersomnolence. J Sleep Res 2023:e14045. [PMID: 37720977 DOI: 10.1111/jsr.14045] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/18/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
Excessive daytime sleepiness is the core symptom of central disorders of hypersomnolence (CDH) and can directly impair driving performance. Sleepiness is reflected in relative alterations in distal and proximal skin temperature. Therefore, we examined the predictive value of skin temperature on driving performance. Distal and proximal skin temperature and their gradient (DPG) were continuously measured in 44 participants with narcolepsy type 1, narcolepsy type 2 or idiopathic hypersomnia during a standardised 1-h driving test. Driving performance was defined as the standard deviation of lateral position (SDLP) per 5 km segment (equivalent to 3 min of driving). Distal and proximal skin temperature and DPG measurements were averaged over each segment and changes over segments were calculated. Mixed-effect model analyses showed a strong, quadratic association between proximal skin temperature and SDLP (p < 0.001) and a linear association between DPG and SDLP (p < 0.021). Proximal skin temperature changes over 3 to 15 min were predictive for SDLP. Moreover, SDLP increased over time (0.34 cm/segment, p < 0.001) and was higher in men than in women (3.50 cm, p = 0.012). We conclude that proximal skin temperature is a promising predictor for real-time assessment of driving performance in people with CDH.
Collapse
Affiliation(s)
- Veronique E C Vael
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
- Leiden University Medical Centre, Department of Neurology, Leiden, The Netherlands
| | - Denise Bijlenga
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
- Leiden University Medical Centre, Department of Neurology, Leiden, The Netherlands
| | - Mink S Schinkelshoek
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
- Leiden University Medical Centre, Department of Neurology, Leiden, The Netherlands
| | - Nick N J J M van der Sluiszen
- Maastricht University, Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht, The Netherlands
| | - Aniek Remmerswaal
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
| | - Sebastiaan Overeem
- Kempenhaeghe, Centre for Sleep Medicine, Heeze, The Netherlands
- Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, The Netherlands
| | - Johannes G Ramaekers
- Maastricht University, Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht, The Netherlands
| | - Annemiek Vermeeren
- Maastricht University, Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht, The Netherlands
| | - Gert Jan Lammers
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
- Leiden University Medical Centre, Department of Neurology, Leiden, The Netherlands
| | - Rolf Fronczek
- Stichting Epilepsie Instellingen Nederland (SEIN), Sleep-Wake Centre, Heemstede, The Netherlands
- Leiden University Medical Centre, Department of Neurology, Leiden, The Netherlands
| |
Collapse
|
19
|
Lipschitz JM, Perez-Rodriguez M, Majd M, Larsen E, Locascio J, Pike CK, Shanahan M, Burdick KE. Modafinil's effects on cognition and sleep quality in affectively-stable patients with bipolar disorder: a pilot study. Front Psychiatry 2023; 14:1246149. [PMID: 37732080 PMCID: PMC10507316 DOI: 10.3389/fpsyt.2023.1246149] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Despite advances in the treatment of bipolar disorder (BD), most patients do not achieve complete inter-episode recovery and functional disability is common. During periods of relative remission, many patients continue to experience neurocognitive dysfunction, reduced daytime activity levels, and sleep disturbances. This 8-week, randomized, placebo-controlled pilot study evaluated the feasibility, safety and preliminary efficacy of the wake-promoting drug, modafinil (Provigil®), on neurocognitive functioning, daytime sleepiness, and sleep quality in affectively-stable BD patients. Methods Twelve individuals with affectively-stable BD were recruited and randomized to a flexible dose of modafinil (100 to 200 mg/day) or placebo, adjunctive to a therapeutic dose of a mood stabilizer. Weekly in-person visits tracked sleep quality and daytime sleepiness as well as side effects and mood symptoms. Neurocognitive functioning was assessed at baseline, week 4, and week 8. Results No serious adverse events were reported. Newly emergent side effects in the modafinil group included heart palpitations, itching, fatigue, and decreased energy. Two patients discontinued modafinil owing to side effects and one of these patients withdrew from the study. One patient discontinued placebo and was withdrawn from the study. Preliminary evaluations of clinical efficacy showed a marginally significant interaction between treatment group and time in two cognitive domains (speed of processing and verbal learning), indicating greater improvement in the modafinil group versus placebo. Additionally, there was a marginally significant effect of treatment group on daytime sleepiness, suggesting lower daytime sleepiness in the modafinil group versus placebo. Counterintuitively, we found a significant treatment group by time interaction effect on sleep quality, suggesting greater improvement in sleep quality in the placebo group versus the modafinil group. Discussion Results suggest that modafinil is a relatively safe medication for affectively-stable BD patients when given with adjunctive mood stabilizers. Results are suggestive of cognitive benefit and improved daytime sleepiness, but worse sleep quality in those patients prescribed modafinil. A fully powered clinical trial is warranted with specific attention to the characteristics of patients who are most likely to benefit from treatment with modafinil and other methodological lessons learned from this pilot. Clinical trial registration ClinicalTrials.gov, identifier NCT01965925.
Collapse
Affiliation(s)
- Jessica M. Lipschitz
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | | | - Marzieh Majd
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Emmett Larsen
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Joseph Locascio
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Department of Neurology and Harvard Catalyst Biostatistical Group, Harvard Medical School, Boston, MA, United States
| | - Chelsea K. Pike
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
| | - Megan Shanahan
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
| | - Katherine E. Burdick
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
20
|
Guo X, Meng Y, Lian H, Li Y, Xu Y, Zhang R, Xu J, Wang H, Xu S, Cai W, Xiao L, Su T, Tang Y. Marital status and living apart affect sleep quality in male military personnel: a study of the China's Navy during COVID-19. Front Psychiatry 2023; 14:1178235. [PMID: 37575585 PMCID: PMC10412872 DOI: 10.3389/fpsyt.2023.1178235] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023] Open
Abstract
Background Marital status is a robust sociodemographic predictor of sleep. Having to live apart from spouse may have different implications than those of cohabitants or singles, especially in military personnel. Further research on this group will help provide knowledge in advance and facilitate early targeted interventions. Methods An online questionnaire study was conducted from July to November 2021. A total of 1,832 male military personnel completed the questionnaire. The marital status was measured by a self-reported single choice question. Pittsburgh sleep quality index (PSQI), Epworth Sleepiness Scale (ESS) and The Dysfunctional Beliefs and Attitudes about sleep scale (DBAS-16) were used to measure sleep-related outcomes. Inverse probability weighting (IPW) was applied to reduce the effects of confounding. Logistic regression was used to analyze the relationship between marital status and sleep and explore the impact of living together or not. Results After inverse probability weighting, the prevalence of poor sleep quality, sleepiness and dysfunctional beliefs were 16.1, 20.1 and 7.1%, respectively. One-way ANOVA results for the means of both groups were statistically significantly different, except for the sleep latency and sleep disturbance dimensions of PSQI. Participants who were married were more likely to have poor sleep quality (OR: 1.408, 95% CI: [1.10, 1.80]), to have daytime sleepiness (OR: 1.560, 95% CI: [1.27, 1.92]) and to develop dysfunctional beliefs and attitudes (OR: 2.497, 95% CI: [1.65, 3.80]) than those who were unmarried. Further analysis showed that the odds of developing poor sleep quality and DBAS in participants who married but living apart were significantly bigger than those unmarried (OR: 1.548 and 3.991, respectively.), while there were no significant differences in the odds of daytime sleepiness (OR: 0.738, p = 0.050). Age was a protective factor for the development of bad sleep outcomes, while family economic was an independent risk factor. Conclusion Marital status appear important for sleep quality, daytime sleepiness and sleep beliefs. The effect of living apart or not should be considered separately as an important predictor of sleep.
Collapse
Affiliation(s)
- Xin Guo
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yao Meng
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
- Department of Diving and Hyperbaric Medical Research, Naval Medical Center, Naval Medical University, Shanghai, China
| | - Hao Lian
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yinan Li
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Ying Xu
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Ruike Zhang
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Jingzhou Xu
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Hao Wang
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Shuyu Xu
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Wenpeng Cai
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Lei Xiao
- Department of Medical Psychology, Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Tong Su
- Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Yunxiang Tang
- Faculty of Psychology, Naval Medical University, Shanghai, China
| |
Collapse
|
21
|
Alchallah MO, Safiah MH, Belah Kajjoun MM, Kalalib Al Ashabi K, Ataya S, Mohsen F, Bakdounes D, ElHomsi MO, Alolabi H, Alistwani D, Alzein A, Ayash A, Youzbashi L, Darjazini Nahas L. Prevalence of childhood obstructive sleep apnoea syndrome and its role in daytime sleepiness in Syria: a large-scale school-based cross-sectional study. Ann Med Surg (Lond) 2023; 85:2579-2586. [PMID: 37363593 PMCID: PMC10289726 DOI: 10.1097/ms9.0000000000000820] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/01/2023] [Indexed: 06/28/2023] Open
Abstract
Obstructive sleep apnoea syndrome (OSAS) has become vastly conceded in the last decade as a possible reason for significant morbidity in childhood. This study aims to evaluate the prevalence of OSAS among school children and to assess the interrelationship between OSAS and daytime sleepiness. Methods and materials This cross-sectional study was conducted with 1029 children and adolescents aged 6-15 years attending elementary and secondary schools in Damascus, Syria. The questions involved 19 sleep problems items using the children sleep habits questionnaire, and 4 sleep disorder items (loud snoring, having snorts or gasps, breathing pauses, daytime sleepiness). Total sleep time (TST) was determined by sleep habits. Severe possible OSAS (p-OSAS) was addressed as having all OSA symptoms "frequently", and mild p-OSAS was defined as having any of the symptoms "sometimes". Severe and mild daytime sleepiness were rated as being very sleepy during the day "frequently", and "sometimes", respectively. Logistic regression was applied to predict risk factors of severe and mild daytime sleepiness. Results The prevalence of p-OSAS was 22.2%, of them 15.8% were mild, and 6.3% were severe. p-OSAS was more recognized in males 15.2% children (P<0.05). Most p-OSAS children sleep less than 6 h of TST; however; the mean TST was significantly lower at the secondary school level (P≤0.001). Predicted risk factors for severe and mild daytime sleepiness were students' grade level (P<0.05), severe and mild p-OSAS (P≤0.001), and TST less than 6 h (P≤0.001). Conclusions A significant number of children have p-OSAS, affecting daytime sleepiness in school age. Physicians should consider loud snoring, and breathing pauses as marked symptoms of severe daytime sleepiness. Moreover, raising parents awareness about OSAS and daytime sleepiness is essential to ensure early access to primary care.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Louei Darjazini Nahas
- Division of Otorhinolaryngology, Department of Surgery, Faculty of Medicine, Syrian Private University
| |
Collapse
|
22
|
Yoon J, Heo S, Lee H, Sul E, Han T, Kwon YJ. Feasibility and Efficacy of Morning Light Therapy for Adults with Insomnia: A Pilot, Randomized, Open-Label, Two-Arm Study. Medicina (Kaunas) 2023; 59:1066. [PMID: 37374270 DOI: 10.3390/medicina59061066] [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] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: Light therapy (LT) is used as an adjunctive treatment for sleep problems. This study evaluates the impact of LT on sleep quality and sleep-related parameters in patients with sleep disorders. Materials and Methods: We performed a pilot, randomized, open-label clinical trial. Fourteen patients aged 20-60 years with insomnia were randomized into the control and LT groups (1:1 ratio). The LT group was instructed to use a device that provides bright LT (6000 K, 380 lux, wavelength 480 nm) for at least 25 min before 09:00 a.m. for two weeks. A self-reported questionnaire was used to evaluate circadian preference, mood, and sleep-related parameters. We analyzed serum cortisol levels and clock genes' expression. Results: The Epworth Sleepiness Scale (ESS), insomnia severity index(ISI), and Pittsburgh Sleep Quality index(PSQI) were significantly improved within the LT group only after the two-week period. When comparing the two groups, only the change in ESS was significant (mean difference, control: -0.14 vs. LT: -1.43, p = 0.021) after adjusting for the baseline characteristics. There were no significant differences in serum cortisol or clock genes' expression. Conclusions: LT can improve daytime sleepiness in patients with sleep disorders; however, further well-designed studies are warranted to confirm its efficacy.
Collapse
Affiliation(s)
- Jihyun Yoon
- Department of Family Medicine, Korean University Anam Hospital, Seoul 02481, Republic of Korea
| | - Seokjae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Hyangkyu Lee
- College of Nursing, Mo-Im Kim Research Institute, Yonsei University, Seoul 03722, Republic of Korea
| | - Eungyeong Sul
- Department of Family Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Taehwa Han
- Health-IT Center, Yonsei University Severance Hospital, Seoul 03722, Republic of Korea
| | - Yu-Jin Kwon
- Department of Family Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| |
Collapse
|
23
|
Strang AR, Covington L, Rani S, Gao D, Flores M, Canter K, Patterson F, Chidekel A. Daytime Sleepiness in Children With Asthma: Examining Respiratory and Non-respiratory Factors. Cureus 2023; 15:e40370. [PMID: 37456480 PMCID: PMC10340127 DOI: 10.7759/cureus.40370] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Daytime sleepiness is common in youth with asthma (YWA). Treatments designed to mitigate daytime sleepiness in YWA require an understanding of the primary causes of this problem. We examined respiratory- and non-respiratory-related factors associated with daytime sleepiness in YWA. Methods One hundred YWA (eight to 17 years old) were included in a cross-sectional study. Daytime sleepiness, quality of life, anxiety, bedtime cellphone use, and respiratory symptoms were self-reported. Asthma severity, lung function, and the number of prescribed medications were obtained from electronic medical records. Multivariable regression models identifying variables associated with daytime sleepiness were generated. Results Participants were 54% male and 45% Black, with a mean age of 12.1 years. The multivariable regression model showed decreased quality of life (b = -0.328, p = 0.004) and increased bedtime cellphone use (b = 0.300, p = 0.004)were significantly related to daytime sleepiness, while anxiety (b = 0.213, p = 0.05), prescribed asthma medications (b = 0.173, p = 0.05), and worse lung function (b = -0.173, p = 0.05)were marginally related to daytime sleepiness. Conclusions In addition to optimizing asthma control, strategies targeting anxiety, quality of life, and nocturnal cellphone use are important to mitigate daytime sleepiness in YWA.
Collapse
Affiliation(s)
- Abigail R Strang
- Pediatric Pulmonology, Nemours Children's Health System, Wilmington, USA
| | | | - Seema Rani
- Pediatric Pulmonology, Nemours Children's Health System, Wilmington, USA
| | - David Gao
- Pediatric Pulmonology, Nemours Children's Health System, Wilmington, USA
| | - Micayla Flores
- Pediatric Pulmonology, Nemours Children's Health System, Wilmington, USA
| | - Kimberly Canter
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, USA
| | - Freda Patterson
- Sleep and Health Research Program, Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, USA
| | - Aaron Chidekel
- Pediatric Pulmonology, Nemours Children's Health System, Wilmington, USA
| |
Collapse
|
24
|
Rubin A, Mangal R, Stead TS, Walker J, Ganti L. The extent of sleep deprivation and daytime sleepiness in young adults. Health Psychol Res 2023; 11:74555. [PMID: 37197394 PMCID: PMC10184883 DOI: 10.52965/001c.74555] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
Background Sleep deprivation is a condition in which an individual does not get enough sleep, leading to a variety of negative effects on their physical and mental health. In the United States, sleep deprivation is a common problem, with many people not getting the recommended 7-9 hours of sleep per night. Excessive daytime sleepiness is also a common condition in the United States. It is characterized by a persistent feeling of fatigue or drowsiness during the day, despite getting enough sleep at night. The current study aims to document the frequency of sleepiness symptoms amongst the general US population. Methods A web-based survey was conducted to assess the frequency of daily anxiety symptoms amongst adults residing in the United States. Questions from the Epworth Sleepiness Scale were used to quantify the burden of daytime sleepiness. JMP 16.0 for Mac OS was used to perform statistical analyses. Our Institutional Review Board gave the study an exempt determination (#2022-569). Results In total, 9% of people qualified as having lower normal daytime sleepiness, 34% qualified as having higher normal daytime sleepiness, 26% qualified as having mild excessive daytime sleepiness, 17% qualified as having moderate excessive daytime sleepiness, and 17% qualified as having severe excessive daytime sleepiness. Limitations The present findings are based on cross-sectional survey data. Conclusion Although sleep is one of the most crucial bodily activities, our study of young adults found that more than 60% had moderate to severe sleep deprivation/daytime sleepiness as reported on the Epworth Sleepiness scale.
Collapse
Affiliation(s)
| | | | | | | | - Latha Ganti
- Emergency Medicine & Neurology University of Central Florida College of Medicine
| |
Collapse
|
25
|
Sampasa-Kanyinga H, Chaput JP, Huang BH, Duncan MJ, Hamer M, Stamatakis E. Bidirectional associations of sleep and discretionary screen time in adults: Longitudinal analysis of the UK biobank. J Sleep Res 2023; 32:e13727. [PMID: 36114149 DOI: 10.1111/jsr.13727] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/10/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022]
Abstract
The direction of the association between discretionary screen time (DST) and sleep in the adult population is largely unknown. We examined the bidirectional associations of DST and sleep patterns in a longitudinal sample of adults in the general population. A total of 31,361 UK Biobank study participants (52% female, 56.1 ± 7.5 years) had two repeated measurements of discretionary screen time (TV viewing and leisure-time computer use) and self-reported sleep patterns (five sleep health characteristics) between 2012 and 2018 (follow-up period of 6.9 ± 2.2 years). We categorised daily DST into three groups (low, <3 h/day; medium, 3-4 h/day; and high, >4 h/day), and calculated a sleep pattern composite score comprising morning chronotype, adequate sleep duration (7-8 h/day), never or rare insomnia, never or rare snoring, and infrequent daytime sleepiness. The overall sleep pattern was categorised into three groups (healthy: ≥ 4; intermediate: 2-3; and poor: ≤ 1 healthy sleep characteristic). Multiple logistic regression analyses were applied to assess associations between DST and sleep with adjustments for potential confounders. Participants with either an intermediate (OR: 1.40; 95% CI: 1.15, 1.71) or a poor (OR: 1.16; 95% CI: 1.10, 1.24) sleep pattern at baseline showed higher odds for high DST at follow-up, compared with those with a healthy baseline sleep pattern. Participants with medium (OR: 1.40; 95% CI: 1.14, 1.71) or high DST (OR: 1.62; 95% CI: 1.30, 2.00) at baseline showed higher odds for poor sleep at follow-up, compared with participants with a low DST. In conclusion, our findings provide consistent evidence that a high DST at baseline is associated with poor sleep over a nearly 7 year follow-up period, and vice versa.
Collapse
Affiliation(s)
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Bo-Huei Huang
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Mitch J Duncan
- School of Medicine & Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Mark Hamer
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, Institute of Sport, Exercise and Health, University College London, London, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| |
Collapse
|
26
|
Öğütlü H, Karatekin Ş, Sürücü Kara İ, McNicholas F. Sluggish cognitive tempo, eating habits, and daytime sleepiness in obese adolescents. Clin Child Psychol Psychiatry 2023; 28:595-609. [PMID: 35638558 DOI: 10.1177/13591045221105194] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Rates of obesity have risen steeply in the western world in all age groups. Sluggish Cognitive Tempo (SCT) is characterized by a cluster of symptoms. Daytime sleepiness, commonly seen in obesity, may share a similar origin with sleepiness and daydreaming symptoms of SCT. This study aims to investigate the relationship between obesity, SCT, daytime sleepiness, and eating habits. METHOD Adolescents, aged between 10-17 years, with a BMI >95th centile, were recruited to the study. Clinical interviews were supplemented with standardized questionnaires. RESULTS Of the 35 adolescents, more than one quarter (N = 10, 28.6%) had SCT. Emotional overeating and food enjoyment subscale scores showed moderate correlations with the SCT scores, though these associations were not significant when controlling for ADHD symptoms. Daytime sleepiness score in adolescents with SCT was found to be significantly higher than those without. CONCLUSION Sluggish Cognitive Tempo is frequently present in adolescents with obesity and associated with higher levels of emotional overeating, food enjoyment, and daytime sleepiness. Targeting aspects of SCT might offer additional avenues to assist in weight management programs for youth.
Collapse
Affiliation(s)
- Hakan Öğütlü
- Department of Child and Adolescent Psychiatry, 536164Ankara City Hospital, Ankara, Turkey
| | - Şeyma Karatekin
- Department of Pediatrics, 375269Samsun Training and Research Hospital, Samsun, Turkey
| | - İlknur Sürücü Kara
- Division of Pediatric Metabolism, Department of Pediatrics, 37504Ankara University, Ankara, Turkey
| | - Fiona McNicholas
- Child and Adolescent Psychiatry Department, 8797University College of Dublin, Dublin, Ireland.,Children Hospital Ireland, Crumlin, Dublin, Ireland.,SJOG C AMHS, Lucena Rathgar, Dublin, Ireland
| |
Collapse
|
27
|
Moustakbal M, Maataoui SB. Depression symptoms among adolescents in Morocco: a school-based cross-sectional study. Pan Afr Med J 2023; 44:147. [PMID: 37396692 PMCID: PMC10311232 DOI: 10.11604/pamj.2023.44.147.36713] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/14/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction depression in adolescents is a major health condition that can interfere with daily life, lead to suicidal thoughts and behavior, and affect a person throughout life. However, studies about adolescents´ depression in Morocco are scarce. The aim of this study was to determine the prevalence of depression symptoms among in-school adolescents from the region of Settat-Morocco, as well as assessing its relation to daytime sleepiness and poor academic achievement. Methods the researchers conducted a cross-sectional school-based study. The sample included participants aged 12-20 years, in either urban or rural areas. We selected 722 students through a proportionate stratified sampling procedure. The participants responded to multiple questionnaires that included the Patient Health Questionnaire-9, the Epworth Sleepiness Scale, a questionnaire assessing several sociodemographic and socioeconomic variables, and finally an academic achievement questionnaire. We analyzed the collected data using descriptive statistical methods, χ2 test, and odds ratios. Results forty-four point seven percent (44.7%) of the respondents had "moderately severe" to "severe depression symptoms" and 32.5% of the sample suffered from excessive daytime sleepiness. Nineteen point nine percent (19.9%) of the total sample reported having a poor academic achievement. Significant predictors for depression symptoms included "female gender" (OR = 2.06; p-value < 0.001), "having divorced parents" (OR = 6.00; p-value < 0.001), "poor academic achievement" (OR = 5.03; p-value < 0.001), and "excessive daytime sleepiness" (OR = 2.30; p-value = 0.002). Conclusion this study provides important information about Morocco adolescents´ depression symptoms. These findings can help in implementing school-based mental and sleep health programs that target the promotion of mental wellness, prevention of mental health problems, and reduction of adolescent suicide risk.
Collapse
Affiliation(s)
- Marouane Moustakbal
- Biochemistry, Neurosciences, Natural Resources and Environment Laboratory, Sciences and Technologies Faculty, Hassan 1 University, Settat, Morocco
| | - Souad Belabbes Maataoui
- Biochemistry, Neurosciences, Natural Resources and Environment Laboratory, Sciences and Technologies Faculty, Hassan 1 University, Settat, Morocco
| |
Collapse
|
28
|
Liu X, Commodore-Mensah Y, Himmelfarb CR, Li J, Stoner L, Shahane A, Logan JG. Determinants of Daytime Sleepiness Among Middle-Aged Adults. Clin Nurs Res 2023; 32:571-579. [PMID: 36851893 DOI: 10.1177/10547738231156148] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Daytime sleepiness is highly prevalent in middle-aged adults and has a detrimental impact on their quality of life. Our study examined the psychological and behavioral determinants of daytime sleepiness among adults aged 35 to 64 years. The main variables of interest were psychological factors (perceived stress and anxiety), physical activity factors (moderate-to-vigorous physical activity and sedentary behaviors), and dietary factors (fat, sugar, fruit, and vegetable intake). Partial correlation and multiple linear regression were conducted to determine their associations with daytime sleepiness, with adjustment for covariates. Our sample included 87 adults with a mean age of 47 ± 9 years. About 21% met the criterion for excessive daytime sleepiness. Greater anxiety, longer time spent in sedentary behaviors, and higher consumption of foods rich in trans fat, sugar, and calories were independently associated with higher daytime sleepiness levels. Targeted interventions or treatments are warranted to address the identified risk factors for middle-aged adults.
Collapse
Affiliation(s)
- Xiaoyue Liu
- Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Junxin Li
- Johns Hopkins University, Baltimore, MD, USA
| | - Lee Stoner
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | | |
Collapse
|
29
|
Palot A, Nguyên XL, Launois S, Prigent A, Graml A, Aversenq E, Koltes C, Recart D, Lavergne F. Effect of switching from continuous to bilevel positive airway pressure on sleep quality in patients with obstructive sleep apnea: the prospective POP IN VAuto study. J Thorac Dis 2023; 15:918-927. [PMID: 36910096 PMCID: PMC9992565 DOI: 10.21037/jtd-22-825] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/02/2022] [Indexed: 03/05/2023]
Abstract
Background Issues with tolerability and side effects can decrease continuous positive airway pressure (CPAP) device usage and the benefits of therapy. Different positive airway pressure (PAP) therapy modes providing expiratory pressure relief or using a different pressure during inspiration vs. expiration (bilevel PAP) may alleviate some of these issues. This multicenter, prospective study evaluated the effects of switching from CPAP to bilevel PAP (VAuto mode) on respiratory parameters, device usage, side effects and patient-reported outcomes in patients with obstructive sleep apnea (OSA). Methods Eligible OSA patients had started CPAP ≥3 months previously, had good compliance (mean 6.1±2.0 h/night) and well-controlled OSA [residual apnea-hypopnea index (AHI) 4.9±3.1/h] but had pressure tolerance issues or persistent side effects/discomfort. All were switched from CPAP to bilevel PAP (AirCurve 10 VAuto; ResMed). Effectiveness (residual AHI), sleep quality, daytime sleepiness, fatigue, therapy-related side effects, and patient satisfaction/preference were assessed after 3 months and 1 year. Results Forty patients were analyzed (68% male, age 64±11 years, body mass index 30.7±5.8 kg/m2). At 3 months and 1 year after switching to bilevel PAP, median [interquartile range] residual AHI was 4/h [2-5.3] and 3.7/h [1.8-5], respectively, and device usage was 7.0 [4.9-7.5] and 6.4 [4.4-7.3] h/night, respectively. Device switch was associated with significant reductions from baseline in expiratory PAP {from 12 [11-13] to 8 [7-9] cmH2O at 3 months (P<0.001) and 9 [8-12] cmH2O at 1 year (P=0.005)}, 95th percentile pressure {from 14 [12-14] to 10 [9-11] and 10 [8-11] cmH2O; P<0.001 and P=0.001, respectively} and leak {from 1 [0-6] to 0 [0-1] and 0 [0-2] L/min; P=0.049 and P=0.033, respectively}. The Pittsburgh Sleep Quality Index score decreased significantly from baseline to 3 and 6 months [7.2±4.0 to 5.0±3.2 (P=0.005) and 4.5±2.7 (P<0.001), respectively]. CPAP-related mouth dryness, choking sensation and aerophagia were significantly improved one year after switching to bilevel PAP. Bilevel PAP was preferred over CPAP by 90% of patients. Conclusions Switching to bilevel PAP had several benefits in patients struggling with CPAP, facilitating therapy acceptance and ongoing device usage.
Collapse
|
30
|
Quevedo-Blasco R, Díaz-Román A, Quevedo-Blasco VJ. Associations between Sleep, Depression, and Cognitive Performance in Adolescence. Eur J Investig Health Psychol Educ 2023; 13:501-11. [PMID: 36826222 DOI: 10.3390/ejihpe13020038] [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: 12/30/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
The relevance of cognitive performance during adolescence requires further studies that analyze potential associated factors. This study aimed to analyze inductive reasoning, reading comprehension, and mathematical thinking (problem-solving and number and calculation) in relation to sleep and depression in 244 students aged 12-17 years (47.6% boys and 52.4% girls). Daytime sleepiness, sleep quality, dysthymia, and euthymia (state and trait) were assessed by self-reported questionnaires. Moreover, correlations between these variables and cognitive performance, and differences depending on sociodemographic variables (sex, age, or academic year) were analyzed using non-parametric tests. Robust regression models were also conducted to evaluate the predictive role of significant variables on cognitive performance. The results showed significant bidirectional relationships between sleep- and depression-related variables, and between the latter ones and cognitive performance. Depression-trait was more related to cognitive performance than depression-state, and euthymia more than dysthymia, but neither daytime sleepiness nor sleep quality significantly correlated with it. As for sociodemographic variables, girls reported worse sleep and more depressive symptoms than boys did, and younger students reported better sleep but performed worse than the older ones. Although these findings should be further explored in forthcoming studies adding other promising variables, they highlight the importance of promoting euthymia to improve cognitive performance in adolescents.
Collapse
|
31
|
Alfonsi V, Varallo G, Scarpelli S, Gorgoni M, Filosa M, De Gennaro L, Musetti A, Franceschini C. 'This is the last episode': the association between problematic binge-watching and loneliness, emotion regulation, and sleep-related factors in poor sleepers. J Sleep Res 2023; 32:e13747. [PMID: 36254098 PMCID: PMC10078456 DOI: 10.1111/jsr.13747] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/30/2022] [Accepted: 09/16/2022] [Indexed: 02/03/2023]
Abstract
Evidence on the relation between binge-watching and sleep quality is still scarce and inconsistent and none has taken into account both the healthy and pathological dimensions of the phenomenon. This study aimed at filling this gap by investigating both aspects in healthy participants with high and low sleep quality. Further, we aimed at identifying sociodemographic, psychological and sleep-related determinants of problematic binge-watching in poor sleepers. We first conducted independent comparisons between good (n = 253) and poor sleepers (n = 209) on different binge-watching symptoms and motives, assessed through 'Binge-watching Engagement and Symptoms' and 'Watching TV Series Motives' questionnaires, respectively. Then, we focused on the problematic aspects of binge-watching in poor sleepers, investigating the role of emotion regulation, loneliness, and sleep-related factors using hierarchical multiple regressions. Comparisons between the two groups revealed a greater extent of binge-watching behaviour (t = -2.80, p = 0.005) and greater use of this practise to cope with negative emotions (t = -4.17, p < 0.001) in poor sleepers. In addition, hierarchical multiple regressions showed that gender (β = -0.166, p = 0.008), alcohol consumption (β = -0.135, p = 0.035), emotional dysregulation (β = 0.260, p = 0.001; β = 0.298, p < 0.001), feelings of loneliness (β = 0.159, p = 0.029; β = 0.199, p = 0.003), and daytime sleepiness (β = 0.149, p = 0.016) are significant determinants of problematic binge-watching in this population. In addition to showing for the first time the relationship between sleep quality and different aspects of binge-watching, our findings indicate that emotional dysregulation, feelings of loneliness, and daytime sleepiness play a key role in determining problematic binge-watching in poor sleepers, possibly due to the existence of a pathological vicious circle between these factors in poor sleepers.
Collapse
Affiliation(s)
| | - Giorgia Varallo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Maria Filosa
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | | |
Collapse
|
32
|
Matsuo R, Tanigawa T, Oshima A, Tomooka K, Ikeda A, Wada H, Maruyama K, Saito I. Decreased psychomotor vigilance is a risk factor for motor vehicle crashes irrespective of subjective daytime sleepiness: the Toon Health Study. J Clin Sleep Med 2023; 19:319-325. [PMID: 36271594 PMCID: PMC9892751 DOI: 10.5664/jcsm.10328] [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: 07/08/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
STUDY OBJECTIVES Although excessive daytime sleepiness (EDS) has a crucial impact on motor vehicle crashes (MVCs), the assessment of subjective sleepiness as a screening tool for MVC has limitations. Objective daytime sleepiness may be a better predictor of MVCs rather than subjective daytime sleepiness. Therefore, we aimed to examine the association of psychomotor vigilance as a surrogate marker of objective sleepiness and subjective sleepiness with MVCs in a prospective cohort study of the general population. METHODS The study participants were 903 community-dwelling Japanese followed up 5 years after baseline and ascertained history of MVC over the study period. Psychomotor vigilance was measured by the psychomotor vigilance test and categorized into quartiles by the reciprocal of the mean reaction time (mean1/RT). Subjective EDS was defined using the Japanese version of the Epworth Sleepiness Scale. Multivariable logistic regression analysis was used to examine the association between mean1/RT and MVC after stratification by subjective EDS. RESULTS The multivariable-adjusted odds ratio (95% confidence interval) for MVC among the highest quartile group of mean1/RT was 0.31 (0.17-0.57), compared with the lowest group (P for trend < .01). After stratification by subjective EDS, the significant association was found only among the nonsubjective EDS group (P for trend < .01) and not among the subjective EDS group (P for trend = .16). CONCLUSIONS Decreased psychomotor vigilance measured by the psychomotor vigilance test was associated with a higher risk of MVCs, and the association was more evident among the nonsubjective EDS group. The psychomotor vigilance test may be useful to prevent sleep-related MVCs in the general population, particularly for individuals without subjective EDS. CITATION Matsuo R, Tanigawa T, Oshima A, et al. Decreased psychomotor vigilance is a risk factor for motor vehicle crashes irrespective of subjective daytime sleepiness: the Toon Health Study. J Clin Sleep Med. 2023;19(2):319-325.
Collapse
Affiliation(s)
- Ryotaro Matsuo
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Juntendo University Hospital, Tokyo, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akane Oshima
- Juntendo University Nerima Hospital, Tokyo, Japan
| | - Kiyohide Tomooka
- Department of Public Health, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Ai Ikeda
- Department of Public Health, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroo Wada
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koutatsu Maruyama
- Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, Ehime, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| |
Collapse
|
33
|
Babicki M, Piotrowski P, Mastalerz-Migas A. Insomnia, Daytime Sleepiness, and Quality of Life among 20,139 College Students in 60 Countries around the World-A 2016-2021 Study. J Clin Med 2023; 12. [PMID: 36675621 DOI: 10.3390/jcm12020692] [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: 12/21/2022] [Revised: 12/30/2022] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Sleep disorders are a widespread phenomenon, and the number of individuals suffering from them is increasing every year, especially among young adults. Currently, the literature lacks studies that cover both countries with different levels of development and a period before the announcement of the ongoing COVID-19 pandemic. Therefore, this study aims to globally assess the prevalence of insomnia and daytime sleepiness among students and assess their quality of life. Methods: For this purpose, our own questionnaire was distributed online via Facebook.com. In addition to the questions that assessed socioeconomic status, the survey included psychometric tools, such as the Athens insomnia scale (AIS), the Epworth sleepiness scale (ESS), and the Manchester short assessment of the quality of life (MANSA). The survey distribution period covered 31 January 2016 to 30 April 2021. Results: The survey involved 20,139 students from 60 countries around the world. The vast majority of the students were women (78.2%) and also those residing in countries with very high levels of development and/or high GDP (gross domestic product) per capita at 90.4% and 87.9%, respectively. More than half (50.6%) of the respondents (10,187) took the survey before the COVID-19 pandemic was announced. In the group analyzed, 11,597 (57.6%) students obtained a score indicative of insomnia and 5442 (27.0%) a score indicative of daytime sleepiness. Women, low-income residents, and nonmedical students were significantly more likely to have scores indicating the presence of insomnia. Individuals experiencing both sleepiness (B = −3.142; p < 0.001) and daytime sleepiness (B = −1.331; p < 0.001) rated their quality of life significantly lower. Conclusions: Insomnia and excessive daytime sleepiness are common conditions among students worldwide and are closely related. The COVID-19 pandemic significantly altered students’ diurnal rhythms, which contributed to an increase in insomnia. Students in countries with a high GDP per capita index are significantly less likely to develop insomnia compared to the residents of countries with a low GDP per capita index. Sleep disorders definitely reduce the quality of life of students.
Collapse
|
34
|
Hwang H, Kim KM, Yun CH, Yang KI, Chu MK, Kim WJ. Sleep state of the elderly population in Korea: Nationwide cross-sectional population-based study. Front Neurol 2023; 13:1095404. [PMID: 36698878 PMCID: PMC9868806 DOI: 10.3389/fneur.2022.1095404] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Objective Interest in sleep disorders among the elderly, especially those in Korea, has increased. We aimed to describe the overall sleep status of the elderly population in Korea using survey data and to determine the risk factors concerning different aspects of sleep status. Methods We conducted a cross-sectional survey on 271 respondents aged 65-86 years old. We performed multistage clustered random sampling according to the population and socioeconomic distribution of all Korean territories. The survey questionnaire was used to perform a structural assessment of sociodemographic characteristics; medical comorbidities; psychiatric comorbidities; and sleep status, including sleep duration, sleep quality, presence of insomnia, excessive daytime sleepiness, sleep apnea, and restless legs syndrome. Results Approximately 12.5, 22.%, and 51.3% of the elderly population had poor sleep quality, excessive daytime sleepiness, and insomnia, respectively. Hypertension, dyslipidemia, insomnia, anxiety, and depression predicted poor sleep quality. Female sex, insomnia, and sleep apnea predicted excessive daytime sleepiness. Poor sleep quality and depression predicted insomnia. Conclusion A substantial proportion of the elderly Korean population have sleep problems, including poor sleep quality, excessive daytime sleepiness, and insomnia. Sleep status is influenced by various factors, including age, sex, and metabolic and psychiatric comorbidities.
Collapse
Affiliation(s)
- Heewon Hwang
- Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea,Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyung Min Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kwang Ik Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea,*Correspondence: Won-Joo Kim ✉
| |
Collapse
|
35
|
Manaenkov AE, Prokhorenko NO, Tkachenko ON, Sveshnikov DS, Dorokhov VB. [Correlation of the Karolinska sleepiness scale with performance variables of the monotonous bimanual psychomotor test]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:28-34. [PMID: 37275995 DOI: 10.17116/jnevro202312305228] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the objectivity of measuring the level of sleepiness in the subjects using a monotonous psychomotor bimanual tapping test developed by us, performed on mobile devices running Android OS. MATERIAL AND METHODS Four hundred and ninety-four hour-long experiments with the performance of a psychomotor test were conducted on 102 students. Using the method of mixed linear models, correlations between the levels of sleepiness according to the Karolinska Sleepiness Scale (KSS) and the Epworth Sleepiness Scale (ESS) and the behavioral indicators of the test were evaluated. RESULTS Statistically significant correlations between the increase in KSS scores and such indicators as a decrease in the total number of button taps and an increase in the frequency of «microsleep» episodes are shown. Statistically significant correlations of ESS score characteristics with the behavioral indicators of the test were not found. CONCLUSION A large statistical material shows a reliable correlation of the parameters of the psychomotor test with the level of sleepiness on the Karolinska scale, which allows using the mobile application developed by us to determine the current level of sleepiness /alertness in the field.
Collapse
Affiliation(s)
- A E Manaenkov
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
- Lomonosov Moscow State University, Moscow, Russia
| | - N O Prokhorenko
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - O N Tkachenko
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
| | - D S Sveshnikov
- Medical Institute of Peoples' Friendship University of Russia, Moscow, Russia
| | - V B Dorokhov
- Institute of Higher Nervous Activity and Neurophysiology, Moscow, Russia
| |
Collapse
|
36
|
Tveritin EA, Knyazeva YA, Sizikova EA, Konovalova DA, Khamzin DV, Deriglazova EA, Chigareva ML, Saltanova EV, Ryazanova AE, Smirnova AA, Gilev DV, Lebedeva ER. [An analysis of complaints about sleep disorders as an indicator of poor sleep quality in patients with primary headache disorders]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:89-94. [PMID: 37276004 DOI: 10.17116/jnevro202312305289] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the prevalence of various complaints indicating poor sleep quality and its disturbances in men and women with primary headaches. MATERIAL AND METHODS In total 305 patients (mean age 45 years, age range 18-89 years) with primary headache disorders and complaints of poor quality of sleep were included in the study. Women prevailed among these patients (79%). The average age of men (41.6) and women (45.8) had no statistically significant differences (p=0.8). The initial examination and professional face-to-face interview were initially conducted by an experienced neurologist specializing in the treatment of headaches. Within a week after that, before the start of treatment, patients were interviewed by telephone using standardized questionnaires by specially trained students and physicians. RESULTS A frequent occurrence of many complaints of sleep disturbances were found in primary headache disorders, both in men and women, they included daytime sleepiness (75.7%), lack of sleep (69.2%), difficulty in falling asleep (57.4%), sleep disruption (51.5%), early morning awakening (47.5%), snoring (18.7%). We found the predominance of these complaints in people over 50 years old. Women had these complaints more frequently than men, besides we determined sex differences in the prevalence of these complaints. CONCLUSION Complaints about poor sleep quality are quite common in patients with primary headache disorders and have sex and age differences. Identification of the described complaints of poor sleep quality is a simple tool for the initial analysis of sleep disorders in the practice of any specialist. We recommend paying great attention to these complaints for further diagnostics of sleep disorders and their timely treatment.
Collapse
Affiliation(s)
- E A Tveritin
- Ural State Medical University, Yekaterinburg, Russia
| | - Y A Knyazeva
- Ural State Medical University, Yekaterinburg, Russia
| | - E A Sizikova
- Ural State Medical University, Yekaterinburg, Russia
| | | | - D V Khamzin
- Ural State Medical University, Yekaterinburg, Russia
| | | | - M L Chigareva
- Ural State Medical University, Yekaterinburg, Russia
| | - E V Saltanova
- Ural State Medical University, Yekaterinburg, Russia
| | - A E Ryazanova
- Ural State Medical University, Yekaterinburg, Russia
| | - A A Smirnova
- Ural State Medical University, Yekaterinburg, Russia
| | - D V Gilev
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - E R Lebedeva
- Ural State Medical University, Yekaterinburg, Russia
- International Headache Centre «Europe-Asia», Yekaterinburg, Russia
| |
Collapse
|
37
|
Fredrick JW, Cook TE, Langberg JM, Becker SP. Prospective association between evening circadian preference and academic functioning in adolescents: the role of daytime sleepiness. J Child Psychol Psychiatry 2023; 64:175-184. [PMID: 35953260 PMCID: PMC10087522 DOI: 10.1111/jcpp.13683] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is growing evidence for the role of circadian factors in adolescents' sleep and academic adjustment, with greater evening preference being linked to poorer academic functioning. However, studies have yet to evaluate this association prospectively in adolescence, nor have studies examined daytime sleepiness as a putative mechanism linking evening preference to poor academic functioning. The current study used a multi-informant design to test the prospective association of evening circadian preference, daytime sleepiness, and academic functioning (e.g., global academic impairment and grades) across 2 years in adolescence. As evening circadian preference, sleepiness, and academic problems are elevated in adolescents with ADHD, we used a sample enriched for adolescents with ADHD and explored whether ADHD moderated effects. METHOD Participants were 302 adolescents (Mage = 13.17 years; 44.7% female; 81.8% White; 52% with ADHD). In the fall of eighth grade, adolescents reported on their circadian preference, and in the fall of ninth grade, adolescents and parents completed ratings of daytime sleepiness. In the middle of 10th grade, parents and teachers reported on adolescents' academic impairment and at the end of 10th grade, adolescents' grade point average (GPA) was obtained from school records. RESULTS Above and beyond covariates (e.g., adolescent sex, ADHD status, medication, sleep duration) and baseline academic impairment, greater self-reported evening preference in 8th grade predicted increased parent ratings of academic impairment in 10th grade indirectly via adolescent and parent ratings of daytime sleepiness in 9th grade. Furthermore, evening preference in 8th grade predicted greater teacher ratings of academic impairment and lower average GPA in 10th grade via parent ratings of daytime sleepiness in 9th grade, controlling for covariates and baseline GPA. ADHD status did not moderate indirect effects. CONCLUSION Findings underscore daytime sleepiness as a possible intervening mechanism linking evening preference to poor academic functioning across adolescence. Intervention studies are needed to evaluate whether targeting circadian preference and sleepiness improves academic functioning in adolescents.
Collapse
Affiliation(s)
- Joseph W Fredrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Taryn E Cook
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Joshua M Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
38
|
Buyse B, Nguyen PAH, Leemans J, Verhaeghe V, Peters M, Strobbe S, Van Valckenborgh I, Belge C, Testelmans D. Short-term positive effects of a mandibular advancement device in a selected phenotype of patients with moderate obstructive sleep apnea: a prospective study. J Clin Sleep Med 2023; 19:5-16. [PMID: 35962942 PMCID: PMC9806777 DOI: 10.5664/jcsm.10232] [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: 01/25/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 01/07/2023]
Abstract
STUDY OBJECTIVES To evaluate (determinants of) treatment success of mandibular advancement device application in a selected phenotype of patients with obstructive sleep apnea (OSA). METHODS Ninety nonobese patients with moderate OSA (obstructive apnea-hypopnea index [OAHI] ≥ 15 and < 30 events/h) without comorbidities were prospectively included. Polysomnography was performed at baseline and with a mandibular advancement device. A drug-induced sleep endoscopy with jaw thrust was performed in 83%. RESULTS OAHI reduction ≥ 50% was observed in 73%, OAHI reduction ≥ 50% with OAHI < 10 events/h in 70%, and complete OSA resolution (OAHI < 5 events/h) in 40%. Patients with nonpositional OSA showed a significantly higher rate of complete OSA resolution: Posttest probability increased to 67%. In patients with total disappearance of collapse at velum level and at all levels during drug-induced sleep endoscopy with jaw thrust, the drop in OAHI was impressive with an infinitively high positive likelihood ratio. However, the proportion of patients having nonpositional OSA or the drug-induced sleep endoscopy characteristics as described above was < 20%. The change in snoring disturbance based on a visual analog scale was 76% (interquartile range 40-89%, P < .001) and a statistically significant amelioration in Epworth Sleepiness Scale (especially in somnolent subjects) was observed. High adherence was reported. CONCLUSIONS In this predefined OSA phenotype, a mandibular advancement device was effective in reduction of OAHI and in amelioration of symptoms. Stratification by nonpositional OSA and findings on drug-induced sleep endoscopy with jaw thrust increased treatment success defined as reduction in OAHI. However, the clinical relevance can be questioned because only a small number of patients demonstrated these characteristics. CITATION Buyse B, Nguyen PAH, Leemans J, et al. Short-term positive effects of a mandibular advancement device in a selected phenotype of patients with moderate obstructive sleep apnea: a prospective study. J Clin Sleep Med. 2023;19(1):5-16.
Collapse
Affiliation(s)
- Bertien Buyse
- Department of Pulmonology, Louvain University Center for Sleep and wake disorders (LUCS), University Hospital Gasthuisberg, Leuven, Belgium
- Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven University, Leuven, Belgium
| | - Pham Anh Hong Nguyen
- Department of Pulmonology, Louvain University Center for Sleep and wake disorders (LUCS), University Hospital Gasthuisberg, Leuven, Belgium
| | - Joke Leemans
- Department of Pulmonology, Louvain University Center for Sleep and wake disorders (LUCS), University Hospital Gasthuisberg, Leuven, Belgium
| | | | | | - Simon Strobbe
- ENT, Head and Neck Surgery, UZ Leuven, Leuven, Belgium
| | | | - Catharina Belge
- Department of Pulmonology, Louvain University Center for Sleep and wake disorders (LUCS), University Hospital Gasthuisberg, Leuven, Belgium
- Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven University, Leuven, Belgium
| | - Dries Testelmans
- Department of Pulmonology, Louvain University Center for Sleep and wake disorders (LUCS), University Hospital Gasthuisberg, Leuven, Belgium
- Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven University, Leuven, Belgium
| |
Collapse
|
39
|
Fredrick JW, Yeaman KM, Yu X, Langberg JM, Becker SP. A multi-method examination of sluggish cognitive tempo in relation to adolescent sleep, daytime sleepiness, and circadian preference. J Child Psychol Psychiatry 2022; 63:1658-1667. [PMID: 35045192 DOI: 10.1111/jcpp.13568] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The field's understanding of the association between sluggish cognitive tempo (SCT) and sleep is severely limited by the lack of multi-method and multi-informant research designs that move beyond global ratings, often focused on a limited number of sleep-related domains, such as daytime sleepiness. The current study begins to address these limitations by using actigraphy, daily sleep diary, and self- and parent-report global ratings of sleep in adolescents, a developmental period marked by changes in SCT, sleep, and circadian function. As SCT and sleep are also associated with ADHD symptoms, we tested these associations in a sample of adolescents with and without ADHD. METHODS Adolescents (N = 302; M age = 13.17 years, 44.7% female) with (n = 162) and without ADHD (n = 140) and parents completed global ratings of sleep and daytime sleepiness, and adolescents completed a measure of circadian preference. Adolescents also wore actigraphs for approximately two weeks, during which daily diaries were completed. RESULTS Above and beyond demographic characteristics (i.e., sex, race, and family income), pubertal development, medication use, and ADHD group status, adolescents' self-reported SCT symptoms were uniquely associated with shorter sleep duration and later sleep onset per both actigraphy and daily diary. SCT symptoms were also uniquely associated with longer sleep onset latency and poorer overall sleep (per daily diary), more sleep/wake problems and daytime sleepiness (per adolescent rating), more difficulties initiating and maintaining sleep (per parent rating), and later eveningness preference (per adolescent rating). Nearly all significant effects remained in sensitivity analyses controlling for adolescent- or parent-reported ADHD symptom dimensions. CONCLUSIONS Findings provide the strongest evidence to date for SCT being uniquely linked to poorer sleep, greater daytime sleepiness, and a later evening circadian preference across subjective and objective measures. Longitudinal studies are needed to evaluate predictive and bidirectional associations.
Collapse
Affiliation(s)
- Joseph W Fredrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kiley M Yeaman
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Xiaoqian Yu
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Joshua M Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
40
|
Halfeld S, Sonnesen L. Daytime Sleepiness and Quality of Life in Obstructive Sleep Apnoea Patients before and after Long-Term Mandibular Advancement Device Treatment. Dent J (Basel) 2022; 10. [PMID: 36547042 DOI: 10.3390/dj10120226] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/09/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022] Open
Abstract
This study compared daytime sleepiness and quality of life in OSA patients with healthy controls and compared sleepiness and quality of life in OSA patients before and after long-term treatment with a mandibular advancement device (MAD). A total of 27 OSA patients (18 men, 9 women, mean age 52.3 years) and 32 healthy age- and sex-matched controls (20 men, 12 women, mean age 51.1 years) were included. At baseline and after MAD treatment, daytime sleepiness and quality of life were recorded by the Epworth Sleepiness Scale (ESS) and Short Form-36 questionnaires (SF-36). Daytime sleepiness occurred significantly more often in OSA patients compared to controls at baseline (p = 0.01). The quality of life domains Energy and vitality (p < 0.0001), General perception of health (p = 0.0002), Mental health (p = 0.0031), Social functioning (p = 0.0119), Role limitations due to emotional problems (p = 0.0173) and Physical functioning (p = 0.0226) were significantly poorer in OSA patients compared to controls at baseline. After long-term MAD treatment, daytime sleepiness decreased (p < 0.01) and the quality of life domain Energy and Vitality increased (p < 0.01) in OSA patients compared to baseline. The results of the present study support the relevance of MAD treatment as an effective tool for decreasing daytime sleepiness and increasing the quality of life in OSA patients—also in the long term.
Collapse
|
41
|
Liu X, Yang Y, Liu Z, Jia C. Associations between Insomnia, Daytime Sleepiness, and Depressive Symptoms in Adolescents: A Three-Wave Longitudinal Study. J Clin Med 2022; 11:jcm11236912. [PMID: 36498487 PMCID: PMC9739758 DOI: 10.3390/jcm11236912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Insomnia, daytime sleepiness, and depressive symptoms are prevalent in adolescents. This three-wave prospective study examined the associations between the three symptoms in adolescents. METHODS A total of 6995 schoolchildren in 7th and 10th grades (Mean age = 14.86 years) participated in a longitudinal study of behavior and health in Shandong, China. Standardized rating scales were used to assess symptoms of insomnia, daytime sleepiness, and depression in November-December in 2015, 1 year later, and 2 years later. RESULTS Insomnia was cross-sectionally associated with 10-14-fold increased odds of daytime sleepiness and 5-9-fold increased odds of depression. Daytime sleepiness was associated with 4-5-fold increased odds of depression. Insomnia, daytime sleepiness, or depression at a later time point was significantly predicted by itself at earlier time points. Insomnia was a significant predictor of daytime sleepiness and depression and a mediator between depression and daytime sleepiness. Daytime sleepiness was a significant predictor of insomnia and a mediator between depression and insomnia. Depression was a significant predictor of insomnia and daytime sleepiness and a mediator between insomnia and daytime sleepiness. CONCLUSIONS Insomnia, daytime sleepiness, and depressive symptoms were highly comorbid in adolescents. The associations of insomnia with daytime sleepiness and depression were bidirectional. Depression predicted daytime sleepiness, but not vice versa. Further research is needed to understand the underlying neurobiological mechanisms between insomnia, daytime sleepiness, and depression during adolescence.
Collapse
Affiliation(s)
- Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA 19104, USA
- Correspondence:
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL 32306, USA
| | - Zhenzhen Liu
- School of Psychology, Northeast Normal University, Changchun 130024, China
| | - Cunxian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan 250012, China
| |
Collapse
|
42
|
Butt M, Chavarria Y, Ninmol J, Arif A, Tebha SS, Daniyal M, Siddiqui UM, Shams SS, Sarfaraz Q, Haider SF, Essar MY. Association of increased pain intensity, daytime sleepiness, poor sleep quality, and quality of life with mobile phone overuse in patients with migraine: A multicenter, cross-sectional comparative study. Brain Behav 2022; 12:e2760. [PMID: 36128652 PMCID: PMC9575598 DOI: 10.1002/brb3.2760] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The number of regular smartphone users has increased dramatically worldwide. Headaches, followed by sleep difficulties, forgetfulness, dizziness, and other ailments, are among the most prevalent complaints among smartphone users during or after use. In addition, migraine is a debilitating disease and is the world's second leading cause of disability. Hence, we performed this study to determine how smartphone overuse influenced migraine patients' level of disability, pain intensity, sleep quality, and overall quality of life. METHODS In this observational study, the patients were divided into two groups high mobile phone use group (HMPUG) and the low mobile phone user group (LMPUG) using the Mobile Phone Problematic Use Scale. We assessed, for each group, patients' level of disability, pain intensity, sleep quality, daytime sleepiness, and quality of life through the Migraine Disability Assessment Scale, Visual Analogue Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and 24-h Migraine Quality of Life Questionnaire, respectively. RESULTS Our study showed that the respondents' average age was 27.59 (9.79) years. The average number of family members was 5.98 (2.3251). A total of 65.8% (n = 263) of the 400 participants were female, while 34.3 % (n = 137) were male. Greater pain intensity, poor sleep quality, and reduced medication effectivity were found in HMPUG compared to LMPUG (p < .05). However, increased duration of migraine and medication intake was reported in the LMPUG (p < .05). CONCLUSION We observed that smartphone overuse could worsen pain, sleep, and reduce treatment efficacy in individuals with migraine. Therefore, controlled smartphone use is recommended to avoid worsening symptoms.
Collapse
Affiliation(s)
- Mehwish Butt
- Department of Neurosurgery and NeurologyJinnah Medical and Dental CollegeKarachiSindhPakistan
| | - Yeny Chavarria
- Department of NeurologyUniversity of CaliforniaIrvineCalifornia
| | - Jesse Ninmol
- Department of Public HealthUniversity of CaliforniaBerkeleyCalifornia
| | - Aabiya Arif
- Department of MedicineZiauddin UniversityKarachiSindhPakistan
| | - Sameer Saleem Tebha
- Department of Neurosurgery and NeurologyJinnah Medical and Dental CollegeKarachiSindhPakistan
| | - Muhammad Daniyal
- Department of StatisticsThe Islamia University of BahawalpurBahawalpurPunjabPakistan
| | - Umesa Mazhar Siddiqui
- Department of Neurosurgery and NeurologyJinnah Medical and Dental CollegeKarachiSindhPakistan
| | - Syeda Samia Shams
- Department of Neurosurgery and NeurologyJinnah Medical and Dental CollegeKarachiSindhPakistan
| | - Qubra Sarfaraz
- Department of Neurosurgery and NeurologyJinnah Medical and Dental CollegeKarachiSindhPakistan
| | - Syeda Fatima Haider
- Department of Neurosurgery and NeurologyJinnah Medical and Dental CollegeKarachiSindhPakistan
| | | |
Collapse
|
43
|
Polat F, Karasu F. Effect of sleep hygiene training given to elderly individuals on daytime sleepiness and fatigue: A randomized controlled trial. Perspect Psychiatr Care 2022; 58:2161-2169. [PMID: 35124807 DOI: 10.1111/ppc.13043] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/25/2022] [Accepted: 01/30/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This study was conducted to determine the effect of sleep hygiene training given to elderly individuals on daytime sleepiness and fatigue. DESIGN AND METHODS The sample size was calculated by G. Power and determined as 134 elderly individuals. The experimental group was trained in sleep, two sessions a week for a total of 2 weeks. FINDINGS The difference between Epworth Sleepiness Scale and Fatigue Severity Scale posttest mean scores of the elderly individuals in the experimental and control groups were found to be statistically significant (p < 0.05). PRACTICE IMPLICATIONS Sleep hygiene training reduced daytime sleepiness and fatigue in older adults.
Collapse
Affiliation(s)
- Filiz Polat
- Department of Midwifery, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Fatma Karasu
- Department of Nursing, Yusuf Şerefoğlu Faculty of Health Sciences, Kilis 7 Aralık University, Kilis, Turkey
| |
Collapse
|
44
|
Bettega F, Leyrat C, Tamisier R, Mendelson M, Grillet Y, Sapène M, Bonsignore MR, Pépin JL, Kattan MW, Bailly S. Application of Inverse-Probability-of-Treatment Weighting to Estimate the Effect of Daytime Sleepiness in Patients with Obstructive Sleep Apnea. Ann Am Thorac Soc 2022; 19:1570-80. [PMID: 35380937 DOI: 10.1513/AnnalsATS.202109-1036OC] [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] [Indexed: 11/20/2022] Open
Abstract
Rationale: Continuous positive airway pressure (CPAP), the first line therapy for obstructive sleep apnea (OSA), is considered effective in reducing daytime sleepiness. Its efficacy relies on adequate adherence, often defined as >4 hours per night. However, this binary threshold may limit our understanding of the causal effect of CPAP adherence and daytime sleepiness, and a multilevel approach for CPAP adherence can be more appropriate. Objectives: In this study, we show how two causal inference methods can be applied on observational data for the estimation of the effect of different ranges of CPAP adherence on daytime sleepiness as measured by the Epworth Sleepiness Scale (ESS). Methods: Data were collected from a large prospective observational French cohort for patients with OSA. Four groups of CPAP adherence were considered (0-4, 4-6, 6-7, and 7-10 h per night). Multivariable regression, inverse-probability-of-treatment weighting (IPTW), and inverse propensity weighting with regression adjustment (IPW-RA) were used to assess the impact of CPAP adherence level on daytime sleepiness. Results: In this study, 9,244 patients with OSA treated by CPAP were included. The mean initial ESS score was 11 (±5.2), with a mean reduction of 4 points (±5.1). Overall, there was evidence of the causal effect of CPAP adherence on daytime sleepiness which was mainly observed between the lower CPAP adherence group (0-4 h) compared with the higher CPAP adherence group (7-10 h). There are no differences by considering higher level of CPAP adherence (>4 h). Conclusions: We showed that IPTW and IPW-RA can be easily implemented to answer questions regarding causal effects using observational data when randomized trials cannot be conducted. Both methods give a direct causal interpretation at the population level and allow the assessment of the appropriate consideration of measured confounders.
Collapse
|
45
|
Serçe S, Ovayolu Ö, Bayram N, Ovayolu N, Kul S. The effect of breathing exercise on daytime sleepiness and fatigue among patients with obstructive sleep apnea syndrome. J Breath Res 2022; 16. [PMID: 36004722 DOI: 10.1088/1752-7163/ac894d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/26/2022] [Accepted: 08/12/2022] [Indexed: 11/12/2022]
Abstract
This study was conducted with randomized controlled and experimental design to examine the effect of breathing exercise on daytime sleepiness and fatigue on patients with obstructive sleep apnea syndrome. The first application was performed by teaching patients in the intervention group breathing exercises including diaphragmatic and pursed lip breathing via the face-to-face interview technique. Then, the researcher applied breathing exercises in the same patient group every morning/evening for 10-15 min and a total of 20-30 min for eight weeks via the online interview method. The data were collected via a questionnaire, Epworth sleepiness scale (ESS), and Piper Fatigue Scale (PFS). Chi-square, Student's t, Mann Whitney U, paired sample t-test, analysis of variance (ANOVA) and generalized estimating equations were used to assess the data. It was determined that PFS total mean score of the intervention group which was 6.15 ± 1.65 before the application decreased to 5.34 ± 1.94 in the eighth week (p> 0.05) and PFS total mean score of the control group which was 5.59 ± 1.76 before the application increased to 5.77 ± 1.81 in the eighth week (p> 0.05). ESS total mean score of the intervention group which was 12.13 ± 4.34 at the baseline decreased to 9.13 ± 4.71 in the eighth week (p> 0.05) and ESS total mean score of the control group which was 10.37 ± 2.77 at the baseline increased to 10.5 ± 2.85 in the eighth week (p> 0.05). It was concluded that breathing exercise performed in the intervention group decreased the fatigue and daytime sleepiness mean scores of the patients at the end of the fourth and eighth week. In addition, the group-time interaction was significant, which was associated with the intervention group.
Collapse
Affiliation(s)
- Sibel Serçe
- Faculty of Health Sciences, Department of Nursing, Department of Internal Medicine Nursing, Gaziantep University
| | - Özlem Ovayolu
- Faculty of Health Sciences, Department of Nursing, Department of Internal Medicine Nursing, Gaziantep University
| | - Nazan Bayram
- Faculty of Medicine, Department of Chest Diseases, Gaziantep University
| | - Nimet Ovayolu
- Faculty of Health Sciences, Department of Nursing, Department of Internal Medicine Nursing, SANKO University
| | - Seval Kul
- Faculty of Medicine, Basic Medical Sciences Department, Gaziantep University
| |
Collapse
|
46
|
Hsin LJ, Lee YC, Lin WN, Lu YA, Lee LA, Tsai MS, Cheng WN, Chiang YT, Li HY. Transoral Tongue Suspension for Obstructive Sleep Apnea-A Preliminary Study. J Clin Med 2022; 11. [PMID: 36078891 DOI: 10.3390/jcm11174960] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/10/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives: To evaluate the safety and efficacy of a novel technique for transoral tongue suspension (TOTS) in obstructive sleep apnea (OSA) patients. Material and Methods: The retrospective study enrolled 24 consecutive OSA patients (21 males; average age, 43 years; average apnea−hypopnea index (AHI), 42.2 event/h; average body mass index (BMI), 25.7 kg/m2) with tongue obstruction confirmed by drug-induced sleep endoscopy. All patients received TOTS as the main procedure in conjunction with uvulopalatopharyngoplasty (UPPP). Key procedures of TOTS included a transoral sublabial approach, drilling two holes on the mandible, passing the polypropylene through the hole to the tongue base using a suture passer and returning the polypropylene through loop traction, and tying the polypropylene to the mandible. Lingual tonsil ablation (n = 8) was also implemented in hypertrophic lingual tonsils (grades III and IV). Results: The operation time for TOTS was around 30 min. No wound bleeding or airway compromise occurred throughout the postoperative period. Minor complications were temporary and included swelling of the tongue, numbness of the lower incisor, and sublabial wound dehiscence (n = 2). The quality of life improved significantly in the patients’ subjective daytime sleepiness according to the Epworth Sleepiness Scale (11.4 ± 3.2 vs. 5.7 ± 1.6, p < 0.001). The objective parameters of OSA also improved significantly in the apnea/hypopnea index (42.2 ± 21.8 vs. 19.5 ± 16.2, p < 0.001), minimal oxygen saturation (77.1 ± 12.2 vs. 81.7 ± 8.1, p = 0.026), and snoring index (207 ± 141 vs. 101 ± 91, p = 0.03). Conclusions: The demonstrated TOTS showed its advantage in low morbidity with a scarless exterior and easy performance with free availability in treating adult OSA patients with tongue obstruction. TOTS combined with UPPP significantly improved AHI and daytime sleepiness. TOTS can be implemented with lingual tonsillectomy to achieve both stabilization of the tongue and widening of hypopharyngeal airway.
Collapse
|
47
|
Chin WC, Wang CH, Huang YS, Hsu JF, Chu KC, Tang I, Paiva T. Quality of life changes and their predictors in young adult narcolepsy patients after treatment: A real-world cohort study. Front Psychiatry 2022; 13:956037. [PMID: 36016973 PMCID: PMC9395703 DOI: 10.3389/fpsyt.2022.956037] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background We conducted a five-year prospective follow-up study to track the real-world quality of life of patients with narcolepsy after medication and analyzed predictors. Methods The study ultimately included 157 participants who completed 5-year follow-up, 111 had type 1 narcolepsy (NT1) and 46 had type 2 narcolepsy (NT2). Polysomnography, multiple sleep latency test, actigraphy and HLA-typing were conducted. The Short Form 36 Health Survey Questionnaire (SF-36), the Stanford Center for Narcolepsy Sleep Inventory, the Epworth Sleepiness Scale (ESS), the visual analog for hypersomnolence (VAS), and Conners' Continuous Performance Test were used. Descriptive statistics, repeated measures, and hierarchical linear models were applied for analysis. Results Most demographic and clinical data did not significantly differ between groups, but the NT1 group had significantly more overweight, more severe narcoleptic symptoms, more positive HLA typing, shorter mean sleep latency, and more sleep onset rapid eye movement periods. No significant change to the physical domains of SF-36 was found in the total group, but we observed significant changes in emotional role functioning and social function. The NT1 group showed significant improvements in physical role functioning, emotional role functioning, and social function. The NT2 group demonstrated significant improvements in emotional role functioning. At the baseline, the NT2 group had significantly better scores, but there was no significant group difference after treatment, except for physical and social function. ESS and VAS were significantly improved during follow-up. At the baseline, the NT1 group had significantly higher ESS and VAS scores, and continuously significantly higher ESS scores during follow-up. Narcolepsy types, HLA typing, age of onset, symptom severity, attention and vigilance were significantly correlated with SF-36. Conclusion Symptom control greatly associates with the quality of life in narcoleptic patients, and medication can play the most important role. Management targeting narcoleptic symptoms, attention impairment, and drug adherence should be provided.
Collapse
Affiliation(s)
- Wei-Chih Chin
- Division of Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Huan Wang
- Department of Psychology, Zhejiang Normal University, Jinhua, China
| | - Yu-Shu Huang
- Division of Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jen-Fu Hsu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuo-Chung Chu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - I Tang
- Division of Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Teresa Paiva
- Neurophysiology and Sleep Medicine, University of Lisbon, Lisbon, Portugal
| |
Collapse
|
48
|
Hansell NK, Strike LT, de Zubicaray GI, Thompson PM, McMahon KL, Wright MJ. Persistence of Anxiety/Depression Symptoms in Early Adolescence: A Prospective Study of Daily Life Stress, Rumination, and Daytime Sleepiness in a Genetically Informative Cohort. Twin Res Hum Genet 2022;:1-14. [PMID: 35856184 DOI: 10.1017/thg.2022.26] [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] [Indexed: 11/06/2022]
Abstract
In this prospective study of mental health, we examine the influence of three interrelated traits - perceived stress, rumination, and daytime sleepiness - and their association with symptoms of anxiety and depression in early adolescence. Given the known associations between these traits, an important objective is to determine the extent to which they may independently predict anxiety/depression symptoms. Twin pairs from the Queensland Twin Adolescent Brain (QTAB) project were assessed on two occasions (N = 211 pairs aged 9-14 years at baseline and 152 pairs aged 10-16 years at follow-up). Linear regression models and quantitative genetic modeling were used to analyze the data. Prospectively, perceived stress, rumination, and daytime sleepiness accounted for 8-11% of the variation in later anxiety/depression; familial influences contributed strongly to these associations. However, only perceived stress significantly predicted change in anxiety/depression, accounting for 3% of variance at follow-up after adjusting for anxiety/depression at baseline, although it did not do so independently of rumination and daytime sleepiness. Bidirectional effects were found between all traits over time. These findings suggest an underlying architecture that is shared, to some degree, by all traits, while the literature points to hypothalamic-pituitary-adrenal (HPA) axis and/or circadian systems as potential sources of overlapping influence and possible avenues for intervention.
Collapse
|
49
|
Ma J, Dou K, Liu R, Liao Y, Yuan Z, Xie A. Associations of Sleep Disorders With Depressive Symptoms in Early and Prodromal Parkinson's Disease. Front Aging Neurosci 2022; 14:898149. [PMID: 35754965 PMCID: PMC9226450 DOI: 10.3389/fnagi.2022.898149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/26/2022] [Indexed: 12/24/2022] Open
Abstract
Background Non-motor symptoms, including sleep disorders and depression, are common in Parkinson’s disease (PD). The purpose of our study is to explore the effect of sleep disorders, including the probable rapid eye movement (REM) sleep behavior disorder (pRBD) and the daytime sleepiness, on depressive symptoms in patients with early and prodromal PD. Methods A total of 683 participants who obtained from the Parkinson Progression Markers Initiative (PPMI) were included, consisting of 423 individuals with early PD, 64 individuals with prodromal PD, and 196 healthy controls (HCs), who were followed up to 5 years from baseline. Multiple linear regression models and linear mixed-effects models were conducted to explore the relationship between sleep disorders and depression at baseline and longitudinally, respectively. Multiple linear regression models were used to further investigate the association between the change rates of daytime sleepiness score and depression-related score. Mediation analyses were also performed. Results At baseline analysis, individuals with early and prodromal PD, who had higher RBD screening questionnaire (RBDSQ) score, or who were considered as pRBD, or who manifested specific behaviors of RBD (things falling down when sleep or disturbance of sleep), showed significantly the higher score of depression-related questionnaires. Our 5-year follow-up study showed that sleep disorders, including pRBD and daytime sleepiness, were associated with the increased depressive-related score in individuals with early and prodromal PD. Interestingly, we also found that the increased possibilities of daytime sleepiness were associated with depressive-related score. Finally, mediation analysis demonstrated that the relationship between RBD and depressive symptoms was partially mediated by autonomic symptoms, such as postural hypertension, salivation, dysphagia, and constipation. Conclusion Our study shows that sleep disorders, including pRBD and daytime sleepiness, are associated with depression at baseline and longitudinally, which is partially mediated by the autonomic dysfunction in early and prodromal PD, with an implication that sleep management is of great value for disease surveillance.
Collapse
Affiliation(s)
- Jiangnan Ma
- Departmentof Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Kaixin Dou
- Departmentof Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ruize Liu
- Department of Intensive Care Unit, Affiliated Qingdao Municipal Hospital of Qingdao University, Qingdao, China
| | - Yajin Liao
- The Brain Science Center, Beijing Institute of Basic Medical Sciences, Beijing, China
| | - Zengqiang Yuan
- Departmentof Neurology, Affiliated Hospital of Qingdao University, Qingdao, China.,The Brain Science Center, Beijing Institute of Basic Medical Sciences, Beijing, China
| | - Anmu Xie
- Departmentof Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| |
Collapse
|
50
|
Pojatić Đ, Nikić D, Tolj I, Pezerović D, Šantić A, Degmečić D. Alexithymia, Phosphorus Levels, and Sleep Disorders in Patients on Hemodialysis. J Clin Med 2022; 11:jcm11113218. [PMID: 35683604 PMCID: PMC9181024 DOI: 10.3390/jcm11113218] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
Alexithymia, or the inability to distinguish between bodily feelings and emotions, has been linked to poor sleep quality in some studies. Rare studies examined the associations between electrolyte phosphorus in patients on hemodialysis and their sleep quality, daytime sleepiness, and alexithymia with inflammatory factors. Hemodialysis is a treatment method for terminal renal patients that involves the diffusion of unwanted metabolic products through the dialyzer membrane. Our study aimed to examine whether there was a difference in phosphorus levels, inflammatory factors, and daytime sleepiness according to the hemodialysis patients’ levels of alexithymia. The study involved 170 HD patients that had been treated with chronic dialysis for more than three months. Prior to the hemodialysis procedure, laboratory findings were sampled. Respondents completed the Pittsburgh Sleep Quality Index, the Toronto Alexithymia Scale 26, and the Epworth Sleepiness Scale, and were questioned about depression. The results showed that alexithymic HD patients exhibited significantly higher leukocyte counts, lower predialysis phosphorus values, and more pronounced daily sleepiness than the alexithymia-free group (Mann−Whitney U test, p = 0.02, p = 0.005, and p < 0.001, respectively). We concluded that alexithymia was an independent predictor of high daytime sleepiness in HD patients (OR = 1.05, 95% CI 1.02 to 1.09).
Collapse
Affiliation(s)
- Đorđe Pojatić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Department of Internal Medicine, General County Hospital Vinkovci, 32 100 Vinkovci, Croatia
| | - Dajana Nikić
- Department of Plant Sciences, Faculty of Biosciences, Norwegian University of Life Sciences, P.O. Box 5003, N-1432 As, Norway;
| | - Ivana Tolj
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Department of Internal Medicine, University Hospital Osijek, 31 000 Osijek, Croatia
| | - Davorin Pezerović
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia
- Department of Internal Medicine, General County Hospital Vinkovci, 32 100 Vinkovci, Croatia
| | - Andrijana Šantić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Department of Psychiatry, University Hospital Osijek, 31 000 Osijek, Croatia
| | - Dunja Degmečić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31 000 Osijek, Croatia; (Đ.P.); (I.T.); (D.P.); (A.Š.)
- Department of Psychiatry, University Hospital Osijek, 31 000 Osijek, Croatia
- Correspondence: ; Tel.: +385-31-511794
| |
Collapse
|