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Shi Y, Ren R, Zhang Y, Zhang H, Feng X, Sanford LD, Tang X. High stability of EEG spectral power across polysomnography and multiple sleep latency tests in good sleepers and chronic insomniacs. Behav Brain Res 2024; 463:114913. [PMID: 38367773 DOI: 10.1016/j.bbr.2024.114913] [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: 11/01/2023] [Revised: 02/04/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
To assess the stability of electroencephalographic (EEG) spectral features across overnight polysomnography (PSG) and daytime multiple sleep latency tests (MSLTs) in chronic insomniacs (CIs) and normal controls (NCs). A total of 20 NCs and 22 CIs underwent standard PSG and MSLTs. Spectral analyses were performed on EEG data from PSG and MSLTs and absolute and relative power in central, frontal and occipital channels were obtained for wake (W) and non-rapid eye movement sleep stage 1 and 2 (N1, N2). Intraclass correlation coefficients (ICCs) were used to assess the stability of EEG spectral power across PSG and MSLTs for W, N1 and N2. The absolute power of all frequency bands except delta exhibited high stability across PSG and MSLTs in both NCs and CIs (ICCs ranged from 0.430 to 0.978). Although delta absolute power was stable in NCs during N1 and N2 stages (ICCs ranged from 0.571 to 0.835), it tended to be less stable in CIs during W and sleep stages (ICCs ranged from 0.042 to 0.807). We also observed lower stability of relative power compared to absolute power though the majority of relative power outcomes maintained high stability in both groups (ICCs in relative power ranged from 0.044 to 0.962). Most EEG spectral bandwidths across PSG and MSLT in W, N1 and N2 show high stability in good sleepers and chronic insomniacs. EEG signals from either an overnight PSG or a daytime MSLT may be useful for reliably exploring EEG spectral features during wakefulness or sleep.
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Affiliation(s)
- Yuan Shi
- Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Ren
- Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ye Zhang
- Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Haipeng Zhang
- Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xujun Feng
- Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Larry D Sanford
- Sleep Research Laboratory, Center for Integrative Neuroscience and Inflammatory Diseases, Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, United States
| | - Xiangdong Tang
- Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
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Reffi AN, Moore DA, Drake CL. Objective sleep disturbance in nightmares: is prolonged sleep onset latency a proxy for fear-of-sleep-related arousal? Sleep 2024; 47:zsae040. [PMID: 38353132 PMCID: PMC11009021 DOI: 10.1093/sleep/zsae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Affiliation(s)
- Anthony N Reffi
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI 48202, USA
- Department of Psychiatry, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
| | - David A Moore
- Division of Acute Care Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI 48202, USA
- Division of Consultation Liaison Psychiatry, Department of Psychiatry and Behavioral Health, Henry Ford Hospital, Detroit, MI 48202, USA
- Department of Psychiatry, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI 48202, USA
- Department of Psychiatry, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
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Potthoff J, Schienle A. Effects of (non)deceptive placebos on reported sleep quality and food cue reactivity. J Sleep Res 2024; 33:e13947. [PMID: 37221456 DOI: 10.1111/jsr.13947] [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: 03/17/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023]
Abstract
A lack of sleep can increase appetite, particularly for high-calorie food. The current study tested the effects of an open-label placebo for improving sleep quality and reducing food cue reactivity. In open-label placebo interventions, placebo recipients are informed that they are receiving a placebo without a pharmacologically active substance. Participants (n = 150) were randomly allocated to one of three groups that received either an open-label placebo to improve sleep quality, a deceptive placebo ("melatonin"), or no placebo. The placebo was administered daily before bedtime for 1 week. Sleep quality and reactivity to high-calorie food cues (appetite, visual attention to food images) were assessed. The deceptive placebo (but not the open-label placebo) reduced reported sleep-onset latency. The open-label placebo decreased perceived sleep efficiency. The placebo interventions did not change food cue reactivity. This study demonstrated that open-label placebos do not present an alternative to deceptive placebos for improving sleep quality. The undesirable open-label placebo effects found warrant further exploration.
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Affiliation(s)
- Jonas Potthoff
- Institute of Psychology, University of Graz, Graz, Austria
| | - Anne Schienle
- Institute of Psychology, University of Graz, Graz, Austria
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Maski KP, Amos LB, Carter JC, Koch EE, Kazmi U, Rosen CL. Recommended protocols for the Multiple Sleep Latency Test and Maintenance of Wakefulness Test in children: guidance from the American Academy of Sleep Medicine. J Clin Sleep Med 2024; 20:631-641. [PMID: 38149645 PMCID: PMC10985297 DOI: 10.5664/jcsm.10974] [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: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 12/28/2023]
Abstract
The American Academy of Sleep Medicine commissioned a task force of clinical experts in pediatric sleep medicine to review published literature on performing the Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test for diagnosis and management of central disorders of hypersomnolence among children and adolescents. This paper follows a format similar to that of the paper "Recommended protocols for the Multiple Sleep Latency Test and Maintenance of Wakefulness Test in adults: guidance from the American Academy of Sleep Medicine" that was published in 2021. Since there is insufficient evidence to specify a recommended protocol for the Maintenance of Wakefulness Test in children and adolescents, this paper focuses only on the MSLT protocol. This protocol paper provides guidance to health care providers who order, sleep specialists who interpret, and technical staff who administer the MSLT to pediatric patients. Similar to the adult protocol paper, this document provides guidance based on pediatric expert consensus and evidence-based data when available. Topics include patient preparation, evaluation of medication and substance use, sleep needs before testing, scheduling considerations, optimal test conditions for youth, and documentation. Specific changes recommended for pediatric MSLT protocols include (1) provision of a minimum of 7 hours of sleep (with a minimum 8-hour recording time) on polysomnography the night before the MSLT, ideally meeting age-based needs; (2) use of clinical judgment to guide the need for sleep-disordered breathing treatments before polysomnography-MSLT testing; and (3) shared patient-health care provider decision-making regarding modifications in the protocol for children and adolescents with neurodevelopmental/neurological disorders, young age, and/or delayed sleep phase. CITATION Maski KP, Amos LB, Carter JC, Koch EE, Kazmi U, Rosen CL. Recommended protocols for the Multiple Sleep Latency Test and Maintenance of Wakefulness Test in children: guidance from the American Academy of Sleep Medicine. J Clin Sleep Med. 2024;20(4):631-641.
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Affiliation(s)
- Kiran P. Maski
- Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts
- Department of Neurology, Harvard Medical School, Boston, Massachusetts
| | - Louella B. Amos
- Pediatric Pulmonology and Sleep Medicine, Children’s Wisconsin, Milwaukee, Wisconsin
- Department of Pediatrics, Division of Pulmonary and Sleep Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John C. Carter
- Department of Medicine, MetroHealth Medical Center, Cleveland, Ohio
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Ellen E. Koch
- American Academy of Sleep Medicine, Darien, Illinois
| | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, Illinois
| | - Carol L. Rosen
- Case Western Reserve University School of Medicine, Cleveland, Ohio
- American Academy of Sleep Medicine, Darien, Illinois
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Bauducco SV, Gardner LA, Champion K, Newton N, Gradisar M. It's past your bedtime, but does it matter anymore? How longitudinal changes in bedtime rules relate to adolescents' sleep. J Sleep Res 2024; 33:e13940. [PMID: 37192612 DOI: 10.1111/jsr.13940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/18/2023]
Abstract
This study investigated how changing or maintaining parent-set bedtimes over time relates to adolescents' sleep timing, latency, and duration. Adolescents (n = 2509; Mage = 12.6 [0.5] years; 47% m) self-reported their sleep patterns, and whether they had parent-set bedtimes on two separate occasions in 2019 (T1; 12.6 years) and 2020 (T2; 13.7 years). We identified four groups based on parent-set bedtimes: (1) bedtime rules at both T1 and T2 (46%, n = 1155), (2) no bedtime rules at T1 nor T2 (26%, n = 656), (3) bedtime rules at T1 but not T2 (19%, n = 472), (4) no bedtime rules at T1 but a parent-set bedtime at T2 (9%, n = 226). As expected, the entire sample showed that bedtimes generally became later and sleep duration shorter across adolescence, but the change differed among the groups. Adolescents whose parents introduced bedtime rules at T2 reported earlier bedtimes and longer sleep duration (~20 min) compared with adolescents with no bedtime rules at T2. Importantly, they no longer differed from adolescents who consistently had bedtimes across T1 and T2. There was no significant interaction for sleep latency, which declined at a similar rate for all groups. These results are the first to suggest that maintaining or re-introducing a parent-set bedtime may be possible and beneficial for adolescents' sleep.
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Affiliation(s)
- S V Bauducco
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Sweden
- College of Education, Psychology & Social Work, Flinders University, Adelaide, South Australia, Australia
| | - L A Gardner
- The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - K Champion
- The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - N Newton
- The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - M Gradisar
- Sleep Cycle, Gothenburg, Sweden
- WINK Sleep, Adelaide, South Australia, Australia
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Krizan Z, Boehm NA, Strauel CB. How emotions impact sleep: A quantitative review of experiments. Sleep Med Rev 2024; 74:101890. [PMID: 38154235 DOI: 10.1016/j.smrv.2023.101890] [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: 10/25/2022] [Revised: 10/10/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023]
Abstract
Although sleep and emotional processes are recognized as mutually dependent, the causal impact of emotions on sleep has been comparatively neglected. To appraise evidence for the causal influence of emotions on sleep, a meta-analysis of the existing experimental literature evaluated the strength, form, and context of experimental effects of emotion inductions on sleep parameters (k = 31). Quality of experiments was evaluated, and theoretically-relevant features were extracted and examined as moderating factors of observed effects (i.e., sleep parameter, design, sleep context, types of emotion inductions and emotions). Random-effect models were used to aggregate effects for each sleep parameter, while-mixed effect models examined moderators. There was a significant impact of emotion inductions on delayed sleep onset latency (D = 3.36 min, 95%CI [1.78, 4.94], g = 0.53), but not other parameters. There was little evidence of publication bias regarding sleep-onset latency effect, the studies overall were heterogeneous, sometimes of limited methodological quality, and could only detect moderate-to-large impacts. The findings supported the hypothesis that negative emotions delayed sleep onset, but evidence regarding other sleep parameters was inconclusive. The results call for more targeted investigation to disambiguate distinct features of emotions and their import for sleep.
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Affiliation(s)
- Zlatan Krizan
- Department of Psychology, Iowa State University, USA.
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Nisbet LC, Nixon GM, Anantharajah A, Davey MJ. Is there a role for repeating the multiple sleep latency test across childhood when initially non-diagnostic? Sleep Med 2024; 115:1-4. [PMID: 38286043 DOI: 10.1016/j.sleep.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND The gold standard investigation for central disorders of hypersomnolence is the Multiple Sleep Latency Test (MSLT). As the clinical features of these disorders of hypersomnolence evolve with time in children, clinicians may consider repeating a previously non-diagnostic MSLT. Currently there are no guidelines available regards the utility and timing of repeating paediatric MSLTs. METHODS Retrospective review of children aged 3-18years with ≥2MSLTs between 2005 and 2022. Narcolepsy was defined as mean sleep latency (MSL) <8min with ≥2 sleep onset REM (SOREM); idiopathic hypersomnia (IH) was defined as MSL <8min with <2 SOREM. MSLTs not meeting these criteria were labelled non-diagnostic. RESULTS 19 children (9 female) with initial non-diagnostic MSLT underwent repeat MSLT, with 6 proceeding to a 3rd MSLT following 2 non-diagnostic MSLTs. The 2nd MSLT resulted in diagnosis in 6/19 (32 %) (3 narcolepsy, 3 IH); and 2/6 (33 %) 3rd MSLT were diagnostic (2 IH). Median age at initial MSLT was 7.5y (range 3.4-17.8y), with repeat performed after median of 2.9y (range 0.9-8.2y), and 3rd after a further 1.9 years (range 1.2-4.2y). Mean change in MSL on repeat testing was -2min (range -15.5min to +4.9min, p = 0.18). Of the 8 diagnostic repeat MSLTs, in addition to the MSL falling below 8 min, 2 children also developed ≥2 SOREM that had not been previously present. CONCLUSIONS A third of repeat MSLTs became diagnostic, suggesting repeat MSLT should be considered in childhood if clinical suspicion persists. Further work needs to address the ideal interval between MSLTs and diagnostic cut-points specific to the paediatric population.
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Affiliation(s)
- Lauren C Nisbet
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia.
| | - Gillian M Nixon
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
| | - Aveena Anantharajah
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia
| | - Margot J Davey
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Monash Health, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
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Maltezos A, Perrault AA, Walsh NA, Phillips EM, Gong K, Tarelli L, Smith D, Cross NE, Pomares FB, Gouin JP, Dang-Vu TT. Methodological approach to sleep state misperception in insomnia disorder: Comparison between multiple nights of actigraphy recordings and a single night of polysomnography recording. Sleep Med 2024; 115:21-29. [PMID: 38325157 DOI: 10.1016/j.sleep.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/11/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
STUDY OBJECTIVE To provide a comprehensive assessment of sleep state misperception in insomnia disorder (INS) and good sleepers (GS) by comparing recordings performed for one night in-lab (PSG and night review) and during several nights at-home (actigraphy and sleep diaries). METHODS Fifty-seven INS and 29 GS wore an actigraphy device and filled a sleep diary for two weeks at-home. They subsequently completed a PSG recording and filled a night review in-lab. Sleep perception index (subjective/objective × 100) of sleep onset latency (SOL), sleep duration (TST) and wake duration (TST) were computed and compared between methods and groups. RESULTS GS displayed a tendency to overestimate TST and WASO but correctly perceived SOL. The degree of misperception was similar across methods within the GS group. In contrast, INS underestimated their TST and overestimated their SOL both in-lab and at-home, yet the severity of misperception of SOL was larger at-home than in-lab. Finally, INS overestimated WASO only in-lab while correctly perceiving it at-home. While only the degree of TST misperception was stable across methods in INS, misperception of SOL and WASO were dependent on the method used. CONCLUSIONS We found that GS and INS exhibit opposite patterns and severity of sleep misperception. While the degree of misperception in GS was similar across methods, only sleep duration misperception was reliably detected by both in-lab and at-home methods in INS. Our results highlight that, when assessing sleep misperception in insomnia disorder, the environment and method of data collection should be carefully considered.
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Affiliation(s)
- Antonia Maltezos
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Neuroscience, Université de Montreal, Montreal, QC, Canada
| | - Aurore A Perrault
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada.
| | - Nyissa A Walsh
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Psychology & Centre for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Emma-Maria Phillips
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Neuroscience, Université de Montreal, Montreal, QC, Canada
| | - Kirsten Gong
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Psychology & Centre for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Lukia Tarelli
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Psychology & Centre for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Dylan Smith
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada
| | - Nathan E Cross
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada
| | - Florence B Pomares
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada
| | - Jean-Philippe Gouin
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Psychology & Centre for Clinical Research in Health, Concordia University, Montreal, QC, Canada
| | - Thien Thanh Dang-Vu
- Sleep, Cognition and Neuroimaging Lab, Department of Health, Kinesiology and Applied Physiology & Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Ile-de-Montréal, QC, Canada; Department of Neuroscience, Université de Montreal, Montreal, QC, Canada.
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Garcia JM, Murray M, Brazendale K, Rice DJ, Fukuda D. Effects of a family judo program on sleep quality in youth with Autism Spectrum Disorder. Sleep Med 2024; 115:152-154. [PMID: 38367356 DOI: 10.1016/j.sleep.2023.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/20/2023] [Indexed: 02/19/2024]
Abstract
OBJECTIVE The purpose of this study was to examine the effects of a family-based judo program on sleep quality in youth diagnosed with Autism Spectrum Disorder (ASD). METHODS Eighteen youth (13.17 years ± 3.76, 78% male) diagnosed with ASD participated in a 14-week family judo program. Sleep quality was assessed using the Actigraph GT9X accelerometer pre- and post-judo intervention. Non-parametric paired t-tests were conducted to examine changes in sleep quality variables. RESULTS There was a significant increase in sleep efficiency (p = .05), and a significant decrease in both sleep latency (p = .001) and wake after sleep onset (p = .02) following participation in the judo program. There were no changes in sleep duration observed in this sample (p = .83). CONCLUSION Participation in a family judo program may improve sleep quality in youth with ASD. More research is necessary to understand the mechanisms by which judo may improve sleep quality in youth with ASD.
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Affiliation(s)
- Jeanette M Garcia
- School of Sport Sciences, College of Applied Human Sciences, West Virginia University, Morgantown, WV, USA.
| | - Michelle Murray
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - Keith Brazendale
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | - David J Rice
- School of Sport Sciences, College of Applied Human Sciences, West Virginia University, Morgantown, WV, USA
| | - David Fukuda
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
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10
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Hu S, Shi L, Li Z, Ma Y, Li J, Bao Y, Lu L, Sun H. First-night effect in insomnia disorder: a systematic review and meta-analysis of polysomnographic findings. J Sleep Res 2024; 33:e13942. [PMID: 37254247 DOI: 10.1111/jsr.13942] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 02/20/2023] [Accepted: 05/04/2023] [Indexed: 06/01/2023]
Abstract
Polysomnographic studies have been performed to investigate the first-night effect in insomnia disorder. However, these studies have revealed discrepant findings. This meta-analysis aimed to summarise and quantify the characteristics of the first-night effect in insomnia disorder. We performed a systematic search of the PubMed, Medline, EMBASE, Web of Science and PsycINFO databases to identify studies published through October 2019. A total of 11,862 articles were identified, and seven studies with eight independent populations were included in the meta-analysis. A total of 639 patients with insomnia disorder and 171 healthy controls underwent more than 2 consecutive nights of in-laboratory polysomnography. Pooled results demonstrated that both variables of sleep continuity and sleep architecture, other than slow-wave sleep were significantly altered in the first-night effect in insomnia disorder. Furthermore, the results indicated that patients with insomnia disorder had a disruption of sleep continuity in the first-night effect, including increased sleep onset latency and reduced total sleep time, compared to healthy controls. Overall, the findings show that patients with insomnia disorder experience the first-night effect, rather than reverse first-night effect, and the profiles of the first-night effect in patients with insomnia are different from healthy controls. These indicate that an adaptation night is necessary when sleep continuity and sleep architecture is to be studied in patients with insomnia disorder. More well-designed studies with large samples are needed to confirm the results.
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Affiliation(s)
- Sifan Hu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhe Li
- Sleep Medicine Center, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yundong Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jinyu Li
- Peking University Health Science Center, Beijing, China
| | - Yanping Bao
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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11
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Anantharajah A, Davey MJ, Nixon GM. Sleepy Kids: are the current diagnostic criteria for multiple sleep latency tests enough? Sleep Med 2024; 114:272-278. [PMID: 38244465 DOI: 10.1016/j.sleep.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/29/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024]
Abstract
Excessive daytime sleepiness (EDS) is common in childhood and is currently quantified using adult criteria on a multiple sleep latency test (MSLT). This study aimed to describe paediatric MSLT results, particularly focussing on a previously proposed alternative mean sleep latency (MSL) threshold for children of 12 min, and assess the impact of a 5th nap. We performed a retrospective analysis of MSLTs at a single paediatric centre from 2004 to 2021. Narcolepsy was defined as a mean sleep latency (MSL) ≤8min with ≥2 sleep onset REM (SOREM) periods. Idiopathic Hypersomnia (IH) was defined as a MSL ≤8min with <2 SOREMs. An ambiguous MSLT result was defined as a MSL 8-12min and/or ≥2 SOREM periods. Of 214 MSLTs [50 % female, median age 14.0y (range 3.3-20.1y)], narcolepsy was diagnosed in 48 (22 %), IH in 22 (10 %) and the result was ambiguous in 44 (21 %). Those with ambiguous MSLT results were older (15.6 vs 13.4y, p = 0.006) with a higher proportion of females (61 % vs 35 %, p = 0.01) in comparison to the narcolepsy group. A 5th nap was performed in 60 (28 %) of MSLTs and only changed the outcome in one case. In conclusion, MSLT results are borderline in 21 % of paediatric cases, suggesting that current adult diagnostic criteria may miss narcolepsy and IH in children. A 5th nap usually makes no difference or increases the MSL, suggesting that a four nap MSLT protocol could be used apart from rare cases where the result is borderline after the 4th nap.
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Affiliation(s)
- Aveena Anantharajah
- Melbourne Children's Sleep Centre, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC, 3168, Melbourne, Australia
| | - Margot J Davey
- Melbourne Children's Sleep Centre, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC, 3168, Melbourne, Australia; Department of Paediatrics, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Melbourne, Australia
| | - Gillian M Nixon
- Melbourne Children's Sleep Centre, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC, 3168, Melbourne, Australia; Department of Paediatrics, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Melbourne, Australia.
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12
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Jansson-Fröjmark M, Nordenstam L, Alfonsson S, Bohman B, Rozental A, Norell-Clarke A. Stimulus control for insomnia: A systematic review and meta-analysis. J Sleep Res 2024; 33:e14002. [PMID: 37496454 DOI: 10.1111/jsr.14002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/11/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/28/2023]
Abstract
Stimulus control (SC) is commonly viewed as an evidence-based treatment for insomnia, but it has not been evaluated comprehensively with modern review and meta-analytic techniques. The aim of the current study was thus to perform a systematic review and meta-analysis of trials that examine the efficacy of stimulus control for insomnia. A systematic search for eligible articles and dissertations was conducted in six online bibliographic databases. The 11 included studies, with the majority published between 1978 and 1998, were randomised controlled and experimental studies in adults, comparing stimulus control for insomnia with passive and active comparators and assessing insomnia symptoms as outcomes. A random effects model was used to determine the standardised mean difference Hedge's g at post-treatment and follow-up for three sleep diary measures: the number of awakenings, sleep onset latency, and total sleep time. A test for heterogeneity was conducted, forest plots were produced, the risk of publication bias was estimated, and the study quality was assessed. In the trials identified, stimulus control resulted in small to large improvements on sleep onset latency and total sleep time, relative to passive comparators (g = 0.38-0.85). Compared with active comparators, the improvements following stimulus control were negligible (g = 0.06-0.30). Although methodological uncertainties were observed in the included trials, stimulus control appears to be an efficacious treatment for insomnia when compared with passive comparators and with similar effects to active comparators. More robust studies are, however, warranted before stronger conclusions are possible to infer.
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Affiliation(s)
- Markus Jansson-Fröjmark
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden
| | - Lisa Nordenstam
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden
| | - Sven Alfonsson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden
| | - Benjamin Bohman
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden
| | - Alexander Rozental
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Annika Norell-Clarke
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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13
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Sun Y, Li T, Li J, Zou K, Tang X. The Epworth sleepiness scale may have more advantages than the multiple sleep latency test in assessing sleepiness in patients with obstructive sleep apnea. Cereb Cortex 2024; 34:bhad513. [PMID: 38216521 DOI: 10.1093/cercor/bhad513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 01/14/2024] Open
Abstract
This study aimed to analyze the brain function of severe obstructive sleep apnea patients with various sleepiness assessment methods and explore the brain imaging basis for the differences between these methods. This study included 30 severe obstructive sleep apnea patients and 19 healthy controls. Obstructive sleep apnea patients were divided into a subjective excessive daytime sleepiness group and a subjective non-excessive daytime sleepiness group according to the Epworth sleepiness scale. Moreover, they were divided into an objective excessive daytime sleepiness group and an objective non-excessive daytime sleepiness group according to the multiple sleep latency test. The fractional amplitude of low-frequency fluctuation was used to assess the features of brain function. Compared with healthy controls, participants in the subjective excessive daytime sleepiness group exhibited higher fractional amplitude of low-frequency fluctuation signals in the right thalamus, left cerebellar lobe 6, left putamen, and pallidum. Participants in the objective excessive daytime sleepiness group showed higher fractional amplitude of low-frequency fluctuation signals in the right thalamus and lower fractional amplitude of low-frequency fluctuation signals in the right superior frontal gyrus, the dorsolateral and superior frontal gyrus, and the medial orbital. We concluded that the thalamus may be involved in subjective and objective sleepiness regulation. Functional abnormalities in the putamen and pallidum may be involved in subjective sleepiness, whereas the frontal lobe may be involved in objective sleepiness.
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Affiliation(s)
- Yuangfeng Sun
- Sleep Medicine Center, West China Hospital, Sichuan University, 28 Telecom South Street, Wuhou District, Chengdu 610041, China
| | - Taomei Li
- Sleep Medicine Center, West China Hospital, Sichuan University, 28 Telecom South Street, Wuhou District, Chengdu 610041, China
| | - Jing Li
- Center for Neurological Function Test and Neuromodulation, West China Xiamen Hospital, Sichuan University, 699 Jinyuan West Road, Xingbin Street, Jimei District, Xiamen, Fujian 361021, China
| | - Ke Zou
- Sleep Medicine Center, West China Hospital, Sichuan University, 28 Telecom South Street, Wuhou District, Chengdu 610041, China
| | - Xiangdong Tang
- Sleep Medicine Center, West China Hospital, Sichuan University, 28 Telecom South Street, Wuhou District, Chengdu 610041, China
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14
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Eiman MN, Kumar S, Serrano Negron YL, Tansey TR, Harbison ST. Genome-wide association in Drosophila identifies a role for Piezo and Proc-R in sleep latency. Sci Rep 2024; 14:260. [PMID: 38168575 PMCID: PMC10761942 DOI: 10.1038/s41598-023-50552-z] [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: 03/28/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Sleep latency, the amount of time that it takes an individual to fall asleep, is a key indicator of sleep need. Sleep latency varies considerably both among and within species and is heritable, but lacks a comprehensive description of its underlying genetic network. Here we conduct a genome-wide association study of sleep latency. Using previously collected sleep and activity data on a wild-derived population of flies, we calculate sleep latency, confirming significant, heritable genetic variation for this complex trait. We identify 520 polymorphisms in 248 genes contributing to variability in sleep latency. Tests of mutations in 23 candidate genes and additional putative pan-neuronal knockdown of 9 of them implicated CG44153, Piezo, Proc-R and Rbp6 in sleep latency. Two large-effect mutations in the genes Proc-R and Piezo were further confirmed via genetic rescue. This work greatly enhances our understanding of the genetic factors that influence variation in sleep latency.
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Affiliation(s)
- Matthew N Eiman
- Laboratory of Systems Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Shailesh Kumar
- Laboratory of Systems Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Division of Neuroscience and Behavior, National Institute On Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Yazmin L Serrano Negron
- Laboratory of Systems Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Terry R Tansey
- Laboratory of Systems Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Susan T Harbison
- Laboratory of Systems Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
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15
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Wei J, Wang M, Guo Y, Liu Y, Dong X. Sleep structure assessed by objective measurement in patients with mild cognitive impairment: A meta-analysis. Sleep Med 2024; 113:397-405. [PMID: 38134714 DOI: 10.1016/j.sleep.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES A meta-analysis was used to explore the characteristic changes in objective sleep structure of patients with mild cognitive impairment (MCI) compared with cognitively healthy older adults. MATERIALS AND METHODS PubMed, EMBAS, Cochrane Library, Scopus, and Web of Science were searched until November 2023. A literature quality evaluation was performed according to the Newcastle-Ottawa Scale, and a meta-analysis was performed by RevMan 5.3 software. RESULTS Fifteen studies with 771 participants were finally included. Compared with normal control groups, patients with MCI had a decreased total sleep time by 34.44 min, reduction in sleep efficiency by 7.96 %, increased waking after sleep onset by 19.61 min, and increased sleep latency by 6.97 min. Ten included studies showed that the patients with MCI had increased N1 sleep by 2.72 % and decreased N3 sleep by 0.78 %; however, there was no significant difference between the MCI and control groups in percentage of N2 sleep. Moreover, Twelve included studies reported the MCI groups had shorter REM sleep of 2.69 %. CONCLUSION Our results provide evidence of abnormal sleep architecture in patients with MCI. As a "plastic state," abnormal sleep architecture may be a promising therapeutic target for slowing cognitive decline and dementia prevention.
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Affiliation(s)
- Jianing Wei
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Min Wang
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuanli Guo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yanjin Liu
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xiaofang Dong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
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16
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Kawai K, Iwamoto K, Miyata S, Okada I, Ando M, Fujishiro H, Ando M, Noda A, Ozaki N. LPS and its relationship with subjective-objective discrepancies of sleep onset latency in patients with psychiatric disorders. Sci Rep 2023; 13:22637. [PMID: 38114534 PMCID: PMC10730694 DOI: 10.1038/s41598-023-49261-4] [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: 04/18/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023] Open
Abstract
Subjective-objective discrepancies in sleep onset latency (SOL), which is often observed among psychiatric patients, is attributed partly to the definition of sleep onset. Recently, instead of SOL, latency to persistent sleep (LPS), which is defined as the duration from turning out the light to the first consecutive minutes of non-wakefulness, has been utilized in pharmacological studies. This study aimed to determine the non-awake time in LPS that is most consistent with subjective sleep onset among patients with psychiatric disorders. We calculated the length of non-awake time in 30-s segments from lights-out to 0.5-60 min. The root mean square error was then calculated to determine the most appropriate length. The analysis of 149 patients with psychiatric disorders showed that the optimal non-awake time in LPS was 12 min. On the other hands, when comorbid with moderate or severe obstructive sleep apnea (OSA), the optimal length was 19.5 min. This study indicates that 12 min should be the best fit for the LPS non-awake time in patients with psychiatric disorders. When there is comorbidity with OSA, however, a longer duration should be considered. Measuring LPS minimizes discrepancies in SOL and provides important clinical information.
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Affiliation(s)
- Keita Kawai
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa, Nagoya, Aichi, 466-8550, Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa, Nagoya, Aichi, 466-8550, Japan.
| | - Seiko Miyata
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa, Nagoya, Aichi, 466-8550, Japan
| | - Ippei Okada
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa, Nagoya, Aichi, 466-8550, Japan
| | - Motoo Ando
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa, Nagoya, Aichi, 466-8550, Japan
| | - Hiroshige Fujishiro
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa, Nagoya, Aichi, 466-8550, Japan
| | - Masahiko Ando
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Akiko Noda
- Department of Biomedical Sciences, Chubu University Graduate School of Life and Health Sciences, Kasugai, Aichi, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa, Nagoya, Aichi, 466-8550, Japan
- Pathophysiology of Mental Disorders, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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17
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Kwon M, Zhu J, Wilding GE, Dickerson SS, Dean GE. Sleep-wake state discrepancy among cancer survivors with insomnia symptoms. Support Care Cancer 2023; 32:2. [PMID: 38047967 DOI: 10.1007/s00520-023-08177-5] [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: 07/06/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023]
Abstract
PURPOSE To evaluate the discrepancy and correlation between sleep-wake measures (i.e., time in bed (TIB), total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE%)) reported on sleep diary and measured by actigraphy among cancer survivors with insomnia symptoms; and examine the influences of sociodemographic and clinical variables on these measurement differences. METHODS A heterogenous sample of cancer survivors with insomnia symptoms (n = 120; M age = 63.7 ± 10.1; female = 58.3%) was included. Seven consecutive days of sleep diary and actigraphic data were obtained along with information on demographic, sleep, and mental health symptoms. Bland-Altman plot, Pearson correlation coefficient, concordance correlation coefficient, and mixed linear model approach were used to conduct the analysis. RESULTS Self-reported TIB, SOL, and WASO were longer than measured by actigraphy (TIB: 8.6 min. (95% CI, 3.7, 13.5; p < .001); SOL: 14.8 min. (95% CI, 9.4, 20.2; p < .0001); and WASO: 20.7 min. (95% CI, 9.4, 20.2; p < .0001), respectively); and self-reported TST and SE% were shorter than measured by actigraphy (TST: 6.8 min. (95% CI, -18.7, 5.13); and SE%: 0.7% (95%CI, -3.0, 2.0), respectively), but were not statistically significant. Sex, higher insomnia severity, and poor sleep quality were associated with discrepancy between several sleep-wake measures. CONCLUSION Subjective and objective sleep-wake measures may present discrepant finding among cancer survivors with symptoms of insomnia. Future research is needed to validate appropriate sleep-wake assessment, and better understand factors that influence the discrepancy that exists between measures among this population. CLINICAL TRIAL REGISTRATION Clinical trials identifier: NCT03810365. Date of registration: January 14, 2019.
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Affiliation(s)
- Misol Kwon
- University of Pennsylvania Perelman School of Medicine, Division of Sleep Medicine, Philadelphia, PA, USA.
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
- University at Buffalo School of Nursing, The State University of New York, Buffalo, NY, USA.
| | - Jingtao Zhu
- University at Buffalo School of Public Health and Health Professions, Department of Biostatistics, The State University of New York, Buffalo, NY, USA
| | - Gregory E Wilding
- University at Buffalo School of Public Health and Health Professions, Department of Biostatistics, The State University of New York, Buffalo, NY, USA
| | - Suzanne S Dickerson
- University at Buffalo School of Nursing, The State University of New York, Buffalo, NY, USA
| | - Grace E Dean
- University at Buffalo School of Nursing, The State University of New York, Buffalo, NY, USA
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18
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Hamilton NA, Russell JA, Youngren WA, Gallegos AM, Crean HF, Cerulli C, Bishop TM, Hamadah K, Schulte M, Pigeon WR, Heffner KL. Cognitive behavioral therapy for insomnia treatment attrition in patients with weekly nightmares. J Clin Sleep Med 2023; 19:1913-1921. [PMID: 37421316 PMCID: PMC10620662 DOI: 10.5664/jcsm.10710] [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: 01/03/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/10/2023]
Abstract
STUDY OBJECTIVES This study's objective was to evaluate the effect of nightmares (NMs) on attrition and symptom change following cognitive behavioral therapy for insomnia (CBT-I) treatment using data from a successful CBT-I randomized controlled trial delivered to participants with recent interpersonal violence exposure. METHODS The study randomized 110 participants (107 women; mean age: 35.5 years) to CBT-I or to an attention-control group. Participants were assessed at 3 time periods: baseline, post-CBT-I (or attention control), and at time 3 (T3) post-cognitive processing therapy received by all participants. NM reports were extracted from the Fear of Sleep Inventory. Participants with weekly NMs were compared with those with fewer than weekly NMs on outcomes including attrition, insomnia, posttraumatic stress disorder, and depression. Change in NM frequency was examined. RESULTS Participants with weekly NMs (55%) were significantly more likely to be lost to follow-up post-CBT-I (37%) compared with participants with infrequent NMs (15.6%) and were less likely to complete T3 (43%) than patients with less frequent NMs (62.5%). NMs were unrelated to differential treatment response in insomnia, depression, or posttraumatic stress disorder. Treatment with CBT-I was not associated with reduced NM frequency; however, change in sleep-onset latency from post-CBT-I to T3 predicted fewer NMs at T3. CONCLUSIONS Weekly NMs were associated with attrition but not a reduced change in insomnia symptoms following CBT-I. NM symptoms did not change as a function of CBT-I, but change in sleep-onset latency predicted lower NM frequency. CBT-I trials should screen for NMs and consider augmenting CBT-I to specifically address NMs. CITATION Hamilton NA, Russell JA, Youngren WA, et al. Cognitive behavioral therapy for insomnia treatment attrition in patients with weekly nightmares. J Clin Sleep Med. 2023;19(11):1913-1921.
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Affiliation(s)
| | | | - Westley A. Youngren
- U.S. Department of Veterans Affairs Center of Excellence for Suicide Prevention, Finger Lakes Health Care System, Canandaigua, New York
| | - Autumn M. Gallegos
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Hugh F. Crean
- U.S. Department of Veterans Affairs Center of Excellence for Suicide Prevention, Finger Lakes Health Care System, Canandaigua, New York
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
- Elaine Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, New York
| | - Catherine Cerulli
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
- Susan B. Anthony Center and Laboratory of Interpersonal Violence and Victimization, University of Rochester Medical Center, Rochester, New York
| | - Todd M. Bishop
- U.S. Department of Veterans Affairs Center of Excellence for Suicide Prevention, Finger Lakes Health Care System, Canandaigua, New York
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | | | | | - Wilfred R. Pigeon
- U.S. Department of Veterans Affairs Center of Excellence for Suicide Prevention, Finger Lakes Health Care System, Canandaigua, New York
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Kathi L. Heffner
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
- Elaine Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, Rochester, New York
- Division of Geriatrics & Aging, Department of Medicine, University of Rochester Medical Center, Rochester, New York
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19
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Jayakumar A, Gillett ES, Wee CP, Kim A, Vidmar AP. Impact of 8-hour time-limited eating on sleep in adolescents with obesity. J Clin Sleep Med 2023; 19:1941-1949. [PMID: 37477160 PMCID: PMC10620649 DOI: 10.5664/jcsm.10734] [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: 05/18/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
STUDY OBJECTIVES The relationship between time-limited eating (TLE) and sleep quality is a topic of growing interest in the field of chronobiology. Data in adult cohorts shows that TLE may improve sleep quality, but this has not been evaluated in adolescents. The aim of this secondary analysis was to (1) examine the impact of 8-hour TLE on sleep parameters in youth with obesity and (2) explore if there was any association between sleep patterns and glycemic profiles. METHODS Adolescents with obesity were randomized into one of three groups: 8-hour TLE (participants self-selected their eating window) + real-time continuous glucose monitor, 8-hour TLE + blinded continuous glucose monitor, or a prolonged eating window. In the primary analysis, it was found that participants in the real-time continuous glucose monitor group + 8-hour TLE group did not access their continuous glucose monitor data and thus for this analysis the two TLE groups were combined and only completers who had available Pittsburgh Sleep Quality Index (PSQI) data at all three time points were included. Participants completed the PSQI at baseline, week 4, and week 12. Mixed-effects generalized linear regression models were utilized to examine the change in PSQI score and assess association between glycemic variability and PSQI total score overtime by intervention arm. RESULTS The median PSQI total score for the TLE groups (n = 27) was 6 at week 0 (interquartile range = 5 to 10) and 5 at week 12 (interquartile range = 2 to 7). There was no significant difference in the change in total PSQI score or sleep latency between TLE and control over the study period (P > .05). There was no association between PSQI score and change in weight or glycemic profile between groups (all P values > 0.05). CONCLUSIONS These results suggest that in adolescents with obesity, an 8-hour TLE approach did not negatively impact sleep quality or efficiency when compared to a prolonged eating window. The potential effects of TLE on sleep should be further investigated in larger randomized trials. CITATION Jayakumr A, Gillett ES, Wee CP, Kim A, Vidmar AP. Impact of 8-hour time-limited eating on sleep in adolescents with obesity. J Clin Sleep Med. 2023;19(11):1941-1949.
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Affiliation(s)
- Archana Jayakumar
- Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Emily S. Gillett
- Division of Pediatric Pulmonology and Sleep Medicine, Children’s Hospital Los Angeles, Los Angeles, California
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Choo Phei Wee
- Southern California Clinical and Translational Science Institute, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Ahlee Kim
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
- Center for Endocrinology, Diabetes and Metabolism, Diabetes & Obesity Program, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Alaina P. Vidmar
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
- Center for Endocrinology, Diabetes and Metabolism, Diabetes & Obesity Program, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
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20
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Baumer AM, Nestor BA, Potter K, Knoll S, Evins AE, Gilman J, Kossowsky J, Schuster RM. Assessing changes in sleep across four weeks among adolescents randomized to incentivized cannabis abstinence. Drug Alcohol Depend 2023; 252:110989. [PMID: 37839357 PMCID: PMC10691527 DOI: 10.1016/j.drugalcdep.2023.110989] [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: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Withdrawal from cannabis use is associated with sleep disturbances, often leading to resumption of use. Less is known about the impact of abstinence on sleep in adolescence, a developmental window associated with high rates of sleep disturbance. This study investigated effects of sustained abstinence on self-reported sleep quality and disturbance in adolescents reporting frequent cannabis use. METHODS Non-treatment seeking adolescents, recruited from school screening surveys and the community, with frequent cannabis use (MAge=17.8, SDAge=1.7, 47% female, 45% non-white) were randomized to four weeks of biochemically-verified abstinence, motivated via contingency management (CB-Abst, n=53), or monitoring without an abstinence requirement (CB-Mon, n=63). A mixed-effects model was used to predict change in Pittsburgh Sleep Quality Index (PSQI) scores. RESULTS Participants in CB-Abst reported higher overall PSQI scores than those in CB-Mon (M=1.06, p=0.01) indicating worse sleep during the four-week trial. Sleep disruptions in CB-Abst increased during Week 1 of abstinence (d=0.34, p=0.04), decreased during Week 2 (d=0.36, p=0.04), and remained constant for the rest of the trial. At Week 4, sleep was comparable to baseline levels for those in CB-Abst (p=0.87). Withdrawal-associated sleep disruption in the CB-Abst group was circumscribed to increases in sleep latency (b=0.35; p=0.05). CONCLUSIONS Cannabis abstinence in adolescents was associated with transient delayed onset of sleep initiation falling asleep during the first week of abstinence. Findings highlight withdrawal-associated changes in sleep latency as an intervention target for supporting adolescents attempting abstinence. Future research should use objective measures of sleep and focus on elucidating mechanisms underlying sleep disturbances with cannabis use and withdrawal.
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Affiliation(s)
- Andreas M Baumer
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, 333 Longwood Ave, Massachusetts 02115, USA
| | - Bridget A Nestor
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, 333 Longwood Ave, Massachusetts 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Kevin Potter
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
| | - Sarah Knoll
- Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
| | - A Eden Evins
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
| | - Jodi Gilman
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
| | - Joe Kossowsky
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, 333 Longwood Ave, Massachusetts 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Randi M Schuster
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, 101 Merrimac Street, Suite 320, Boston, MA 02114, USA
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21
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Liang X, Qiu H, Li SX. Objectively measured sleep continuity in children and adolescents with ADHD: A systematic review and meta-analysis. Psychiatry Res 2023; 328:115447. [PMID: 37657199 DOI: 10.1016/j.psychres.2023.115447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/25/2023] [Accepted: 08/27/2023] [Indexed: 09/03/2023]
Abstract
Sleep disturbances are often linked to attention-deficit/hyperactivity disorder (ADHD). Consistent findings document that children and adolescents with ADHD report more sleep problems than their typically developing (TD) peers across subjective sleep domains. However, few differences between these groups were observed in objectively measured sleep parameters, such as polysomnography (PSG) and actigraphy. This study synthesized empirical studies to identify objectively measured sleep continuity differences between children and adolescents with ADHD and TD. We included observational research and baseline data from intervention studies between 5- to 18-year-old individuals with ADHD and their TD peers at five databases from inception and September 2022. This systematic review and meta-analysis of 45 articles, including 1622 children and adolescents with ADHD and 2013 TD, found that compared with TD, children and adolescents with ADHD have higher sleep latency and moderately decreased sleep efficiency measured by actigraphy. Polysomnography-measured differences between ADHD and TD were not significant. Medication status and comorbid psychiatric status significantly moderated the group differences in sleep efficiency between ADHD and TD. Also, the group differences in sleep latency between ADHD and TD were moderated by actigraphy recorded nights. These findings highlight the importance of reducing disparities in sleep parameters among children and adolescents with and without ADHD.
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Affiliation(s)
- Xiao Liang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Hui Qiu
- Department of Educational Administration and Policy, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shirley Xin Li
- Department of Psychology, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China
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Iskander A, Jairam T, Wang C, Murray BJ, Boulos MI. Normal multiple sleep latency test values in adults: A systematic review and meta-analysis. Sleep Med 2023; 109:143-148. [PMID: 37442016 DOI: 10.1016/j.sleep.2023.06.019] [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: 04/11/2023] [Revised: 06/09/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
Sleep latency is a measure of time it takes to enter sleep. Very short sleep latencies are indicative of excessive daytime sleepiness and pathological sleep conditions such as narcolepsy. The normal range of mean sleep latency calculated from the multiple sleep latency test in healthy adults is not well-established. We provide a review of normative mean sleep latency values on the multiple sleep latency test by synthesizing data from 110 healthy adult cohorts. We also examine the impact of demographic variables such as age, sex, body mass index, sleep architecture and sleep-disordered breathing as well as methodological variables such as sleep onset definitions and multiple sleep latency test protocols. The average mean sleep latency was 11.7 min (95% CI: 10.8-12.6; 95% PI: 5.2-18.2) for cohorts evaluated using the earlier definition of sleep onset and 11.8 min (95% CI: 10.7-12.8; 95% PI: 7.2-16.3) for those evaluated using the later definition. There were no significant associations between mean sleep latency and demographic or methodological variables. A negative association of -0.29 per one unit increase (95% CI: -0.55 to -0.04) was found between mean sleep latency and apnea-hypopnea index on prior night polysomnography. Establishing updated ranges for mean sleep latency among healthy adults may guide clinical decision-making surrounding sleep pathologies and inform future research into the associations between patient variables, daytime sleepiness, and sleep pathologies.
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Affiliation(s)
- Andrew Iskander
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Trevor Jairam
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Christine Wang
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Brian J Murray
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Sleep Laboratory, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mark I Boulos
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Sleep Laboratory, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
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23
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Lavender I, McCartney D, Marshall N, Suraev A, Irwin C, D'Rozario AL, Gordon CJ, Saini B, Grunstein RR, Yee B, McGregor I, Hoyos CM. Cannabinol (CBN; 30 and 300 mg) effects on sleep and next-day function in insomnia disorder ('CUPID' study): protocol for a randomised, double-blind, placebo-controlled, cross-over, three-arm, proof-of-concept trial. BMJ Open 2023; 13:e071148. [PMID: 37612115 PMCID: PMC10450062 DOI: 10.1136/bmjopen-2022-071148] [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: 12/21/2022] [Accepted: 08/07/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVE Insomnia is the most prevalent sleep disorder, with few effective pharmacotherapies. Anecdotal reports and recent preclinical research suggest that cannabinol (CBN), a constituent of Cannabis sativa derived from delta-9-tetrahydrocannabinol, could be an effective treatment. Despite this, the isolated effects of CBN on sleep have yet to be systematically studied in humans. METHODS The present protocol paper describes a randomised, double-blind, placebo-controlled, single-dose, three-arm, cross-over, proof-of-concept study which investigates the effects of CBN on sleep and next-day function in 20 participants with clinician-diagnosed insomnia disorder and an Insomnia Severity Index Score ≥15. Participants receive a single fixed oral liquid dose of 30 mg CBN, 300 mg CBN and matched placebo, in random order on three treatment nights; each separated by a 2-week wash-out period. Participants undergo overnight sleep assessment using in-laboratory polysomnography and next-day neurobehavioural function tests. The primary outcome is wake after sleep onset minutes. Secondary outcomes include changes to traditional sleep staging, sleep-onset latency and absolute spectral power during non-rapid eye movement (NREM) sleep. Tertiary outcomes include changes to sleep spindles during NREM sleep, arousal indices, absolute spectral power during REM sleep and subjective sleep quality. Safety-related and exploratory outcomes include changes to next-day simulated driving performance, subjective mood and drug effects, postural sway, alertness and reaction time, overnight memory consolidation, pre and post-sleep subjective and objective sleepiness; and plasma, urinary, and salivary cannabinoid concentrations. The study will provide novel preliminary data on CBN efficacy and safety in insomnia disorder, which will inform larger clinical trials. ETHICS AND DISSEMINATION Human Research Ethics Committee approval has been granted by Bellberry (2021-08-907). Study findings will be disseminated in a peer-reviewed journal and at academic conferences. TRIAL REGISTRATION NUMBER NCT05344170.
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Affiliation(s)
- Isobel Lavender
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Danielle McCartney
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Nathaniel Marshall
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Anastasia Suraev
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris Irwin
- School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Angela L D'Rozario
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Christopher J Gordon
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
| | - Bandana Saini
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
| | - Ronald R Grunstein
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
- CPC-RPA clinic, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Brendon Yee
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, New South Wales, Australia
- CPC-RPA clinic, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Iain McGregor
- Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Science, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Camilla M Hoyos
- Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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Siddiquee AT, Lee SK, Kim S, Lee MH, Kim HJ, Shin C. All-cause and major-cause mortality associated with sleep latency in the Korean Genome and Epidemiology Study (KoGES): a population-based prospective cohort study. Lancet Healthy Longev 2023; 4:e316-e325. [PMID: 37421960 DOI: 10.1016/s2666-7568(23)00080-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND The all-cause and cause-specific mortality risk associated with sleep latencies in the general adult population is unknown. We aimed to investigate the association of habitual prolonged sleep latency with long-term all-cause and cause-specific mortality in adults. METHODS The Korean Genome and Epidemiology Study (KoGES) is a population-based prospective cohort study comprising community-dwelling men and women aged 40-69 years from Ansan, South Korea. The cohort was studied bi-annually from April 17, 2003, to Dec 15, 2020, and the current analysis included all individuals who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire between April 17, 2003, and Feb 23, 2005. The final study population comprised 3757 participants. Data were analysed from Aug 1, 2021, to May 31, 2022. The main exposure was sleep latency groups based on the PSQI questionnaire: fell asleep in 15 min or less, fell asleep in 16-30 min, occasional prolonged sleep latency (fell asleep in >30 min once or twice a week in the past month) and habitual prolonged sleep latency (fell asleep in >60 min more than once a week or fell asleep in >30 min ≥3 times a week, or both) in the past month at baseline. Outcomes were all-cause and cause-specific (cancer, cardiovascular disease, and other causes) mortality reported during the 18-year study period. Cox proportional hazards regression models were used to examine the prospective relationship between sleep latency and all-cause mortality, and competing risk analyses were done to investigate the association of sleep latency with cause-specific mortality. FINDINGS During a median follow-up of 16·7 years (IQR 16·3-17·4), 226 deaths were reported. After adjusting for demographic characteristics, physical characteristics, lifestyle factors, chronic conditions, and sleep variables, self-reported habitual prolonged sleep latency was associated with an increased risk of all-cause mortality (hazard ratio [HR] 2·22, 95% CI 1·38-3·57) compared to the reference group (those who fell asleep in 16-30 min). In the fully adjusted model, habitual prolonged sleep latency was associated with a more than doubled risk of dying from cancer compared to the reference group (HR 2·74, 95% CI 1·29-5·82). No significant association was observed between habitual prolonged sleep latency and deaths from cardiovascular disease and other causes. INTERPRETATION In this population-based prospective cohort study, habitual prolonged sleep latency was independently associated with an increased risk of all-cause and cancer-specific mortality in adults (independently of demographic characteristics, lifestyle factors, chronic morbidities, and other sleep variables). Although further studies are warranted to investigate the causality of the relationship, strategies or interventions to prevent habitual prolonged sleep latencies might enhance longevity in the general adult population. FUNDING Korea Centers for Disease Control and Prevention.
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Affiliation(s)
- Ali Tanweer Siddiquee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea
| | - Seung Ku Lee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea
| | - Soriul Kim
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea
| | - Min-Hee Lee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea
| | - Hyeon Jin Kim
- Department of Neurology, Korea University Ansan Hospital, Ansan, South Korea
| | - Chol Shin
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, South Korea; Biomedical Research Center, Korea University Ansan Hospital, Ansan, South Korea.
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25
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Mohamed AZ, Andersen T, Radovic S, Del Fante P, Kwiatek R, Calhoun V, Bhuta S, Hermens DF, Lagopoulos J, Shan ZY. Objective sleep measures in chronic fatigue syndrome patients: A systematic review and meta-analysis. Sleep Med Rev 2023; 69:101771. [PMID: 36948138 PMCID: PMC10281648 DOI: 10.1016/j.smrv.2023.101771] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) often report disrupted and unrefreshing sleep in association with worsened fatigue symptoms. However, the nature and magnitude of sleep architecture alteration in ME/CFS is not known, with studies using objective sleep measures in ME/CFS generating contradictory results. The current manuscript aimed to review and meta-analyse of case-control studies with objective sleep measures in ME/CSF. A search was conducted in PubMed, Scopus, Medline, Google Scholar, and Psychoinfo databases. After review, 24 studies were included in the meta-analysis, including 20 studies with 801 adults (ME/CFS = 426; controls = 375), and 4 studies with 477 adolescents (ME/CFS = 242; controls = 235), who underwent objective measurement of sleep. Adult ME/CFS patients spend longer time in bed, longer sleep onset latency, longer awake time after sleep onset, reduced sleep efficiency, decreased stage 2 sleep, more Stage 3, and longer rapid eye movement sleep latency. However, adolescent ME/CFS patients had longer time in bed, longer total sleep time, longer sleep onset latency, and reduced sleep efficiency. The meta-analysis results demonstrate that sleep is altered in ME/CFS, with changes seeming to differ between adolescent and adults, and suggesting sympathetic and parasympathetic nervous system alterations in ME/CFS.
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Affiliation(s)
- Abdalla Z Mohamed
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia.
| | - Thu Andersen
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Sanja Radovic
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Peter Del Fante
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Richard Kwiatek
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, 55 Park Pl NE, 18th Floor, Atlanta, GA, 30303, USA
| | - Sandeep Bhuta
- Medical Imaging Department, Gold Coast University Hospital, Parklands, QLD, 4215, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
| | - Zack Y Shan
- Thompson Institute, University of the Sunshine Coast, 12 Innovation Parkway, Birtinya, QLD, 4575, Australia
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26
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Schöllhorn I, Stefani O, Lucas RJ, Spitschan M, Slawik HC, Cajochen C. Melanopic irradiance defines the impact of evening display light on sleep latency, melatonin and alertness. Commun Biol 2023; 6:228. [PMID: 36854795 PMCID: PMC9974389 DOI: 10.1038/s42003-023-04598-4] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
Evening light-emitting visual displays may disrupt sleep, suppress melatonin and increase alertness. Here, we control melanopic irradiance independent of display luminance and colour, in 72 healthy males 4 h before habitual bedtime and expose each of them to one of four luminance levels (i.e., dim light, smartphone, tablet or computer screen illuminance) at a low and a high melanopic irradiance setting. Low melanopic light shortens the time to fall asleep, attenuates evening melatonin suppression, reduces morning melatonin, advances evening melatonin onset and decreases alertness compared to high melanopic light. In addition, we observe dose-dependent increases in sleep latency, reductions in melatonin concentration and delays in melatonin onset as a function of melanopic irradiance-not so for subjective alertness. We identify melanopic irradiance as an appropriate parameter to mitigate the unwanted effects of screen use at night. Our results may help the many people who sit in front of screens in the evening or at night to fall asleep faster, feel sleepier, and have a more stable melatonin phase by spectrally tuning the visual display light without compromising the visual appearance.
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Affiliation(s)
- Isabel Schöllhorn
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
- Research Platform Molecular and Cognitive Neurosciences (MCN), University of Basel, Basel, Switzerland
| | - Oliver Stefani
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
- Research Platform Molecular and Cognitive Neurosciences (MCN), University of Basel, Basel, Switzerland
| | - Robert J Lucas
- Centre for Biological Timing, Division of Neuroscience, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - Manuel Spitschan
- Translational Sensory & Circadian Neuroscience, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- Chronobiology & Health, TUM Department of Sport and Health Sciences (TUM SG), Technical University of Munich, Munich, Germany
- TUM Institute for Advanced Study (TUM-IAS), Technical University of Munich, Garching, Germany
| | - Helen C Slawik
- Clinical Sleep Laboratory, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Christian Cajochen
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland.
- Research Platform Molecular and Cognitive Neurosciences (MCN), University of Basel, Basel, Switzerland.
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27
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Sampat AC, Avidan AY. Multiple Sleep Latency Test/Maintenance of Wakefulness Test and Central Hypersomnias: Evolving Diagnostic and Therapeutic Approaches. J Clin Neurophysiol 2023; 40:203-214. [PMID: 36872499 DOI: 10.1097/wnp.0000000000000786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
SUMMARY Central disorders of hypersomnolence include a spectrum of conditions, such as narcolepsy, idiopathic hypersomnia, and Kleine-Levin syndrome, in which excessive daytime sleepiness is the primary feature. Subjective testing with tools, such as sleep logs and sleepiness scales, are often helpful in the evaluation of these disorders but do not necessarily correlate well with objective testing, such as polysomnography and multiple sleep latency test and maintenance of wakefulness test. The most recent International Classification of Sleep Disorders-Third Edition has incorporated biomarkers, such as cerebrospinal fluid hypocretin level, into the diagnostic criteria and have restructured the classification of conditions based on our evolved understanding of their underlying pathophysiologic mechanisms. Therapeutic approaches largely consist of behavioral therapy, with a focus on optimizing sleep hygiene, optimizing opportunity for sleep, and strategic napping, along with judicious use of analeptic and anticataleptic agents when necessary. Emerging therapy has revolved around hypocretin-replacement therapy, immunotherapy, and nonhypocretin agents, with the goal of better targeting the underlying pathophysiology of these disorders rather than addressing symptoms. The most novel treatments have targeted the histaminergic system (pitolisant), dopamine reuptake transmission (solriamfetol), and gamma-aminobutyric acid modulation (flumazenil and clarithromycin) to promote wakefulness. Continued research is required for a more solid understanding of the biology of these conditions to develop a more robust armamentarium of therapeutic options.
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Affiliation(s)
- Ajay C Sampat
- Department of Neurology, UC Davis School of Medicine, Sacramento, California, U.S.A.; and
| | - Alon Y Avidan
- Department of Neurology, UCLA School of Medicine; UCLA Sleep Disorders Center, Los Angels, California, U.S.A
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28
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Ferreira ABDM, Ribeiro BLL, Batista EDS, Dantas MP, Mortatti AL. The Influence of Different Training Load Magnitudes on Sleep Pattern, Perceived Recovery, and Stress Tolerance in Young Soccer Players. J Strength Cond Res 2023; 37:351-357. [PMID: 36354748 DOI: 10.1519/jsc.0000000000004235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
ABSTRACT Ferreira, ABdM, Ribeiro, BLL, Batista, EdS, Dantas, MP, and Mortatti, AL. The influence of different training load magnitudes on sleep pattern, perceived recovery, and stress tolerance in young soccer players. J Strength Cond Res 37(2): 351-357, 2023-The aim of this study was to analyze the influence of 3 weeks on sleep parameters, perceived recovery, and stress tolerance in young soccer players using different training load magnitudes. A total of 13 young male soccer athletes (15.9 ± 0.5 years; 68.7 ± 6.1 kg; 170 ± 7 cm) who performed 3 typical training weeks with different workloads were analyzed. The external training load (ETL) was verified by the PlayerLoad method, and the internal training load (ITL) was determined using the session rating of perceived exertion method. Sleep was monitored using a wrist-actigraphy monitor. Sleep variables, including total time in bed (TTB), total sleep time (TST), sleep latency (SL), wake after sleep onset (WASO), and sleep efficiency (SE), were evaluated across all nights of sleep. The recovery status was assessed with the perceived recovery status (PRS) scale, and the stress tolerance was monitored using the "daily analysis of life demands of athletes" questionnaire. There was an increase in sleep time during the week with the highest training load (week 2) (TTB: +35 minutes, TST: +46 minutes, SL: -5 minutes, SE: +3%). There was no difference in the PRS or in the stress tolerance during the evaluation weeks. A very large within-individual correlation was observed between ITL and ETL ( r = 0.78) and moderate within-individual correlation between ETL and TST ( r = 0.34), between ITL and TST ( r = 0.45), and between ITL and SE ( r = 0.359). These results showed that there was an increase in TST during a microcycle with intensified loads, without impairing bedtime and resulting in maintenance of the perceived recovery or stress tolerance values.
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Testoff AC, Solle NS, Shafazand S, Louzado-Feliciano P, Lee DJ, Koru-Sengul T, Kobetz EN, Caban-Martinez AJ. Sleep Latency and Post-Traumatic Stress Disorder Among Retired Career Florida Firefighters: Evidence From the Advancing Epidemiology of Retired Firefighters Aging Longitudinally Cohort. J Occup Environ Med 2022; 64:e851-e856. [PMID: 36221257 PMCID: PMC9729374 DOI: 10.1097/jom.0000000000002722] [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] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Our objective was to estimate the association of post-traumatic stress disorder (PTSD) and sleep latency among retired firefighters. METHODS Baseline health survey data collected from retried career Florida firefighters participating in an ongoing prospective cohort study from 2017 to 2021 were analyzed. Risk for PTSD was assessed using a four-item primary care PTSD screening construct, and sleep onset latency was assessed by self-reported length of time to fall asleep. RESULTS Among the 500 participants, 8.0% screened positive for PTSD risk and 37.6% had prolonged sleep onset latency (≥20 minutes to fall asleep). Retired firefighters with PTSD risk were 2.7 times more likely (adjusted odds ratio, 2.70; 95% confidence interval, 1.27-5.75) to have prolonged sleep latency compared with those without PTSD risk while controlling for covariates. CONCLUSIONS Retired firefighters who screen positive for PTSD risk are three times more likely to report delayed sleep onset latency.
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Affiliation(s)
- Addison C. Testoff
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Natasha Schaefer Solle
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Shirin Shafazand
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Paola Louzado-Feliciano
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - David J. Lee
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Erin N. Kobetz
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Physical Medicine and Rehabilitation, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
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Jørgensen CK, Hermann R, Juul S, Faltermeier P, Horowitz M, Moncrieff J, Gluud C, Jakobsen JC. Melatonin for sleep disorders in children with neurodevelopmental disorders: protocol for a systematic review with meta-analysis and Trial Sequential Analysis of randomised clinical trials. BMJ Open 2022; 12:e065520. [PMID: 36446459 PMCID: PMC9710329 DOI: 10.1136/bmjopen-2022-065520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Neurodevelopmental disorders are a group of disorders thought to be associated with the functioning of the brain and the nervous system. Children with neurodevelopmental disorders often have sleep-related comorbidities that may negatively affect quality of life for both the children and their families. Melatonin is one of the most used interventions in children with neurodevelopmental disorders and sleep disorders. Previous reviews have investigated the effects of melatonin for sleep disorders in children with neurodevelopmental disorders, but these had important limitations, such as inadequate analysis of adverse effects, small sample sizes and short follow-up. METHODS AND ANALYSIS This is a protocol for a systematic review with meta-analysis and Trial Sequential Analysis of randomised clinical trials. The protocol is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. We will search for published and unpublished trials in the Cochrane Central Register of Controlled Trials, MEDLINE Ovid, Embase Ovid, LILACS, Science Citation Index Expanded, Conference Proceedings Citation Index-Science, PsycINFO, ClinicalTrials.gov and the International Clinical Trials Registry Platform. We will search the databases from their inception without language restrictions. We will also request clinical study reports from regulatory authorities and pharmaceutical companies. Review authors working in pairs will screen reports, extract data and conduct risk of bias assessments using the Cochrane Risk of Bias tool. We will include randomised clinical trials comparing melatonin versus placebo or no intervention for sleep disorders in children with neurodevelopmental disorders. Primary outcomes will be total sleep time and adverse effects. Secondary outcomes will be quality of life of the child and caregivers and sleep onset latency. Data will be analysed using random-effects and fixed-effect meta-analyses. Certainty of evidence will be assessed with Grading of Recommendations, Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION Ethical approval was not required for this protocol. The systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022337530.
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Affiliation(s)
- Caroline Kamp Jørgensen
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Rikke Hermann
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Centre for Children, Youth, and Families, Glostrup, Denmark
| | - Sophie Juul
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Pascal Faltermeier
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- MSH Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Mark Horowitz
- Research and Development Department, North East London NHS Foundation Trust (NELFT), London, UK
| | - Joanna Moncrieff
- Research and Development Department, North East London NHS Foundation Trust (NELFT), London, UK
- Division of Psychiatry, University College London, London, UK
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Janus Christian Jakobsen
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Abstract
PURPOSE The current study aims to quantify the effect of brief behavioral treatment for insomnia (BBTI) studies through meta-analysis. METHOD Searches were performed from inception to February 2020, reporting on the effects of BBTI using randomized controlled trials (RCT) (adults aged 32 to 84). The main outcome measures were sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE%), and total sleep time (TST). RESULTS BBTI showed improved SOL compared with control group in mean difference at early (-15.42 [95% CI: -33.05 to -12.01; I2 =49%]) and late follow-up (-10.52 [95% CI: -1.12 to 0.54; I2=93%]). This was statistically significant at early follow-up, but not at late follow-up. The improvement of WASO by BBTI over the control group was shown at early follow-up (-17.47 [95% CI: -2.67 to 0.45; I2=90%]), and was statistically significant. For WASO, a non-statistically significant improvement of BBTI over the control group was shown at late follow-up (-12.77 [95% CI: -22.47 to -3.08; I2=0%]). SE% was shown improved statistically significant by BBTI over control group at early (4.47 [95% CI: -0.35 to 9.29; I2=98%]) and at late follow-up (6.52 [95% CI: -4.00 to 17.05; I2=89%]). The TST was shown no improvement by BBTI at early follow-up in mean difference (-2.97 [95% CI -38.83 to 32.90; I2=96%]). At late follow-up, TST was shown improvement in BBTI with mean difference (14.52 [95% CI: -31.64 to 60.68; I2=94%]) compared with the control group. CONCLUSION Current evidence suggests that BBTI can be considered preliminarily efficacious and can be used for samples of middle-aged and older adults.
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Affiliation(s)
- Misol Kwon
- School of Nursing, University at Buffalo, State University of New York, NY
| | - Jia Wang
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, State University of New York, NY
| | - Gregory Wilding
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, State University of New York, NY
| | | | - Grace E. Dean
- School of Nursing, University at Buffalo, State University of New York, NY
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Zhong X, Gou F, Jiao H, Zhao D, Teng J. Association between night sleep latency and hypertension: A cross-sectional study. Medicine (Baltimore) 2022; 101:e31250. [PMID: 36281125 PMCID: PMC9592274 DOI: 10.1097/md.0000000000031250] [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] [Indexed: 11/14/2022] Open
Abstract
Sleep disorders have been shown to increase the risk of hypertension, while the relationship between night sleep latency and hypertension is less well-known. We aimed to investigate the association between night sleep latency and hypertension, as well as related sleep factors by gender in the Chinese population. We conducted a cross-sectional study of the relationship between night sleep latency and hypertension. The sample size included 619 consecutive hospitalized patients (M/F: 302/317, 64.01 ± 12.27 years). T test, Chi-square test, and ANOVA were performed to analyze baseline data and intergroup comparisons. Spearman correlation analysis was performed to find the interrelationships. Multivariate logistic regression analysis was performed to adjust for covariables. The findings showed hypertension patients had longer night sleep latency (P < .001). After adjusting for confounding factors, night sleep latency was positively correlated with hypertension in both men and women (odds ratio: 1.065, 95% confidence interval: 1.044-1.087). Spearman correlation analysis suggested that night sleep latency was positively correlated with systolic blood pressure (r = 0.186, P < .001), diastolic blood pressure (r = 0.136, P < .001), sleep initiation time (r = 0.091, P = .023), and global Pittsburg Sleep Quality Index score (r = 0.371, P < .001), was negatively correlated with sleep duration (r = -0.186, P < .001), sleep time on weekdays (r = -0.183, P < .001), and sleep time on weekends (r = -0.179, P < .001). Longer night sleep latency was associated with an increased risk of hypertension in men and women, which might involve the pathological progression of hypertension along with other sleep factors.
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Affiliation(s)
- Xia Zhong
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, PR China
| | - Fuyue Gou
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, PR China
| | - Huachen Jiao
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, PR China
- *Correspondence: Huachen Jiao, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Room 101, Unit 3, Building 1, No. 125, Huanshan Road, Lixia District, Jinan, Shandong 250014, PR China (e-mail: )
| | - Dongsheng Zhao
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, PR China
| | - Jing Teng
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, PR China
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Maski K, Worhach J, Steinhart E, Boduch M, Morse AM, Strunc M, Scammell T, Owens J, Jesteadt L, Crisp C, Williams D, Sideridis G. Development and Validation of the Pediatric Hypersomnolence Survey. Neurology 2022; 98:e1964-e1975. [PMID: 35314496 PMCID: PMC9141629 DOI: 10.1212/wnl.0000000000200187] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/26/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Narcolepsy and idiopathic hypersomnia usually begin in early adolescence, but diagnostic delays ranging from 5 to 10 years are common, affecting disease burden. To improve early identification of these treatable conditions, we developed and validated the Pediatric Hypersomnolence Survey (PHS). METHODS Content was developed through literature review, patient focus groups, interviews with experts in the field, and field testing. We then validated the 14-item self-reported survey across 3 hospitals and web recruitment from patient groups. In the validation phase, we recruited a total of 331 participants (patients with narcolepsy type 1 [n = 64], narcolepsy type 2 [n = 34], idiopathic hypersomnia [n = 36], and other sleep disorders [n = 97] and healthy controls [n = 100], ages 8-18 years) to complete the survey. We assessed a range of psychometric properties, including discriminant diagnostic validity for CNS disorders of hypersomnolence using receiver operating characteristic curve analysis and reliability across a 1-week period. RESULTS Confirmatory factor analysis indicated a 4-domain solution with good reliability expressed by satisfactory omega values. Across groups, the PHS total score showed appropriate positive correlations with other validated surveys of sleepiness (r = 0.65-0.78, p < 0.001) and negative correlations with multiple sleep latency test measures (mean sleep latency: r = -0.27, p = 0.006; number of sleep-onset REM periods: r = 0.26, p = 0.007). Compared to controls and patients with other sleep disorders, the area under the curve for participants with narcolepsy or idiopathic hypersomnia was 0.87 (standard error 0.02, 95% CI 0.83-0.91) with high sensitivity (81.3, 95% CI 73.7%-87.5%) and specificity (81.2%, 95 CI 75.1%-86.4%). Test-retest reliability was r = 0.87. DISCUSSION The PHS is a valid and reliable tool for clinicians to identify pediatric patients with narcolepsy and idiopathic hypersomnia. Implemented in clinical practice, the PHS will potentially decrease diagnostic delays and time to treatment, ultimately reducing disease burden for these debilitating conditions. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that the PHS accurately identifies patients with central disorders of hypersomnolence.
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Affiliation(s)
- Kiran Maski
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Jennifer Worhach
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Erin Steinhart
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Madeline Boduch
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Anne Marie Morse
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Michael Strunc
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Thomas Scammell
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Judith Owens
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Lindsay Jesteadt
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Claire Crisp
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - David Williams
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
| | - Georgios Sideridis
- From the Department of Neurology (K.M., J.W., M.B., T.S., J.O.), Boston Children's Hospital; Massachusetts General Hospital (E.S.), Boston; Department of Neurology (A.M.), Geisinger Medical Center, Danville, PA; Department of Neurology (M.S.), Children's Hospital of the King's Daughter, Norfolk, VA; Department of Neurology (T.S.), Beth Israel Deaconess Medical Center, Boston; 6. Wake Up Narcolepsy, Inc (L.J., C.C.), Worcester; and ICCTR Biostatistics and Research Design Center (D.W., G.S.), Boston Children's Hospital, MA
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Omichi C, Kadotani H, Sumi Y, Ubara A, Nishikawa K, Matsuda A, Ozeki Y. Prolonged Sleep Latency and Reduced REM Latency Are Associated with Depressive Symptoms in a Japanese Working Population. IJERPH 2022; 19:ijerph19042112. [PMID: 35206296 PMCID: PMC8872621 DOI: 10.3390/ijerph19042112] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/01/2022] [Accepted: 02/10/2022] [Indexed: 12/26/2022]
Abstract
Background: Examining the relationship between sleep and depression may be important for understanding the aetiology of affective disorders. Most studies that use electroencephalography (EEG) to objectively assess sleep have been conducted using polysomnography in the laboratory. Impaired sleep continuity, including prolonged sleep latency and changes in rapid eye movement (REM) sleep, have been reported to be associated with depression in clinical settings. Here, we aimed to use home EEG to analyse the association between sleep and depressive symptoms. Methods: We performed a cross-sectional epidemiological study in a large Japanese working population to identify the EEG parameters associated with depressive symptoms based on the results of a questionnaire survey and home EEG measurements using 1-channel (1-Ch) EEG. Results: The study included 650 Japanese patients (41.2% male, 44.7 ± 11.5 years) who underwent home EEG monitoring along with the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms. Logistic regression analysis revealed that depressive symptoms (PHQ-9 ≥ 10) were associated with sleep latency (odds ratio (OR) 1.02; 95% confidence interval (CI): 1.00–1.04) and REM latency (OR, 0.99; 95% CI: 0.99–1.00). Conclusions: Our results suggest that depressive symptoms are associated with prolonged sleep latency and reduced REM latency in a Japanese working population. The 1-Ch EEG may be a useful tool to monitor sleep and screen depression/depressive symptoms in non-clinical settings.
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Affiliation(s)
- Chie Omichi
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City 520-2192, Japan; (C.O.); (Y.S.); (A.U.); (K.N.); (A.M.); (Y.O.)
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Hygiene and Public Health, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City 520-2192, Japan; (C.O.); (Y.S.); (A.U.); (K.N.); (A.M.); (Y.O.)
- Correspondence: or ; Tel.: +81-77-548-2291
| | - Yukiyoshi Sumi
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City 520-2192, Japan; (C.O.); (Y.S.); (A.U.); (K.N.); (A.M.); (Y.O.)
| | - Ayaka Ubara
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City 520-2192, Japan; (C.O.); (Y.S.); (A.U.); (K.N.); (A.M.); (Y.O.)
- Graduate School of Psychology, Doshisha University, Kyoto 610-0394, Japan
- Japan Society for the Promotion of Science, Research Fellowships, Tokyo 102-0083, Japan
| | - Kohei Nishikawa
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City 520-2192, Japan; (C.O.); (Y.S.); (A.U.); (K.N.); (A.M.); (Y.O.)
- Japan CBT Center, CG Building F4, 3-12 Chuo-cho, Hikone 522-0063, Japan
| | - Arichika Matsuda
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City 520-2192, Japan; (C.O.); (Y.S.); (A.U.); (K.N.); (A.M.); (Y.O.)
| | - Yuji Ozeki
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City 520-2192, Japan; (C.O.); (Y.S.); (A.U.); (K.N.); (A.M.); (Y.O.)
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Ding L, Chen B, Dai Y, Li Y. A meta-analysis of the first-night effect in healthy individuals for the full age spectrum. Sleep Med 2022; 89:159-165. [PMID: 34998093 DOI: 10.1016/j.sleep.2021.12.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 09/18/2021] [Revised: 11/12/2021] [Accepted: 12/14/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The first-night effect (FNE) affects the accuracy of polysomnography (PSG) findings. However, the levels of FNE in different ages are unclear. METHODS We searched PubMed, Cochrane Library, Embase and Web of Science. The studies that reported sleep parameters by PSG for at least 2 consecutive nights from healthy individuals were included. The weighted mean differences were used to assess the effect size of differences in each sleep parameters between the first and second nights, as well as between the second and the third. RESULTS A total of 53 studies from 1422 subjects with mean age of 9.2-85.5 years were included. Meta-analyses showed that prolonged sleep onset latency, wake time after sleep onset and rapid eye movement sleep (REM) latency, accompanied by decreased total sleep time, sleep efficiency, and REM and increased non-rapid eye movement sleep stage 1 (N1) during the first night compared to the second (all P-value ≤ 0.001). No significant differences were observed in N2 and slow wave sleep, apnea-hypopnea index or periodic limb movement index (all P-value > 0.5). A non-linear association between FNE and age was observed: young adults (age 20-29 years) had the lowest level of FNE compared to other age ranges. Moreover, no significant differences were observed in most sleep parameters between the second and third night except more N2 and less REM in the second night (both P-value < 0.05). CONCLUSIONS The FNE exists in most cases but only in the first night of PSG recording and is less pronounced among young adults.
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Affiliation(s)
- Lei Ding
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Baixin Chen
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Yanyuan Dai
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Yun Li
- Department of Sleep Medicine, Shantou University Mental Health Center, Shantou, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
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Himes BJ, Blotter JD, Kay DB, Steffensen SC, Feland JB, Bills KB, Mcpherson DL, Manwaring K, Lafont-Tanner D, Layton B. The Effect of Beat Frequency Vibration on Sleep Latency and Neural Complexity: A Pilot Study. IEEE Trans Neural Syst Rehabil Eng 2021; 29:872-883. [PMID: 33950842 DOI: 10.1109/tnsre.2021.3076983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Insomnia affects millions of people worldwide, and non-pharmacological treatment options are limited. A bed excited with multiple vibration sources was used to explore beat frequency vibration (BFV) as a non-pharmacological treatment for insomnia. A repeated measures design pilot study of 14 participants with mild-moderate insomnia symptom severity (self-reported on the Insomnia Severity Index) was conducted to determine the effects of BFV, and traditional standing wave vibration (SWV) on sleep latency and sleep electrocortical activity. Participants were monitored using high-density electroencephalography (HD-EEG). Sleep latency was compared between treatment conditions. A trend of decreasing sleep latency due to BFV was found for unequivocal sleep latency (p ≤ 0.068). Neural complexity during wake, N1, and N2 stages were compared using Multi-Scale Sample Entropy (MSE), which demonstrated significantly lower MSE between wake and N2 stages (p ≤ 0.002). During N2 sleep, BFV showed lower MSE than the control session in the left frontoparietal region. As a measure of information integration, reduced entropy may indicate that BFV decreases conscious awareness during deeper stages of sleep. SWV caused reduced alpha activity and increased delta activity during wake. BFV caused increased delta activity during N2 sleep. These preliminary results suggest that BFV may help decrease sleep latency, reduce conscious awareness, and increase sleep drive expression during deeper stages of sleep. SWV may be beneficial for decreasing expression of arousal and increasing expression of sleep drive during wake, implying that beat frequency vibration may be beneficial to sleep.
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Alharbi AS, Alshahrani SM, Alsaadi MM, AL-Jahdali HH, Wali SO, BaHammam AS. Sleep quality and insomnia during the COVID-19 lockdown among the Saudi public: A cross-sectional study. Saudi Med J 2021; 42:384-390. [PMID: 33795493 PMCID: PMC8128641 DOI: 10.15537/smj.2021.42.4.20200735] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/11/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To measure the Saudi population's sleep quality during the lockdown of COVID-19. METHODS An internet-based questionnaire that was performed during the lockdown of the COVID-19 pandemic among the Saudi population over 2 weeks from April 1 to April 15, 2020. We used the instant messaging application WhatsApp and Twitter to reach the targeted population. Saudi citizens and non-Saudi residents who can read and understand the questionnaire were recruited. Data were analyzed using Stata and SPSS. RESULTS A total of 790 responses were included. The majority of participants were the Saudi population 735 (92.9%). The prevalence of insomnia and poor sleep quality were 54.4% and 55.5%, respectively. Saudi citizenship was associated with longer sleep duration (p=0.031). Female gender and being married were associated with worse global PSQI, sleep quality, sleep distribution, sleep latency, and daytime dysfunction. CONCLUSION Our findings showed that during the COVID-19 pandemic, the Saudi population had a high prevalence of insomnia and poor sleep quality. Routine monitoring of the psychological impact of life-threatening outbreaks and the adoption of effective early mental health actions should be considered.
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Affiliation(s)
- Adel S. Alharbi
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Dr. Adel S. Alharbi, Department of Pediatrics, Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: http://orcid.org/0000-0001-7974-4026
| | - Sultan M. Alshahrani
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
| | - Muslim M. Alsaadi
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
| | - Hamdan H. AL-Jahdali
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
| | - Siraj O. Wali
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
| | - Ahmed S. BaHammam
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
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Wang Y, Liu X, Chen G, Tu R, Abdulai T, Qiao D, Liu X, Dong X, Luo Z, Wang Y, Li R, Huo W, Yu S, Guo Y, Li S, Wang C. Association of long-term exposure to ambient air pollutants with prolonged sleep latency: The Henan Rural Cohort Study. Environ Res 2020; 191:110116. [PMID: 32846171 DOI: 10.1016/j.envres.2020.110116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Prolonged sleep latency is associated with far-reaching public health consequences. Although evidence about the effect of air pollution on sleep problem has been shown, the effect on sleep latency remained unknown. The study aimed to analyze the association between long-term exposure to air pollution and prolonged sleep latency in rural China. METHODS In all, 27935 participants were included in the study from Henan Rural Cohort Study. A satellite-based spatiotemporal model was used to evaluate the 3-year average concentration of air pollutants at the home address of participants before the baseline survey. Air pollutants included NO2 (nitrogen dioxide), PM1 (particulate matter with aerodynamic diameters ≤1 μm), PM2.5 (particulate matter with aerodynamic diameters ≤ 2.5 μm), and PM10 (particulate matter with aerodynamic diametes ≤ 10 μm). A logistic regression model was conducted to assess the odds ratio (OR) and 95% confidence interval (95% CI) between air pollutants and prolonged sleep latency. RESULTS There were 5825 (20.85%) participants with prolonged sleep latency. The average concentration of NO2, PM1, PM2.5, and PM10 were 38.22 (2.54) μg/m3, 56.29 (1.75) μg/m3, 72.30 (1.87) μg/m3, and 130.01 (4.58) μg/m3. The odds ratio (95%CI) of prolonged sleep latency with an IQR increase of NO2, PM1, PM2.5, and PM10 were 1.59 (1.33-1.90), 1.23 (1.13-1.33), 1.28 (1.13-1.45) and 1.43 (1.22-1.67). The stratified analysis showed the effect of air pollutants was stronger among those with stroke. CONCLUSION Long-term exposure to NO2, PM1, PM2.5 and PM10 were associated with prolonged sleep latency. The adverse impact of air pollution should be considered when treating sleep problems.
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Affiliation(s)
- Yan Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Tanko Abdulai
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Dou Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xue Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhicheng Luo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yikang Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Songcheng Yu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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MacKay S, Carney AS, Catcheside PG, Chai-Coetzer CL, Chia M, Cistulli PA, Hodge JC, Jones A, Kaambwa B, Lewis R, Ooi EH, Pinczel AJ, McArdle N, Rees G, Singh B, Stow N, Weaver EM, Woodman RJ, Woods CM, Yeo A, McEvoy RD. Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive Sleep Apnea: The SAMS Randomized Clinical Trial. JAMA 2020; 324:1168-1179. [PMID: 32886102 PMCID: PMC7489419 DOI: 10.1001/jama.2020.14265] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
IMPORTANCE Many adults with obstructive sleep apnea (OSA) use device treatments inadequately and remain untreated. OBJECTIVE To determine whether combined palatal and tongue surgery to enlarge or stabilize the upper airway is an effective treatment for patients with OSA when conventional device treatment failed. DESIGN, SETTING, AND PARTICIPANTS Multicenter, parallel-group, open-label randomized clinical trial of upper airway surgery vs ongoing medical management. Adults with symptomatic moderate or severe OSA in whom conventional treatments had failed were enrolled between November 2014 and October 2017, with follow-up until August 2018. INTERVENTIONS Multilevel surgery (modified uvulopalatopharyngoplasty and minimally invasive tongue volume reduction; n = 51) or ongoing medical management (eg, advice on sleep positioning, weight loss; n = 51). MAIN OUTCOMES AND MEASURES Primary outcome measures were the apnea-hypopnea index (AHI; ie, the number of apnea and hypopnea events/h; 15-30 indicates moderate and >30 indicates severe OSA) and the Epworth Sleepiness Scale (ESS; range, 0-24; >10 indicates pathological sleepiness). Baseline-adjusted differences between groups at 6 months were assessed. Minimal clinically important differences are 15 events per hour for AHI and 2 units for ESS. RESULTS Among 102 participants who were randomized (mean [SD] age, 44.6 [12.8] years; 18 [18%] women), 91 (89%) completed the trial. The mean AHI was 47.9 at baseline and 20.8 at 6 months for the surgery group and 45.3 at baseline and 34.5 at 6 months for the medical management group (mean baseline-adjusted between-group difference at 6 mo, -17.6 events/h [95% CI, -26.8 to -8.4]; P < .001). The mean ESS was 12.4 at baseline and 5.3 at 6 months in the surgery group and 11.1 at baseline and 10.5 at 6 months in the medical management group (mean baseline-adjusted between-group difference at 6 mo, -6.7 [95% CI, -8.2 to -5.2]; P < .001). Two participants (4%) in the surgery group had serious adverse events (1 had a myocardial infarction on postoperative day 5 and 1 was hospitalized for observation following hematemesis of old blood). CONCLUSIONS AND RELEVANCE In this preliminary study of adults with moderate or severe OSA in whom conventional therapy had failed, combined palatal and tongue surgery, compared with medical management, reduced the number of apnea and hypopnea events and patient-reported sleepiness at 6 months. Further research is needed to confirm these findings in additional populations and to understand clinical utility, long-term efficacy, and safety of multilevel upper airway surgery for treatment of patients with OSA. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12614000338662.
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Affiliation(s)
- Stuart MacKay
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
- University of Wollongong, NSW, Australia
- Illawarra ENT Head and Neck Clinic, Wollongong, NSW, Australia
| | - A. Simon Carney
- Southern ENT & Adelaide Sinus Centre, Flinders Private Hospital, Adelaide, SA, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Peter G. Catcheside
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Ching Li Chai-Coetzer
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Respiratory and Sleep Service, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Michael Chia
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Peter A. Cistulli
- Charles Perkins Centre, Faculty for Medicine and Health, University of Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, NSW, Australia
| | - John-Charles Hodge
- Ear Nose and Throat Department, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Andrew Jones
- Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
- University of Wollongong, NSW, Australia
- Illawarra Sleep Medicine Centre, Wollongong, NSW, Australia
| | - Billingsley Kaambwa
- Health Economics Unit, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Richard Lewis
- Hollywood Medical Centre, Perth, WA, Australia
- Department of Otolaryngology, Head & Neck Surgery, Royal Perth Hospital, Perth, WA, Australia
| | - Eng H. Ooi
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, Adelaide, SA, Australia
| | - Alison J. Pinczel
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Nigel McArdle
- West Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Guy Rees
- The Memorial Hospital, Adelaide, SA, Australia
| | - Bhajan Singh
- West Australian Sleep Disorders Research Institute, Queen Elizabeth II Medical Centre, Perth, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Faculty of Human Sciences, University of Western Australia, Perth, WA, Australia
| | - Nicholas Stow
- The Woolcock Clinic, University of Sydney, NSW, Australia
| | - Edward M. Weaver
- Department of Otolaryngology/Head and Neck Surgery, University of Washington, Seattle
- Staff Surgeon, Seattle Veterans Affairs Medical Center, Seattle, Washington
| | - Richard J. Woodman
- Flinders Centre for Epidemiology and Biostatistics, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Charmaine M. Woods
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, Adelaide, SA, Australia
| | - Aeneas Yeo
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - R. Doug McEvoy
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Respiratory and Sleep Service, Southern Adelaide Local Health Network, Adelaide, SA, Australia
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Hu C, Zhang Y, Wang S, Lin L, Peng K, Du R, Qi H, Zhang J, Wang T, Zhao Z, Li M, Xu Y, Xu M, Li D, Bi Y, Wang W, Chen Y, Lu J. Association of bedtime with the risk of non-alcoholic fatty liver disease among middle-aged and elderly Chinese adults with pre-diabetes and diabetes. Diabetes Metab Res Rev 2020; 36:e3322. [PMID: 32268002 DOI: 10.1002/dmrr.3322] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/27/2020] [Accepted: 03/30/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Emerging evidence indicated that sleep characteristics may play important roles in the development of metabolic disorders. However, little is known as to the association between bedtime and the risk of non-alcoholic fatty liver disease (NAFLD) in individuals with pre-diabetes and diabetes. METHODS In a prospective cohort of 10 375 adults aged ≥40 years, 1960 of 3484 eligible pre-diabetic and diabetic individuals were identified for the current study. NAFLD was diagnosed using liver ultrasonography at baseline and at follow-up. Information on bedtime was obtained at baseline using a standard questionnaire. RESULTS We documented 433 incident cases of NAFLD among this study population. In multivariable-adjusted logistic regression model, later bedtime was associated with increased risk of NAFLD (29% increased risk per hour of later bedtime). Compared to individuals with bedtime ≤20:00, the odds ratios (95% confidence intervals) of NAFLD for bedtime of 20:00-22:00 and ≥22:00 were 1.56 (1.04-2.34) and 2.05 (1.31-3.20), respectively. In the subgroup analysis, significant associations were observed among those who were overweight or physically inactive, or those with metabolic syndrome or elevated 10-year risks for atherosclerotic cardiovascular disease. When estimating the joint effect of bedtime and other sleep characteristics, higher risk of incident NAFLD was observed in groups of late bed/early rise, late bed/napping (yes), late bed/bad sleeper, or late bed/shorter sleep durations. CONCLUSIONS Later bedtime was significantly associated with an increased risk of incident NAFLD in adults with pre-diabetes and diabetes, underscoring the importance of sleep behaviour management in the prevention of NAFLD.
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Affiliation(s)
- Chunyan Hu
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Yi Zhang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Shuangyuan Wang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Lin Lin
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Kui Peng
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Rui Du
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Hongyan Qi
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Jie Zhang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Tiange Wang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Zhiyun Zhao
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Mian Li
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Yu Xu
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Min Xu
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yufang Bi
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Weiqing Wang
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Yuhong Chen
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
| | - Jieli Lu
- Shanghai National Clinical Research Center for Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai, China
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Hu Z, Zhu X, Kaminga AC, Zhu T, Nie Y, Xu H. Association between poor sleep quality and depression symptoms among the elderly in nursing homes in Hunan province, China: a cross-sectional study. BMJ Open 2020; 10:e036401. [PMID: 32665347 PMCID: PMC7359068 DOI: 10.1136/bmjopen-2019-036401] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To examine the association between the prevalence of poor sleep quality and depression symptoms among the elderly in the nursing homes of Hunan province in China. DESIGN, SETTING AND PARTICIPANTS This was a cross-sectional study investigating 817 elderly people from 24 nursing homes in China's Hunan province. MAIN OUTCOME MEASURES Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) such that poor sleep quality was defined as PSQI Score >5. In addition, depression symptoms were assessed using the Geriatric Depression Scale (GDS). Linear regression models and binary logistic regression models were used to analyse the relationship between the prevalence of poor sleep quality and depression symptoms. RESULTS The mean PSQI Score was 8.5±4.9, and the prevalence of poor sleep quality was 67.3%. Additionally, the mean GDS Score was 9.8±7.5, and the prevalence of depression symptoms was 36.0%. Elderly people with poor sleep quality had increased GDS Score (mean difference=2.54, 95% CI 1.66 to 3.42) and increased risk of depression symptoms (OR=3.19, 95% CI 2.04 to 4.98) after controlling for demographics, chronic disease history, lifestyle behaviours, social support, activities of daily living and negative life events. CONCLUSIONS The prevalence of poor sleep quality was relatively high, and this was associated with increased depression symptoms. Therefore, poor sleep quality could be speculated as a marker of current depression symptoms in the elderly.
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Affiliation(s)
- Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health,Central South University, Changsha, Hunan, China
| | - Xidi Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health,Central South University, Changsha, Hunan, China
| | - Atipatsa Chiwanda Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
| | - Tingting Zhu
- Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China
| | - Yu Nie
- Educational Administration Office, The Second Xiangya Hospital, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health,Central South University, Changsha, Hunan, China
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Garcia-Molina G, Kalyan B, Aquino A. Closed-loop Electroencephalogram-based modulated audio to fall and deepen sleep faster. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:565-568. [PMID: 33018052 DOI: 10.1109/embc44109.2020.9175689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The transition from wake to sleep is a continuum that is well characterized by the electroencephalogram (EEG) power spectral ratio (ρ) between the beta (15 to 30 Hz) and theta (4 to 8 Hz) bands. From wake to sleep, the value of ρ gradually decreases.We have designed and implemented a single EEG-signal based closed-loop system that leverages ρ to modulate the volume of a pink-noise type of audio such that the volume becomes gradually softer as sleep initiates. A proof-of-concept trial was conducted with this system and it was found that using this concept resulted in a reduction of sleep latency and latency to deep sleep.
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Kennert BA, Harshorne TS, Kanouse S, Johnson C. Parent survey of sleep problems among children with CHARGE syndrome. Res Dev Disabil 2020; 101:103614. [PMID: 32248059 DOI: 10.1016/j.ridd.2020.103614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 07/09/2019] [Accepted: 02/17/2020] [Indexed: 06/11/2023]
Abstract
Sleep problems are common among children, especially those with developmental disabilities, visual impairments, and behavioral problems. Past research has indicated a particularly high prevalence of clinically-relevant sleep problems for children with CHARGE syndrome, who often possess all three of these qualities. To gather additional information regarding the nature of these sleep problems and how they are most commonly treated amongst parents, an explorative survey was conducted with 30 parents of children with CHARGE syndrome with comorbid sleep problems using the Sleep Disturbance Scale for Children, as well as demographic and sleep questionnaires developed for use in this study. Our findings indicated that problems of sleep initiation and maintenance were most commonly reported, consistent with previous research. Parents most often reported the following factors suspected of contributing to sleep problems: self-regulation difficulties, teeth grinding, hormonal imbalance, problem behaviors, and anxiety. The most commonly administered treatments were reported to be the use of positive bedtime routines, melatonin treatment, the use of a weighted blanket, and prescription medications, respectively. While parents reported overall that they felt all three of these intervention strategies were slightly effective at improving their child's sleep problem, the use of positive bedtime routines and melatonin treatment were perceived as more effective by parents. These results aid professionals in the selection of future research and intervention strategies to recommend for parents of children with CHARGE syndrome.
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Affiliation(s)
| | | | | | - Carl Johnson
- Central Michigan University, Mount Pleasant, MI, USA
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Bonato M, Merati G, La Torre A, Saresella M, Marvetano I, Banfi G, Vitale JA. Effect of Acute Sleep Hygiene on Salivary Cortisol Level Following A Late Night Soccer-Specific Training Session. J Sports Sci Med 2020; 19:235-236. [PMID: 32132848 PMCID: PMC7039028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Affiliation(s)
| | - Giampiero Merati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Antonio La Torre
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | | | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Vita-Salute San Raffaele University, Milano, Italy
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Rafii F, Ameri F, Haghani H, Ghobadi A. The effect of aromatherapy massage with lavender and chamomile oil on anxiety and sleep quality of patients with burns. Burns 2019; 46:164-171. [PMID: 31859096 DOI: 10.1016/j.burns.2019.02.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Regarding the importance of anxiety management and improvement of the quality of sleep in patients with burn injuries, this study aimed to determine the effect of aromatherapy massage (using aromatic oils of lavender and chamomile) on the anxiety and sleep quality of the patients with burn injuries. METHOD In a quasi-experimental study, 105 patients with burns were recruited by convenience sampling method and then assigned into three groups (control, placebo massage, and combined aromatic oil massage). The study intervention was performed 20min before bedtime in three sessions, within a week. The control group was only under daily routine care. The study data were collected using the Persian version of Spielberg's anxiety scale and the Pittsburgh Sleep Quality Inventory. Descriptive and inferential statistical tests were used to analyze the data in SPSS version 20. RESULTS The results showed a significant difference among the three groups in terms of anxiety score (P<0.001) and in terms of sleep quality after the intervention (P=0.027). CONCLUSION Since the aromatherapy massage as a non-pharmacological and simple method can improve the anxiety and quality of sleep in patients with burns, it is suggested that nurses and burn medical care team apply it to reduce burn patients' anxiety and promote their sleep quality. Applying massage alone also reduces anxiety in burn survivors.
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Affiliation(s)
- Forough Rafii
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Ameri
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Hamid Haghani
- Department of Biostatics, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Ghobadi
- Department of Traditional Medicine, School of Health, Iran University of Medical Sciences, Tehran, Iran
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Kuula L, Gradisar M, Martinmäki K, Richardson C, Bonnar D, Bartel K, Lang C, Leinonen L, Pesonen AK. Using big data to explore worldwide trends in objective sleep in the transition to adulthood. Sleep Med 2019; 62:69-76. [PMID: 31563008 DOI: 10.1016/j.sleep.2019.07.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/05/2019] [Accepted: 07/10/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Development induces changes in sleep, and its duration has been reported to change as a function of aging. Additionally, sleep timing is a marker of pubertal maturation, where during adolescence, the circadian rhythm shifts later. Typically, this is manifested in a later sleep onset in the evening and later awakening in the morning. These changes across development seem to be universal around the world but are unlikely to persist into adulthood. METHODS This study utilized accelerometer data from 17,355 participants aged 16-30 years (56% female) measured by validated Polar wearables over a 14-day period. We compared sleep duration, chronotype (sleep midpoint) and weekend catch-up (ie, social jetlag) sleep across ages and regions over 242,948 nights. RESULTS The data indicate a decline in sleep duration as well as a dramatic shift in sleep onset times throughout adolescence. This continues well into early adulthood and stabilizes nearer age 30. Differences in sleep duration across ages were significant, and ranged from 7:53 h at age 16 to 7:29 h at age 30 in the sample. Additionally, there was a clear difference between females and males throughout adolescence and young adulthood: girls had longer sleep duration and earlier timed sleep in the current study. Differences in sleep were found between regions across the world, and across European areas. CONCLUSIONS Both sleep duration and sleep timing go through a clear developmental pattern, particularly in early adulthood. Females had an earlier sleep midpoint and obtained more sleep. Regional differences in sleep occurred across the world.
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Affiliation(s)
- L Kuula
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland.
| | - M Gradisar
- School of Psychology, Flinders University, Adelaide, Australia
| | - K Martinmäki
- Polar Electro Oy, Research and Technology, Finland
| | - C Richardson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Australia
| | - D Bonnar
- School of Psychology, Flinders University, Adelaide, Australia
| | - K Bartel
- School of Psychology, Flinders University, Adelaide, Australia
| | - C Lang
- Department of Sport, Exercise and Health, Section Sport and Psychosocial Health, University of Basel, Switzerland
| | - L Leinonen
- Polar Electro Oy, Research and Technology, Finland
| | - A K Pesonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
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Abstract
: The accurate assessment of sleep is critical to better understand and evaluate its role in health and disease. The boom in wearable technology is part of the digital health revolution and is producing many novel, highly sophisticated and relatively inexpensive consumer devices collecting data from multiple sensors and claiming to extract information about users' behaviors, including sleep. These devices are now able to capture different biosignals for determining, for example, HR and its variability, skin conductance, and temperature, in addition to activity. They perform 24/7, generating overwhelmingly large data sets (big data), with the potential of offering an unprecedented window on users' health. Unfortunately, little guidance exists within and outside the scientific sleep community for their use, leading to confusion and controversy about their validity and application. The current state-of-the-art review aims to highlight use, validation and utility of consumer wearable sleep-trackers in clinical practice and research. Guidelines for a standardized assessment of device performance is deemed necessary, and several critical factors (proprietary algorithms, device malfunction, firmware updates) need to be considered before using these devices in clinical and sleep research protocols. Ultimately, wearable sleep technology holds promise for advancing understanding of sleep health; however, a careful path forward needs to be navigated, understanding the benefits and pitfalls of this technology as applied in sleep research and clinical sleep medicine.
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Affiliation(s)
| | - Nicola Cellini
- Department of General Psychology, University of Padova,
Padova, Italy
| | - Aimee Goldstone
- Center for Health Sciences, SRI International, Menlo Park,
CA, US
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park,
CA, US
- Melbourne School of Psychological Sciences, University of
Melbourne, Parkville, Victoria, Australia
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park,
CA, US
- Brain Function Research Group, School of Physiology,
University of the Witwatersrand, Johannesburg, South Africa
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Naseer W, Gul O, Saeed H, Qizilbash FH, Jawed Q, Mohsin SF, Fatima Haider SA, Nihal A, Farooq K, Kadri HM. Assessment and comparison of sleep patterns among medical and non-medical undergraduates of Karachi: A cross-sectional study - SPECIAL REPORT. J PAK MED ASSOC 2019; 69:917-921. [PMID: 31201409] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
To assess and compare patterns, habits and quality of sleep in undergraduate medical and non-medical students. The cross-sectional study was conducted from February to March, 2018, at Dow Medical College, Karachi, and Pakistan Air Force-Karachi Institute of Economics and Technology. Data was collected by self-reported questionnaires. Sleep quality of individuals was assessed using Pittsburg Sleep Quality Index. Data was analysed using SPSS 21. Of the 245 subjects, 137(55%) were medical students and 108(45%) were non-medical. Overall, 101(41.2%) subjects aid 8 hours of sleep was sufficient for them; 153(62.4%) reported daytime sleeping; and 168(68.5%) did not take naps. The duration of nap was >30 minutes in 118(48%) students. Factors affecting sleep were cited as electronic media 132(53.9%), caffeine 42(17.1%) and stress 126(51.4%). Of the total, 161(65.7%) subjects had poor sleep quality. There was no significant difference between medical and non-medical students (p>0.05). Majority of medical and non-medical undergraduate students were poor sleepers.
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Affiliation(s)
- Wajiha Naseer
- 5th Year Medical Student, Dow Medical College (DUHS), Karachi, Pakistan
| | - Owais Gul
- 5th Year Medical Student, Dow Medical College (DUHS), Karachi, Pakistan
| | - Hasham Saeed
- 5th Year Medical Student, Dow Medical College (DUHS), Karachi, Pakistan
| | | | - Qirat Jawed
- 5th Year Medical Student, Dow Medical College (DUHS), Karachi, Pakistan
| | | | | | - Arham Nihal
- 5th Year Medical Student, Dow Medical College (DUHS), Karachi, Pakistan
| | - Khatija Farooq
- 5th Year Medical Student, Dow Medical College (DUHS), Karachi, Pakistan
| | - Hasina Maham Kadri
- Department of Community Medicine, Dow Medical College (DUHS), Karachi, Pakistan
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49
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Abstract
Mobile phone use is often blamed for adolescent sleeping difficulties in the popular and scientific literature, with correlations observed between adolescents' mobile phone use and their bedtime. We aimed to obtain experimental evidence to support these causal claims. A within-subjects experiment (baseline, intervention) was conducted in adolescents' homes, to determine the effect of restricting adolescents' pre-bed mobile phone use on school night sleep habits. Following a baseline week, adolescents were given individualized phone stop times, 1 hour before bed for one school week. An online sleep diary was used to monitor bedtime, lights out time, sleep latency and total sleep. Sixty three adolescents (age range 14-18, M = 16.3, SD = 0.93yrs; 17%male) provided data. During one week of phone restriction, adolescents stopped using their phones earlier (80 min, p < .001), turned their lights off earlier (17 min, p = .01), and slept longer (21 min, p = .01). Participant recruitment was low (26%), indicating many adolescents lack motivation to negotiate changes to their evening phone use. Overall, there are potential benefits of restricted mobile phone use during the pre-sleep period, yet, future research is needed to identify non-technological interventions to increase adherence to phone restriction (e.g., motivational interviewing) or otherwise decrease pre-sleep arousal (e.g., cognitive strategies).
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Affiliation(s)
- K Bartel
- a School of Psychology , Flinders University
| | - R Scheeren
- b Department of Psychology , Maastricht University
| | - M Gradisar
- a School of Psychology , Flinders University
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50
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Miller MB, Chan WS, Curtis AF, Boissoneault J, Robinson M, Staud R, Berry RB, McCrae CS. Pain intensity as a moderator of the association between opioid use and insomnia symptoms among adults with chronic pain. Sleep Med 2018; 52:98-102. [PMID: 30296735 PMCID: PMC6246793 DOI: 10.1016/j.sleep.2018.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 05/07/2018] [Revised: 08/02/2018] [Accepted: 08/27/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Research documenting the impact of opioid use on sleep among individuals with chronic pain has been mixed. This study aimed to determine if pain intensity moderates the association between opioid use and insomnia symptoms among adults with comorbid symptoms of insomnia and chronic widespread pain. METHODS Participants (N = 144; 95% female; mean age = 51.6, SD = 11.4) completed assessments of insomnia symptoms, pain and use of sleep/pain medication. Multiple regression was used to determine if pain intensity moderates the association between opioid use (yes/no) sleep onset latency (SOL), wake after sleep onset (WASO), sleep quality, or time in bed. Analyses controlled for gender, symptoms of sleep apnea, symptoms of depression, use of sleep medication (yes/no), and use of non-opioid pain medication (yes/no). RESULTS Stronger pain intensity was associated with longer self-reported WASO and worse sleep quality, independent of opioid use. Conversely, opioid use was associated with longer time in bed, independent of pain intensity. Opioid use and pain intensity interacted in the prediction of SOL, such that opioid use (vs. non-use) was associated with longer SOL in the context of mild but not moderate to severe pain intensity. CONCLUSIONS Opioid use was associated with more difficulty falling asleep among adults with chronic pain; however, this cross-sectional effect was only significant among those reporting lower pain intensity. Authors speculate that this effect is masked among those with severe pain because the pain-related sleep debt they acquire throughout the night then facilitates sleep onset the next day.
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Affiliation(s)
- Mary Beth Miller
- Department of Psychiatry, University of Missouri School of Medicine, Columbia, MO, USA
| | - Wai Sze Chan
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Ashley F Curtis
- Department of Psychiatry, University of Missouri School of Medicine, Columbia, MO, USA
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Michael Robinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Roland Staud
- Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Richard B Berry
- Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Christina S McCrae
- Department of Psychiatry, University of Missouri School of Medicine, Columbia, MO, USA.
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