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Wang Z, Tang Y, Wang G, Deng Y, Jiang Y, Sun W, Sun X, Ip P, Owens J, Zhao M, Xiao Y, Jiang F, Wang G. Insufficient Sleep is Associated With Increasing Trends in Adolescent Suicidal Behaviors. J Adolesc Health 2024; 74:1198-1207. [PMID: 38506779 DOI: 10.1016/j.jadohealth.2024.01.030] [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: 06/07/2023] [Revised: 11/03/2023] [Accepted: 01/12/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE Youth suicide has been increasing and became a public health concern worldwide. Identifying insufficient sleep as the potential risk factor is critical to reducing suicide risk and increasing trends. This study aimed to determine whether insufficient sleep is associated with increasing trends in suicidal behaviors and disparities by sex, age, and race/ethnicity among school adolescents. METHODS The present study used biennial data from the US nationally representative Youth Risk Behavior Survey from 2007 to 2019. Joinpoint regression models were used to estimate biennial percent changes (BPCs) and average BPCs (ABPCs) of suicidal behaviors by sleep duration. Logistic regression models were used to examine the association between insufficient sleep and suicidal behaviors. RESULTS Of 73,356 adolescent students included (mean [standard deviation] age, 16.11 [1.23] years), 50.03% were female. Suicidal ideation and suicide plan among insufficient sleep group increased from 2007 to 2019 (BPC = 2.88% [95% confidence interval {CI}: 1.65%, 4.13%]; BPC = 3.42% [95% CI: 2.09%, 4.77%]), but were nonsignificant among sufficient sleep group. Trends in suicidal ideation (ABPC = 3.03% [95% CI: 1.35%, 4.73%]) and suicide plan (ABPC = 4.03% [95% CI: 2.47%, 5.62%]) among female adolescents with insufficient sleep increased, but nonsignificant among male adolescents with insufficient sleep. Suicidal ideation (ABPC = 1.73% [95% CI: 0.51%, 2.97%]) and suicide plan (ABPC = 2.31% [95% CI: 0.70%, 3.95%]) increased among younger adolescents only with insufficient sleep, whereas suicide trends by sleep duration were similar among older adolescents. Suicide plan among insufficient sleep group increased across the four racial groups, with BPC highest for the White (BPC = 3.48% [95% CI: 1.31%, 5.69%]), and lowest for the Hispanic/Latino (BPC = 1.18% [95% CI: 0.15%, 2.23%]), but were nonsignificant among sufficient sleep group except for the White (BPC = 2.83% [95% CI: 0.62%, 5.09%]). DISCUSSION Insufficient sleep was disproportionately associated with increasing trends in suicidal behaviors among female, younger, and non-White adolescent students. Ensuring sufficient sleep can potentially reduce suicide among school adolescents.
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Affiliation(s)
- Zijing Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yijia Tang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangshuai Wang
- Faculty Artificial Intelligence in Education, National Engineering Research Center of Educational Big Data, Central China Normal University, Wuhan, Hubei, China
| | - Yujiao Deng
- Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wanqi Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoning Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Psychology and Behavioral Science, Antai College of Economics and Management, Shanghai Jiao Tong University, Shanghai, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, China
| | - Judith Owens
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China
| | - Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine|NewYork-Presbyterian, New York, New York.
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
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Kang C, Lee W, Park C, Oh J, Min J, Park J, Choi M, Jang J, Kim H. Beneficial impacts of residential greenness on sleep deprivation in adults aged 19 or older living in South Korea: A nationwide community health survey in 2011-2018. Sci Total Environ 2024; 914:169700. [PMID: 38160836 DOI: 10.1016/j.scitotenv.2023.169700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/22/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Evidence of the relationship between greenness and sleep is limited, and, given the worsening sleep insufficiency worldwide, this relationship needs elucidation. In this study, we investigated the association of greenness with sleep deprivation using nationwide survey data. METHODS This study included 1,727,273 participants in the Korea Community Health Survey who resided in all 229 districts of South Korea from 2011 to 2018. Sleep deprivation variables were defined as strong deprivation or mild deprivation, based on average daily sleep duration of <5 or 5-6 h, respectively. District-specific annual average of satellite-derived enhanced vegetation index (EVI) was used as a green space exposure. A logistic regression with complex survey weights was used to estimate the association between greenness and sleep deprivation, and it was further examined by sex, age group, educational status, income level, and population density. The regression analysis was performed annually, and the annual estimates were pooled by a combined data analysis. RESULTS A higher level of greenness was associated (odds ratio [95 % confidence interval]) with strong and mild sleep deprivation (0.96 [0.93-0.99] and 0.96 [0.95-0.97]), respectively, and males and the younger age group (<65 years) showed a more prominent association with greenness than in females and the elderly group (65 years or older). In addition, only high-population-density areas showed evident associations of greenness with both strong and mild sleep deprivation. CONCLUSIONS This large population-based study provides important epidemiological evidence for improving sleep quantity through an increase in greenness exposure and supports policymakers in establishing strategies for urban planning.
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Affiliation(s)
- Cinoo Kang
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 50612, Republic of Korea.
| | - Chaerin Park
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Jieun Oh
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Jieun Min
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, 25 Magokdong-ro 2-gil, Ganseo-gu, Seoul 07804, Republic of Korea.
| | - Jinah Park
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Munjeong Choi
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Jeongju Jang
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Ho Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
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Faraut B, Pitron V. [Sleep debt epidemic]. Rev Prat 2024; 74:281. [PMID: 38551868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Affiliation(s)
- Brice Faraut
- Université Paris-Cité, UPR VIFASOM (Vigilance, fatigue, sommeil et santé publique), Paris, France Centre du sommeil et de la vigilancepathologie professionnelle, Hôtel-Dieu, AP-HP, Paris, France
| | - Victor Pitron
- Université Paris-Cité, UPR VIFASOM (Vigilance, fatigue, sommeil et santé publique), Paris, France Centre du sommeil et de la vigilancepathologie professionnelle, Hôtel-Dieu, AP-HP, Paris, France
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Xiong B, Wang J, He R, Qu G. Composite dietary antioxidant index and sleep health: a new insight from cross-sectional study. BMC Public Health 2024; 24:609. [PMID: 38408934 PMCID: PMC10895802 DOI: 10.1186/s12889-024-18047-2] [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: 09/19/2023] [Accepted: 02/08/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Low-quality sleep and obstructive sleep apnea (OSA) can result in series of chronic diseases. Healthy diet has been considered as an effective and simple strategy to optimize sleep quality. However, current evidence on the correlation of dietary composite antioxidant intake with sleep health remained obscure. AIM OF THE STUDY To determine the relationship of composite dietary antioxidant index (CDAI) and sleep health. METHODS Cross-sectional analyses were based on National Health and Nutrition Examination Survey (NHANES) 2005-2008. Dietary consumption was assessed by trained staff using 24-h diet recall method and CDAI was calculated based on previous validated approach that included six antioxidants. Sleep-related outcomes were self-reported by a set of questionnaires and classified into OSA, day sleepiness, and insufficient sleep. Weighted logistic regression was conducted to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) regressions were also used to evaluate the dose-response of CDAI and three sleep-related outcomes. RESULTS A total of 7274 subjects included (mean age: 46.97 years) were enrolled in our study, including 3658 were females (52.54%) and 3616 were males (47.46%). Of them, 70.6%, 29.51%, and 35.57% of the subjects reported that they had OSA, day sleepiness and insufficient sleep, respectively. Logistic regression showed the highest quartile of CDAI was inversely associated with the risk of OSA (OR: 0.69, 95%CI: 0.49-0.97), day sleepiness (OR: 0.64, 95%CI: 0.44-0.94) and insufficient sleep (OR: 0.68, 95%CI: 0.50-0.92) compared with the lowest quartile. RCS showed linear relationship of CDAI and insufficient sleep but non-linear relationship of CDAI with OSA and day sleepiness. CONCLUSIONS Our results show that CDAI was non-linearly associated with lower risk of OSA and day sleepiness whereas a linear inverse association between CDAI and insufficient sleep was observed. These findings implicate that combined intake of antioxidants could be a promising and effective approach to optimize sleep quality for public.
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Affiliation(s)
- Bingquan Xiong
- Department of Cardiology, The Second Affilliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China
| | - Jiaxin Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Jinan University, No.613, Huangpu Road, Guangzhou, Guangdong Province, 510632, China
| | - Rui He
- Department of Respiratory and Critical Care Medicine, The Second Affilliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China
| | - Guangsu Qu
- Department of Cardiology, The Second Affilliated Hospital of Chongqing Medical University, No.74, Linjiang Road, Chonqing, 400010, China.
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Miyamoto M, Shibuya K. Sleep duration has a limited impact on the prevalence of menstrual irregularities in athletes: a cross-sectional study. PeerJ 2024; 12:e16976. [PMID: 38374951 PMCID: PMC10875987 DOI: 10.7717/peerj.16976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
Background This study aimed to investigate the relationship between the prevalence of menstrual irregularities, energy intake, and sleep deprivation among female athletes. Methods A total of 128 female athletes, with an average age of 19.2 ± 1.2 years, participated in the study and tracked their food intake over a three-day period. Menstrual status and sleep duration were assessed using a questionnaire, and psychological anxiety was evaluated using the State and Trait Anxiety Inventory (STAI). These were measured once during the investigation. The impact of sleep status on state anxiety and daily energy intake was examined using the T-test. A generalized linear model (GLM) with a log link function was employed to investigate the effects of sleep deprivation on the presence of menstrual irregularities. Results As the results of the present study, sleep deprivation significant increased both state and trait anxiety (p < 0.05), as well as affecting energy intake (p < 0.05), particularly protein and carbohydrate intakes (p < 0.05). However, GLM analysis indicated that while sleep deprivation did not directly influence the prevalence of menstrual irregularities (p > 0.05), state anxiety emerged as a significant factor impacting the prevalence of menstrual irregularities (p < 0.05). Conclusions The results of the present study suggest a potential pathway wherein sleep deprivation might elevate state anxiety levels, consequently indirectly contributing to an increase the probability of menstrual irregularities. In conclusion, the results of the presents study provide novels insights suggesting that sleep deprivation might directly increase state anxiety and indirectly affect the prevalence of menstrual irregularities. Hence, decreased sleep duration might be related to mental health issues and the prevalence of menstrual irregularities both significant concerns among female athletes. Future studies will play a crucial role in further elucidating how sleep patterns impact the health and well-being of female athletes.
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Affiliation(s)
- Mana Miyamoto
- Department of Health and Nutrition, Niigata University of Health and Welfare, Niigata, Japan
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan
| | - Kenichi Shibuya
- Department of Health and Nutrition, Niigata University of Health and Welfare, Niigata, Japan
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan
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Harris E. Even Mild Lack of Sleep Might Raise Women's Diabetes Risk. JAMA 2023; 330:2331-2332. [PMID: 38055296 DOI: 10.1001/jama.2023.24174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
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Guo C, Piao S, Wang C, Yu L, Wang K, Qu Q, Zhang C, Yu X. The prevalence and associated factors of sleep deprivation among healthy college students in China: a cross-sectional survey. PeerJ 2023; 11:e16009. [PMID: 37744238 PMCID: PMC10512935 DOI: 10.7717/peerj.16009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/09/2023] [Indexed: 09/26/2023] Open
Abstract
Background The prevalence of sleep deprivation among college students is increasing and has a few associated factors. Methods The present study analyzed 2,142 college students from 28 provinces in China. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep duration. Binary logistic regression was conducted to explore the sleep deprivation related factors. Age and gender were controlled as covariates. Results Among the 2,142 college students (27.7% male, 72.3% female), 1,620 (75.6%) reported the average sleep duration was below 7 h per day for one month, 49.3% (1,055/2,142) slept 6∼7 h (contains 6 h), 21.0% (449/2,142) slept 5∼6 h (contains 5 h), and 5.4% (116/2,142) slept <5 h. Age increased the risk of sleep deprivation, the adjusted odds ratio = 1.05 (95% CI [1.01∼1.10]). The adjusted odds ratio (A-OR) for sleep deprivation was higher for students of more than 60 min nap duration per day (A-OR = 2.35, 95% CI [1.45∼3.80]), and age growth (A-OR = 1.05, 95% CI [1.01∼1.10]). In contrast, A-ORs were lower among sleeping inconsistency between work and rest days (A-OR = 0.61, 95% CI [0.49∼0.75]), accustomed to staying up late (A-OR = 0.45, 95% CI [0.36∼0.57]), staying up late to work or study (A-OR = 0.62, 95% CI [0.49∼0.78]), stress (A-OR = 0.75, 95% CI [0.58∼0.98]), and repeated thoughts in bed had (A-OR = 0.79, 95% CI [0.62∼0.99]). Conclusions Sleep deprivation is extremely common among healthy college students in China. It is necessary to perform methods maintaining enough sleep due to the current high incidence of sleep deprivation. Controlling the nap duration and getting enough sleep on rest days to replace missing hours of sleep on workdays might improve college students' sleep.
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Affiliation(s)
- Congcong Guo
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Songzhe Piao
- Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Linhai, Zhejiang, China
| | - Chenyu Wang
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Lili Yu
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, China
| | - Kejun Wang
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Qian Qu
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Cuiting Zhang
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Xiaofei Yu
- School of Integrated Traditional Chinese and Western Medicine, Binzhou Medical University, Yantai, Shandong, China
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Affiliation(s)
- Alberto R Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, University of Miami Health System, 1120 NW 14th St, Miami, FL 33136
| | - Anne G Wheaton
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Taylor RW, Haszard JJ, Jackson R, Morrison S, Beebe DW, Meredith-Jones KA, Elder DE, Galland BC. Effect of Sleep Changes on Health-Related Quality of Life in Healthy Children: A Secondary Analysis of the DREAM Crossover Trial. JAMA Netw Open 2023; 6:e233005. [PMID: 36920394 PMCID: PMC10018327 DOI: 10.1001/jamanetworkopen.2023.3005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
IMPORTANCE Little is known regarding the effect of poor sleep on health-related quality of life (HRQOL) in healthy children. OBJECTIVE To determine the effect of induced mild sleep deprivation on HRQOL in children without major sleep issues. DESIGN, SETTING, AND PARTICIPANTS This prespecified secondary analysis focused on HRQOL, a secondary outcome of the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized crossover trial of children who underwent alternating weeks of sleep restriction and sleep extension and a 1-week washout in between. The DREAM trial intervention was administered at participants' homes between October 2018 and March 2020. Participants were 100 children aged 8 to 12 years who lived in Dunedin, New Zealand; had no underlying medical conditions; and had parent- or guardian-reported normal sleep (8-11 hours/night). Data were analyzed between July 4 and September 1, 2022. INTERVENTIONS Bedtimes were manipulated to be 1 hour later (sleep restriction) and 1 hour earlier (sleep extension) than usual for 1 week each. Wake times were unchanged. MAIN OUTCOMES AND MEASURES All outcome measures were assessed during both intervention weeks. Sleep timing and duration were assessed using 7-night actigraphy. Children and parents rated the child's sleep disturbances (night) and impairment (day) using the 8-item Pediatric Sleep Disturbance and 8-item Sleep-Related Impairment scales of the Patient-Reported Outcomes Measurement Information System questionnaire. Child-reported HRQOL was assessed using the 27-item KIDSCREEN questionnaire with 5 subscale scores and a total score. Both questionnaires assessed the past 7 days at the end of each intervention week. Data were presented as mean differences and 95% CIs between the sleep restriction and extension weeks and were analyzed using intention to treat and an a priori difference in sleep of at least 30 minutes per night. RESULTS The final sample comprised 100 children (52 girls [52%]; mean [SD] age, 10.3 [1.4] years). During the sleep restriction week, children went to sleep 64 (95% CI, 58-70) minutes later, and sleep offset (wake time) was 18 (95% CI, 13-24) minutes later, meaning that children received 39 (95% CI, 32-46) minutes less of total sleep per night compared with the sleep extension week in which the total sleep time was 71 (95% CI, 64-78) minutes less in the per-protocol sample analysis. Both parents and children reported significantly less sleep disturbance at night but greater sleep impairment during the day with sleep restriction. Significant standardized reductions in physical well-being (standardized mean difference [SMD], -0.28; 95% CI, -0.49 to -0.08), coping in a school environment (SMD, -0.26; 95% CI, -0.42 to -0.09), and total HRQOL score (SMD, -0.21; 95% CI, -0.34 to -0.08) were reported by children during sleep restriction, with an additional reduction in social and peer support (SMD, -0.24; 95% CI, -0.47 to -0.01) in the per-protocol sample analysis. CONCLUSIONS AND RELEVANCE Results of this secondary analysis of the DREAM trial indicated that even 39 minutes less of sleep per night for 1 week significantly reduced several facets of HRQOL in children. This finding shows that ensuring children receive sufficient good-quality sleep is an important child health issue. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12618001671257.
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Affiliation(s)
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Dean W. Beebe
- Department of Neuropsychology, Cincinnati Children’s Hospital Medical Centre, Cincinnati, Ohio
| | | | - Dawn E. Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
| | - Barbara C. Galland
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
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Tong H, Warren JL, Kang J, Li M. Using multi-sourced big data to correlate sleep deprivation and road traffic noise: A US county-level ecological study. Environ Res 2023; 220:115029. [PMID: 36495963 DOI: 10.1016/j.envres.2022.115029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Road traffic noise is a serious public health problem globally as it has adverse psychological and physiologic effects (i.e., sleep). Since previous studies mainly focused on individual levels, we aim to examine associations between road traffic noise and sleep deprivation on a large scale; namely, the US at county level. METHODS Information from a large-scale sleep survey and national traffic noise map, both obtained from government's open data, were utilized and processed with Geographic Information System (GIS) techniques. To examine the associations between traffic noise and sleep deprivation, we used a hierarchical Bayesian spatial modelling framework to simultaneously adjust for multiple socioeconomic factors while accounting for spatial correlation. FINDINGS With 62.90% of people not getting enough sleep, a 10 dBA increase in average sound-pressure level (SPL) or Ls10 (SPL of the relatively noisy area) in a county, was associated with a 49% (OR: 1.49; 95% CrIs:1.19-1.86) or 8% (1.08; 1.00-1.16) increase in the odds of a person in a particular county not getting enough sleep. No significant association was observed for Ls90 (SPL of the relatively quiet area). A 10% increase in noise exposure area or population ratio was associated with a 3% (1.03; 1.01-1.06) or 4% (1.04; 1.02-1.06) increase in the odds of a person within a county not getting enough sleep. INTERPRETATION Traffic noise can contribute to variations in sleep deprivation among counties. This study suggests that policymakers could set up different noise-management strategies for relatively quiet and noisy areas and incorporate geospatial noise indicators, such as exposure population or area ratio. Furthermore, urban planners should consider urban sprawl patterns differently in terms of noise-induced sleep problems.
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Affiliation(s)
- Huan Tong
- School of Architecture, Harbin Institute of Technology, Shenzhen, China; Institute for Environmental Design and Engineering, The Bartlett, University College London, London, UK.
| | - Joshua L Warren
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, USA.
| | - Jian Kang
- Institute for Environmental Design and Engineering, The Bartlett, University College London, London, UK.
| | - Mingxiao Li
- School of Architecture and Urban Planning, Shenzhen University, Shenzhen, China.
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Full KM, Huang T, Shah NA, Allison MA, Michos ED, Duprez DA, Redline S, Lutsey PL. Sleep Irregularity and Subclinical Markers of Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis. J Am Heart Assoc 2023; 12:e027361. [PMID: 36789869 PMCID: PMC10111477 DOI: 10.1161/jaha.122.027361] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [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: 09/07/2022] [Accepted: 12/02/2022] [Indexed: 02/16/2023]
Abstract
Background Sleep irregularity has been linked to incident cardiovascular disease. Less is known about associations of sleep regularity with atherosclerosis. We examined cross-sectional associations of actigraphy-assessed sleep duration and sleep timing regularity with subclinical atherosclerosis in the community-based MESA (Multi-Ethnic Study of Atherosclerosis). Methods and Results MESA Sleep Ancillary Study participants (N=2032; mean age, 68.6±9.2 years; 37.9% White) completed 7-day wrist actigraphy. Participants underwent assessments of coronary artery calcium, carotid plaque presence, carotid intima-media thickness, and the ankle-brachial index. Sleep regularity was quantified by the 7-day with-in person SD of sleep duration and sleep onset timing. Relative risk regression models were used to calculate prevalence ratios and 95% CIs. Models are adjusted for demographics, cardiovascular disease risk factors, and other objectively assessed sleep characteristics including obstructive sleep apnea, sleep duration, and sleep fragmentation. After adjustment, compared with participants with more regular sleep durations (SD ≤60 minutes), participants with greater sleep duration irregularity (SD >120 minutes) were more likely to have high coronary artery calcium burden (>300; prevalence ratio, 1.33 [95% CI, 1.03-1.71]) and abnormal ankle-brachial index (<0.9; prevalence ratio, 1.75 [95% CI, 1.03-2.95]). Compared with participants with more regular sleep timing (SD ≤30 minutes), participants with irregular sleep timing (SD >90 minutes) were more likely to have high coronary artery calcium burden (prevalence ratio, 1.39 [95% CI, 1.07-1.82]). Associations persisted after adjustment for cardiovascular disease risk factors and average sleep duration, obstructive sleep apnea, and sleep fragmentation. Conclusions Sleep irregularity, particularly sleep duration irregularity, was associated with several measures of subclinical atherosclerosis. Sleep regularity may be a modifiable target for reducing atherosclerosis risk. Future investigation into cardiovascular risk reduction interventions targeting sleep irregularity may be warranted.
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Affiliation(s)
- Kelsie M. Full
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMN
| | - Tianyi Huang
- Channing Division of Network Medicine, Brigham and Women’s HospitalHarvard UniversityBostonMA
- Division of Sleep MedicineHarvard Medical SchoolBostonMA
| | - Neomi A. Shah
- Division of Pulmonary, Critical Care and Sleep MedicineIcahn School of Medicine at Mount SinaiNew YorkNY
| | - Matthew A. Allison
- Division of Preventive MedicineUniversity of California San DiegoSan DiegoCA
| | - Erin D. Michos
- Division of CardiologyJohns Hopkins School of MedicineBaltimoreMD
| | - Daniel A. Duprez
- Cardiovascular DivisionUniversity of Minnesota School of MedicineMinneapolisMN
| | - Susan Redline
- Division of Sleep MedicineHarvard Medical SchoolBostonMA
- Brigham and Women’s Hospital, Division of Sleep and Circadian DisordersHarvard Medical SchoolBostonMA
| | - Pamela L. Lutsey
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMN
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12
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Chaput JP, McHill AW, Cox RC, Broussard JL, Dutil C, da Costa BGG, Sampasa-Kanyinga H, Wright KP. The role of insufficient sleep and circadian misalignment in obesity. Nat Rev Endocrinol 2023; 19:82-97. [PMID: 36280789 PMCID: PMC9590398 DOI: 10.1038/s41574-022-00747-7] [Citation(s) in RCA: 77] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 01/21/2023]
Abstract
Traditional risk factors for obesity and the metabolic syndrome, such as excess energy intake and lack of physical activity, cannot fully explain the high prevalence of these conditions. Insufficient sleep and circadian misalignment predispose individuals to poor metabolic health and promote weight gain and have received increased research attention in the past 10 years. Insufficient sleep is defined as sleeping less than recommended for health benefits, whereas circadian misalignment is defined as wakefulness and food intake occurring when the internal circadian system is promoting sleep. This Review discusses the impact of insufficient sleep and circadian misalignment in humans on appetite hormones (focusing on ghrelin, leptin and peptide-YY), energy expenditure, food intake and choice, and risk of obesity. Some potential strategies to reduce the adverse effects of sleep disruption on metabolic health are provided and future research priorities are highlighted. Millions of individuals worldwide do not obtain sufficient sleep for healthy metabolic functions. Furthermore, modern working patterns, lifestyles and technologies are often not conducive to adequate sleep at times when the internal physiological clock is promoting it (for example, late-night screen time, shift work and nocturnal social activities). Efforts are needed to highlight the importance of optimal sleep and circadian health in the maintenance of metabolic health and body weight regulation.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada.
- Department of Paediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Andrew W McHill
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Rebecca C Cox
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Josiane L Broussard
- Sleep and Metabolism Laboratory, Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Caroline Dutil
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Bruno G G da Costa
- Research Center in Physical Activity and Health, Department of Physical Education, School of Sports, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Hugues Sampasa-Kanyinga
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kenneth P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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13
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Magnavita N, Di Prinzio RR, Meraglia I, Vacca ME, Soave PM, Di Stasio E. Sleep in Residents: A Comparison between Anesthesiology and Occupational Medicine Interns. Int J Environ Res Public Health 2023; 20:2356. [PMID: 36767721 PMCID: PMC9915358 DOI: 10.3390/ijerph20032356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Sleep deprivation is a significant risk to the health and judgment of physicians. We wanted to investigate whether anesthesiology residents (ARs) who work only one night shift per week have different physical and mental health from occupational medicine residents (OMRs) who do not work at night. A total of 21 ARs and 16 OMRs attending a university general hospital were asked to wear an actigraph to record sleep duration, heart rate and step count and to complete a questionnaire for the assessment of sleep quality, sleepiness, fatigue, occupational stress, anxiety, depression and happiness. ARs had shorter sleep duration than OMRs; on average, they slept 1 h and 20 min less (p < 0.001). ARs also had greater daytime sleepiness, a higher heart rate and lower happiness than OMRs. These results should be interpreted with caution given the cross-sectional nature of the study and the small sample size, but they are an incentive to promote sleep hygiene among residents.
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Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Woman, Child & Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Reparata Rosa Di Prinzio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Eugenia Vacca
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Paolo Maurizio Soave
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Emergency, Anesthesiology and Resuscitation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Enrico Di Stasio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Diagnostic and Laboratory Medicine, Unity of Chemistry, Biochemistry and Clinical Molecular Biology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Department of Basic Biotechnological Sciences, Intensive Care and Perioperative Clinics Research, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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14
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Zapata I, Maté-Muñoz JL, Higueras A, Hernández-Lougedo J, Martín-Fidalgo N, García-Fernández P, Redondo-Vega MV, Ruiz-Tovar J. Toxic Habits and Well-Being Measures in Spanish Healthcare University Students during the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:ijerph192013213. [PMID: 36293793 PMCID: PMC9603594 DOI: 10.3390/ijerph192013213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND Unhealthy lifestyles are strongly entrenched in healthcare universities and have sometimes been linked to stress or lack of sleep. This study investigated the prevalence of toxic habits (smoking, patterns of harmful alcohol use, and illicit drug use), stress levels, perceived health status, and sleep duration and assessed the connections between toxic habits and said well-being measures, as well as healthcare students' perception of the influence of the COVID-19 pandemic on these health-related behaviors. METHODS In a cross-sectional study, healthcare students from Alfonso X University (Spain) completed a health survey composed of Alcohol Use Disorders Identification Test (AUDIT-C), Perceived Stress Scale (PSS-10), self-perceived health status, and the number of hours of sleep. RESULTS A total of 997 healthcare students completed the survey, of which 982 were analyzed. Being a smoker (32.2%) was associated with worse health status and insufficient sleep. Risk drinkers (33.2%) were associated with being female, and the consumption of cannabinoids (6.7%), with being male. These three toxic habits were related to each other. High levels of stress (28.2%) were correlated with worse ratings in the perception of health status (29.2%) and with insufficient sleep (45.8%), and all of them were associated with the female sex. Respectively, 49.3% and 44.2% of students recognized a worsening in their perception of stress and their sleep habits during the pandemic. CONCLUSION Healthcare universities must carry out health promotion programs for stress management, sleep habits, and unhealthy lifestyles.
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Affiliation(s)
- Irene Zapata
- Department of Medicine, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - José Luis Maté-Muñoz
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
| | | | - Juan Hernández-Lougedo
- Department of Physical Activity and Sports Science, Alfonso X El Sabio University, 28691 Madrid, Spain
| | | | - Pablo García-Fernández
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
- IdISSC, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
| | | | - Jaime Ruiz-Tovar
- Department of Medicine, Alfonso X El Sabio University, 28691 Madrid, Spain
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15
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Abdalla RN, Ansari SA, Hurley MC, Attarian H, Fargen KM, Hirsch JA, Cantrell DR, Curl PK, Daves PR, Shaibani A. Correlation of Call Burden and Sleep Deprivation with Physician Burnout, Driving Crashes, and Medical Errors among US Neurointerventionalists. AJNR Am J Neuroradiol 2022; 43:1286-1291. [PMID: 36007952 PMCID: PMC9451637 DOI: 10.3174/ajnr.a7606] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/27/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE High call frequency can lead to inadequate sleep, fatigue, and burnout, resulting in detrimental effects on physicians and patients. We aimed to assess the correlation between the frequency and burden of neurointerventional surgery calls and sleep deprivation with physician burnout, physical and driving safety, and fatigue-related medical errors. MATERIALS AND METHODS We sent an online questionnaire to the members of the 2 neurointerventional surgery societies comprising 50 questions and spanning 3 main topics: 1) overnight/weekend call burden, 2) sleeping patterns, and 3) Copenhagen Burnout Inventory. RESULTS One hundred sixty-four surveys were completed. Most (54%) neurointerventional surgeons reported burnout. Call burden of ≥1 every 3 days and being in practice >10 years were independent predictors of burnout. Thirty-nine percent reported falling asleep at the wheel, 23% reported a motor vehicle crash/near-crash, and 34% reported medical errors they considered related to call/work fatigue. On multivariate logistic regression, high call burden (called-in >3 times/week) was an independent predictor of sleeping at the wheel and motor vehicle crashes. Reporting <4 hours of uninterrupted sleep was an independent predictor of motor vehicle crashes and medical errors. Most neurointerventional surgeons recommended a maximum call frequency of once every 3 days. CONCLUSIONS Call frequency and burden, number of years in practice, and sleep deprivation are associated with burnout of neurointerventional surgeons, sleeping at the wheel, motor vehicle crashes, and fatigue-related medical errors. These findings contribute to the increasing literature on physician burnout and may guide future societal recommendations related to call burden in neurointerventional surgery.
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Affiliation(s)
- R N Abdalla
- From the Departments of Radiology (R.N.A., S.A.A., D.R.C., A.S.)
- Neurological Surgery (R.N.A., S.A.A., A.S.)
- Department of Radiology (R.N.A.), Ain Shams University, Cairo, Egypt
| | - S A Ansari
- From the Departments of Radiology (R.N.A., S.A.A., D.R.C., A.S.)
- Neurology (S.A.A.)
- Neurological Surgery (R.N.A., S.A.A., A.S.)
| | - M C Hurley
- Department of Radiology (M.C.H.), University of Chicago, Chicago, Illinois
| | - H Attarian
- Sleep Medicine (H.A.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - K M Fargen
- Department of Neurosurgery (K.M.F.), Wake Forest University, Winston-Salem, North Carolina
| | - J A Hirsch
- Department of Radiology (J.A.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - D R Cantrell
- From the Departments of Radiology (R.N.A., S.A.A., D.R.C., A.S.)
| | - P K Curl
- Department of Radiology (P.K.C.), University of Washington, Seattle, Washington
| | - P R Daves
- Department of Finance (P.R.D.), University of Tennessee, Knoxville, Tennessee
| | - A Shaibani
- From the Departments of Radiology (R.N.A., S.A.A., D.R.C., A.S.)
- Neurological Surgery (R.N.A., S.A.A., A.S.)
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16
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Jinghong Y, Junaid Irshad M, Irshad M, Khalil I, Zahoor S, Akram M, Muddasar Saeed M, Jafari-Sales A, Elbossaty WF, Said MB, Aharwal RP, Hamid GA, Mbaye EHS, El-Ashram S, Ataa AMA, Kiliç Ö. Impact of the coronavirus pandemic on mental prosperity of medical care laborers in tertiary consideration hospital: A case report. Medicine (Baltimore) 2022; 101:e29485. [PMID: 35960123 PMCID: PMC9370247 DOI: 10.1097/md.0000000000029485] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/04/2022] [Accepted: 05/05/2022] [Indexed: 01/04/2023] Open
Abstract
Since the outbreak of the Corona pandemic in December 2019, many people affected, especially medical care laborers, who deal with the treated cases. Coronavirus disease 2019 not only affects the body parts, but also extends to the psychological symptoms. The purpose of this research is to explore the impact of the pandemic on the mental prosperity of the laborers. Clinical staff members from the administration emergency clinic, Lahore, were enlisted. A poll was used to collect data on the segment information, a sleeping disorder, despondency and stress manifestations. Correlation of the segment information and the mental factors were done among the sleeping and non-sleeping disorder samples. All 356 medical service laborers were selected for this investigation. There were manifestations of misery in 222 (62.35%), nervousness in 227 (64.76%), stress in 197 (55.33%) and sleep deprivation in 190 (53.37%) of members. Gentle to extreme side effects of melancholy (91.65% vs 28.9%), nervousness (83.1% vs 41.6%) and stress (84.26% vs 22.22%) were seen predominately in the sleep deprivation gathering (P < .001). Insomnia was more pronounced in the members with low training levels (78.08%) versus post-advanced education (30.9%). Paramedics, attendants, and medical service laborers in confinement/serious consideration units were more inclined to the sleep deprivation (P < .001). Mental prosperity of medical care laborers was influenced because of Coronavirus pandemic. Attendants, paramedics, and those working in the detachment unit showed a critical sleeping disorder. The results and indicators have proven that there is a relationship between the infection with the Corona pandemic and occurrence of disorders in psychological behavior. Therefore, the psychological rehabilitation sessions must be conducted for those infected and those in contact with the Corona cases to relieve the burden of that patients to raise their psychological conditions and support the immune system such that resist against the infection.
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Affiliation(s)
- Yao Jinghong
- Department of Primary Education, College of Humanities and Teacher Education, Wuyi University, Wuyishan City, China
| | - Muhammad Junaid Irshad
- Department of Biochemistry, Faculty of Health Sciences, Hazara University Mansehra KPK, Mansehra, Pakistan
| | - Moin Irshad
- Department of Microbiology, Faculty of Health Sciences, Hazara University Mansehra KPK, Mansehra, Pakistan
| | - Ibrahim Khalil
- Department of Biochemistry, Faculty of Health Sciences, Hazara University Mansehra KPK, Mansehra, Pakistan
| | - Shiza Zahoor
- Department of Allied Health Sciences, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Muddasar Saeed
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Abolfazl Jafari-Sales
- Department of Biology and Microbiology School of Basic Sciences, Kazerun Branch, Islamic Azad University, Kazerun, Iran
| | | | - Mourad Ben Said
- Service de Microbiologie et Immunologie, Ecole Nationale de Médecine Vétérinaire, University Manouba, Sidi Thabet, Tunisia
- Institut Supérieur de Biotechnologie de Sidi Thabet, Département des Sciences Fondamentales, University Manouba, Sidi Thabet, Tunisia
| | | | - Gamal Abdul Hamid
- Faculty of Medicine & Health Sciences, University of Aden, Aden, Yemen
| | - El Hadji Seydou Mbaye
- BCNet international working group, International Agency for Research on Cancer, World Health Organization, Dakar, Senegal
| | - Saeed El-Ashram
- School of Life Science and Engineering, Foshan University, Foshan, China
- Faculty of Science, Kafrelsheikh University, Kafr el-Sheikh, Egypt
| | - Asaad Mohammed A. Ataa
- Department of Biochemical Technology, Faculty of Applied Science, Thamar University, Dhamar, Yemen
| | - Ömer Kiliç
- Adiyaman University, Pharmacy Faculty, Adiyaman, Turkey
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17
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Casjens S, Brenscheidt F, Tisch A, Beermann B, Brüning T, Behrens T, Rabstein S. Social jetlag and sleep debts are altered in different rosters of night shift work. PLoS One 2022; 17:e0262049. [PMID: 34995309 PMCID: PMC8740972 DOI: 10.1371/journal.pone.0262049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/15/2021] [Indexed: 12/17/2022] Open
Abstract
Background Night and shift work are suspected to cause various adverse effects on health and sleep. Sleep deprivation through shift work is assumed to be compensated on free days. So far it is not clear how different shift systems and shift lengths affect sleep structure on work and free days. Especially working night shifts disrupts the circadian rhythm but also extended working hours (12h) might affect sleep characteristics. Hitherto, the magnitude of sleep debt, social jetlag, and Locomotor Inactivity During Sleep (LIDS) in different shift systems is unknown. Methods Here, we investigated the impact of five different shift rosters on sleep in 129 industrial workers from Germany. Permanent night work with multiple shift systems with and without night shifts and with different shift lengths were compared. Wrist-activity was monitored over 28 days revealing sleep on- and offsets as well as LIDS as proxy for sleep quality. Overall, 3,865 sleep bouts comprising 22,310 hours of sleep were examined. Results The mean daily age-adjusted sleep duration (including naps) was 6:43h and did not differ between shift workers of different rosters. However, sleep duration on workdays was particularly low in rotational shift systems with 12h-shifts (5:00h), while overall sleep debt was highest. Shift workers showed a median absolute social jetlag of 3:03h, which differed considerably between shift types and rosters (p<0.0001). Permanent night workers had the highest social jetlag (5:08h) and latest mid-sleeps on workdays and free days. Sleep quality was reduced in permanent night shift workers compared with shift workers in other rosters and differed between daytime and nighttime sleep. Conclusions Shift work leads to partial sleep deprivation, which particularly affects workers in 12h-shifts and permanent night shifts. Working these shifts resulted in higher sleep debts and larger absolute social jetlag whereas sleep quality was especially reduced in permanent night shift workers compared with shift workers of other rosters.
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Affiliation(s)
- Swaantje Casjens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
- * E-mail:
| | - Frank Brenscheidt
- Federal Institute for Occupational Safety and Health (BAuA), Dortmund, Germany
| | - Anita Tisch
- Federal Institute for Occupational Safety and Health (BAuA), Dortmund, Germany
| | - Beate Beermann
- Federal Institute for Occupational Safety and Health (BAuA), Dortmund, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Sylvia Rabstein
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
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18
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O'Mara S. Correcting the record: Extended sleep deprivation is torture, and sleep deprivation impairs, rather than facilitates, interrogations and investigative interviews. Int J Soc Psychiatry 2022; 68:230-231. [PMID: 33375860 DOI: 10.1177/0020764020985549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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19
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Bonilla-Jaime H, Zeleke H, Rojas A, Espinosa-Garcia C. Sleep Disruption Worsens Seizures: Neuroinflammation as a Potential Mechanistic Link. Int J Mol Sci 2021; 22:12531. [PMID: 34830412 PMCID: PMC8617844 DOI: 10.3390/ijms222212531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
Sleep disturbances, such as insomnia, obstructive sleep apnea, and daytime sleepiness, are common in people diagnosed with epilepsy. These disturbances can be attributed to nocturnal seizures, psychosocial factors, and/or the use of anti-epileptic drugs with sleep-modifying side effects. Epilepsy patients with poor sleep quality have intensified seizure frequency and disease progression compared to their well-rested counterparts. A better understanding of the complex relationship between sleep and epilepsy is needed, since approximately 20% of seizures and more than 90% of sudden unexpected deaths in epilepsy occur during sleep. Emerging studies suggest that neuroinflammation, (e.g., the CNS immune response characterized by the change in expression of inflammatory mediators and glial activation) may be a potential link between sleep deprivation and seizures. Here, we review the mechanisms by which sleep deprivation induces neuroinflammation and propose that neuroinflammation synergizes with seizure activity to worsen neurodegeneration in the epileptic brain. Additionally, we highlight the relevance of sleep interventions, often overlooked by physicians, to manage seizures, prevent epilepsy-related mortality, and improve quality of life.
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Affiliation(s)
- Herlinda Bonilla-Jaime
- Departamento de Biología de la Reproducción, Área de Biología Conductual y Reproductiva, Universidad Autónoma Metropolitana-Iztapalapa, Ciudad de Mexico CP 09340, Mexico;
| | - Helena Zeleke
- Neuroscience and Behavioral Biology Program, College of Arts and Sciences, Emory University, Atlanta, GA 30322, USA;
| | - Asheebo Rojas
- Department of Pharmacology and Chemical Biology, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Claudia Espinosa-Garcia
- Department of Pharmacology and Chemical Biology, School of Medicine, Emory University, Atlanta, GA 30322, USA
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20
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Wheaton AG, Claussen AH. Short Sleep Duration Among Infants, Children, and Adolescents Aged 4 Months-17 Years - United States, 2016-2018. MMWR Morb Mortal Wkly Rep 2021; 70:1315-1321. [PMID: 34555000 PMCID: PMC8459893 DOI: 10.15585/mmwr.mm7038a1] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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21
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Gruba G, Kasiak PS, Gębarowska J, Adamczyk N, Sikora Z, Jodczyk AM, Mamcarz A, Śliż D. PaLS Study of Sleep Deprivation and Mental Health Consequences of the COVID-19 Pandemic among University Students: A Cross-Sectional Survey. Int J Environ Res Public Health 2021; 18:9581. [PMID: 34574505 PMCID: PMC8464860 DOI: 10.3390/ijerph18189581] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/04/2021] [Accepted: 09/08/2021] [Indexed: 12/02/2022]
Abstract
The COVID-19 pandemic has changed the way many people live. To assess its impact on sleep quality and quantity, blue light exposure, and the mental health of Polish university students, a cross-sectional survey was conducted. Almost half of the participants were medical students (47.62%; n = 630). The majority of students were suffering from insomnia (58.13%, n = 769). Almost every third student was sleeping less than 7 h a day (30.39%, n = 402). Our study showed that a short sleep duration correlates with poorer mental health outcomes. Respondents who declared sadness and depression were more likely to suffer from insomnia (OR = 5.6997, 95% CI: 4.3641-7.4441). Difficulty with tasks was also more likely to co-occur with insomnia (OR = 5.4723, 95% CI: 4.3007 to 6.9630). The results of this study showed that the COVID-19 pandemic contributed to the deterioration of sleep quality and quantity as well as the psychological well-being of Polish students. It is important to take steps to promote proper sleeping habits to alleviate the risk of mental health disorders in this group of people.
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Affiliation(s)
- Grzegorz Gruba
- Students’ Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (J.G.); (N.A.); (Z.S.); (A.M.J.); (D.Ś.)
| | - Przemysław Seweryn Kasiak
- Students’ Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (J.G.); (N.A.); (Z.S.); (A.M.J.); (D.Ś.)
| | - Joanna Gębarowska
- Students’ Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (J.G.); (N.A.); (Z.S.); (A.M.J.); (D.Ś.)
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland;
| | - Natalia Adamczyk
- Students’ Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (J.G.); (N.A.); (Z.S.); (A.M.J.); (D.Ś.)
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland;
| | - Zuzanna Sikora
- Students’ Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (J.G.); (N.A.); (Z.S.); (A.M.J.); (D.Ś.)
| | - Alicja Monika Jodczyk
- Students’ Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (J.G.); (N.A.); (Z.S.); (A.M.J.); (D.Ś.)
| | - Artur Mamcarz
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland;
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
| | - Daniel Śliż
- Students’ Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland; (J.G.); (N.A.); (Z.S.); (A.M.J.); (D.Ś.)
- Polish Society of Lifestyle Medicine, 00-388 Warsaw, Poland;
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 04-749 Warsaw, Poland
- School of Public Health, Postgraduate Medical Education Center, 01-813 Warsaw, Poland
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Zhao B, Sun S, He X, Yang J, Ma X, Yan B. Sleep fragmentation and the risk of obesity: The Sleep Heart Health Study. Obesity (Silver Spring) 2021; 29:1387-1393. [PMID: 34196121 DOI: 10.1002/oby.23193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 03/06/2021] [Accepted: 04/02/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Sleep disturbances have been recognized as a risk factor for obesity. This study used polysomnography records to investigate associations between sleep fragmentation and obesity. METHODS Objectively measured sleep fragmentation data recorded by in-home polysomnography, including total arousal index (ArI-total), ArI in rapid eye movement (REM) sleep (ArI-REM), ArI in non-REM sleep (ArI-NREM), sleep fragmentation index, sleep efficiency (SE), and wake after sleep onset (WASO), were based on the Sleep Heart Health Study (2,835 men and 2,888 women with a mean [SD] age of 63.2 [11.2] years). Multivariable regression analyses were used to examine the relationship between sleep fragmentation and obesity. RESULTS Multinomial logistic regression showed that participants with obesity have a significantly higher ArI-total (odds ratio [OR] 1.018; 95% CI: 1.010-1.026, p < 0.001), ArI-REM (OR 1.010; 95% CI: 1.002-1.018, p = 0.009), ArI-NREM (OR 1.017; 95% CI: 1.009-1.024, p < 0.001), and WASO (OR 1.003; 95% CI: 1.001-1.005, p = 0.007) compared with those with normal weight. Furthermore, multiple linear regression analyses showed an obvious correlation between ArI-total, ArI-REM, ArI-NREM, SE, WASO, and BMI. CONCLUSIONS The results revealed that ArI-total, ArI-REM, ArI-NREM, SE, and WASO were associated with obesity. The improvement of sleep fragmentation may contribute to decreasing the risk of obesity.
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Affiliation(s)
- Binbin Zhao
- Department of Psychiatry, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuliu Sun
- Department of Obstetrics and Gynecology, Northwest Women's and Children's Hospital, Xi'an, China
- Department of Clinical Research Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyan He
- Department of Psychiatry, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jian Yang
- Department of Psychiatry, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Clinical Research Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiancang Ma
- Department of Psychiatry, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bin Yan
- Department of Psychiatry, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Clinical Research Center, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Al-Zahrani MS, Alhassani AA, Zawawi KH. Tooth loss as a potential risk factor for deficient sleep: an analysis of a nationally representative sample of adults in the USA. Sleep Breath 2021; 25:1101-1107. [PMID: 32583273 DOI: 10.1007/s11325-020-02131-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/28/2020] [Accepted: 06/13/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Sleep deficiency is implicated as a risk factor for several systemic conditions. Loss of teeth has a profound effect on the individual's physiologic and psychologic health and quality of life. This study aimed to assess the association between tooth loss and sleep duration and determine if anterior and/or posterior tooth loss is a significant predictor. METHODS A total of 22,483 individuals ≥ 18 years who participated in the United States National Health and Nutrition Examination Survey (NHANES) 2005-2016 cycles were included. Multinomial logistic regression adjusted for age, gender, race/ethnicity, smoking, diabetes, body mass index, socioeconomic level, education, alcohol, and depression was performed to examine the association between sleep duration and tooth loss. RESULTS Compared to individuals with > 20 remaining teeth, those who were completely edentulous, had 1-10 or 11-20 teeth remaining were more likely to be in the deficient sleep category (OR [95% CI] = 1.59 [1.35-1.87], 1.29 [1.07-1.54], and 1.26 [1.11-1.43], respectively). When the numbers of both missing anterior and posterior teeth were entered in the model, only posterior teeth were significant. There was a 4% increase in the odds of being in the deficient sleep category for each missing posterior tooth (OR [95% CI] = 1.04 [1.02-1.05]). CONCLUSIONS Tooth loss was significantly associated with deficient sleep and posterior tooth loss appeared to be the main contributor. Although further research is needed to clarify the nature of this association, our results suggest that improving oral health might have an impact on overall health and quality of life.
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Affiliation(s)
- Mohammad S Al-Zahrani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed A Alhassani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid H Zawawi
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
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Abstract
STUDY OBJECTIVES This study examines the relationship between experimentally manipulated sleep duration and mood in adolescents. METHODS Thirty-four adolescents (20 male), aged 15-17 years, lived in a sleep laboratory for 10 days and 9 nights. They were allocated to one of three sleep "doses" for five consecutive nights for 5, 7.5, or 10 h sleep opportunity per night. Two baseline nights and two recovery nights entailed 10 h sleep opportunity per night. Mood was measured every 3 h during wake using unipolar visual analogue scales measuring the mood states "depressed," "afraid," "angry," "confused," "anxious," "happy," and "energetic." RESULTS Mixed models analyses with post hoc comparisons revealed that participants in the 5-h group, but not the 7.5- or 10-h groups, reported being significantly more depressed, angry, and confused during sleep restriction than at baseline. Adolescents were significantly less happy and energetic during sleep restricted to 5 h and significantly less energetic during sleep restricted to 7.5 h. When adolescents had 10 h sleep opportunities their happiness significantly increased. No statistically significant effects of sleep restriction were found for fear or anxiety, although small-to-moderate effects of sleep restricted to 5 or 7.5 h were found. Two nights of recovery sleep was not sufficient to recover from increased negative mood states for the 5-h group, although recovery occurred for positive mood states. CONCLUSIONS Given the prevalence of insufficient sleep and the rising incidence of mood disorders and dysregulation in adolescents, these findings highlight the importance of sufficient sleep to mitigate these risks.
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Affiliation(s)
- Stephen A Booth
- School of Human, Health and Social Sciences, Central Queensland University, North Rockhampton, Australia
| | - Mary A Carskadon
- E. P. Bradley Hospital Sleep Research Laboratory, Providence, RI
| | - Robyn Young
- School of Psychology, Flinders University, Adelaide, Australia
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Bhagavan SM, Sahota PK. Sleep Fragmentation and Atherosclerosis: is There a Relationship? Mo Med 2021; 118:272-276. [PMID: 34149089 PMCID: PMC8210987] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sleep fragmentation refers to the disruption of sleep architecture with poor quality of sleep despite optimal duration of sleep. Sleep fragmentation has been shown to have multiple effects on different body systems. This article reviews the effect of sleep fragmentation on the rate of atherosclerosis which has been linked to comorbidities like myocardial infarction, stroke, and coronary artery disease with an aim to educate patients regarding the importance of sleep hygiene and to incorporate a good amount and quality of sleep as life style modification along with diet and exercise.
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Affiliation(s)
- Sachin M Bhagavan
- Resident Physician in the Department of Neurology, University of Missouri-Columbia, Columbia, Missouri (UMC CM)
| | - Pradeep K Sahota
- Professor and Chairman, Department of Neurology and Director, Sleep Disorder Center, UMC CM
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Forsman Å, Anund A, Skyving M, Filtness AJ. Injury crashes and the relationship with disease causing excessive daytime sleepiness. Traffic Inj Prev 2021; 22:272-277. [PMID: 33769162 DOI: 10.1080/15389588.2021.1894639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The objective of this study was to understand the relationship between some of the most common diseases that are known to contribute to excessive daytime sleepiness (EDS) and traffic injury crashes. Specific focus was on the relationship between disease and crash type (single-vehicle or multiple-vehicle crash) and between disease and injury severity. METHODS This registry-based study considered all passenger car drivers involved in a crash in Sweden between 2011 and 2016 who were 40 years or older at the time of the crash (n = 54,090). For each crash-involved driver, selected medical diagnoses registered from 1997 until the day before the crash were extracted from the National Patient Register. The drivers were assigned to 1 of 4 groups, depending on prior diseases: sleep apnea (SA; group 1, n = 2,165), sleep disorders (group 2, n = 724), Parkinson's or epilepsy (group 3, n = 645) and a reference group (group 4, n = 50,556). Logistic regression analysis compared single-vehicle crashes with multiple-vehicle crashes and moderately/severely injured drivers with slightly/uninjured drivers. RESULTS Drivers with EDS-related diseases (groups 1-3) had higher probability of a single-vehicle crash than a multiple-vehicle crash compared to the reference group. The most sizeable effect was found for Parkinson's/epilepsy with an odds ratio (OR) of 2.5 (confidence interval [CI], 2.1-3.0). For multiple-vehicle crashes, the probability of a moderate/severe injury was higher for drivers with other sleep disorders (OR = 1.5; CI, 1.0-2.2) and Parkinson's/epilepsy (OR = 1.6; CI, 1.1-2.3) compared to the reference group. CONCLUSIONS This study has made first steps toward understanding the relationship between some of the most common diseases that are known to contribute to EDS and crashes. Having Parkinson's/epilepsy, in particular, elevated the probability of a single-vehicle crash compared to a multiple-vehicle crash. A single-vehicle crash was seen as indicative of causing a crash; thus, having Parkinson's/epilepsy could be interpreted as a risk factor for crash involvement. Having Parkinson's/epilepsy, as well as other sleep disorders, was also related to more severe outcomes in multiple-vehicle crashes, given that a crash occurred. This was not identified in single-vehicle crashes.
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Affiliation(s)
- Åsa Forsman
- The Swedish National Road and Transport Research Institute (VTI), Linköping, Sweden
| | - Anna Anund
- The Swedish National Road and Transport Research Institute (VTI), Linköping, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
- Rehabilitation Medicine, Linköping University, Linköping, Sweden
| | - Marie Skyving
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Road and Rail Department, Swedish Transport Agency, Kista, Sweden
| | - Ashleigh J Filtness
- Transport Safety Research Centre, SDCA, Loughborough University, Loughborough, Leicestershire, UK
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Okajima I, Komada Y, Ito W, Inoue Y. Sleep Debt and Social Jetlag Associated with Sleepiness, Mood, and Work Performance among Workers in Japan. Int J Environ Res Public Health 2021; 18:2908. [PMID: 33809121 PMCID: PMC8000941 DOI: 10.3390/ijerph18062908] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 01/18/2023]
Abstract
Although sleep debt and social jetlag (SJL) influence daytime dysfunctions, the effects of both sleep debt and SJL on them have not been analyzed. The aim of this study was to examine the mutual relationship between sleep debt and SJL on daytime sleepiness, mood, and work performance. This study was a cross-sectional study on sleep health conducted on the Japanese general population. A total of 4505 general workers (30% female, aged 43.57 ± 11.63 years) were selected and analyzed. Sleep debt was defined by sleep debt index (SDI), which is the discrepancy between desired and real sleep duration. SJL and SDI scores exhibited a positive but weak coefficient (r = 0.19). In a 4 (SJL) × 3 (SDI) two-way ANOVA, the interaction effects were notable for sleepiness and depression scores, while the group effects were notable for the work performance score. For sleepiness and depression scores, SDI >2 h was not significantly different from SJL. In addition, the impact of SDI was higher than that of SJL on sleepiness (β = 0.17), depression (β = 0.16), and work performance (β = -0.10). The impact of sleep debt was more pronounced than SJL on daytime dysfunctions, although both sleep debt and SJL have negative impacts on them.
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Affiliation(s)
- Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo 173-8602, Japan
| | - Yoko Komada
- Liberal Arts, Meiji Pharmaceutical University, Tokyo 204-8588, Japan;
| | - Wakako Ito
- Institute of Neuropsychiatry, Tokyo 162-0851, Japan; (W.I.); (Y.I.)
| | - Yuichi Inoue
- Institute of Neuropsychiatry, Tokyo 162-0851, Japan; (W.I.); (Y.I.)
- Department of Somnology, Tokyo Medical University, Tokyo 151-0053, Japan
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Tsai TH, Chen YL, Gau SSF. Relationships between autistic traits, insufficient sleep, and real-world executive functions in children: a mediation analysis of a national epidemiological survey. Psychol Med 2021; 51:579-586. [PMID: 31769374 DOI: 10.1017/s0033291719003271] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although the literature documents low executive functions and sleep deficits in individuals with autism spectrum disorder or subclinical autistic traits, no study has simultaneously examined their relationships in the general child population. This study aimed to examine whether autistic traits impacted real-world executive functions through insufficient sleep in a nationally representative sample of children. METHODS This was a national survey of 6832 primary and secondary school students, aged 8-14 years old, with equal sex distribution (3479 boys, 50.8%). Parents reported their child's nocturnal sleep duration and the need for sleep to maintain their daytime function and the Social Responsiveness Scale and the Behavior Rating Inventory of Executive Function (BRIEF) for their children's autistic traits and real-world executive functions, respectively. RESULTS We found that autistic traits exerted indirect effects on real-world executive functions through sleep deficits, independent of sex, and age. Moreover, such an indirect effect was observed only from restricted and repetitive behaviors to executive functions through sleep deficits, but not in the other components of autistic traits (i.e. social communication and interaction). CONCLUSIONS Our novel findings underscore the importance of sleep and autistic traits in executive functions and suggest potential mechanisms that may underlie the observed correlational structure among autistic behaviors, sleep deficits, and low executive function performance.
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Affiliation(s)
- Tsung-Han Tsai
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Lung Chen
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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29
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Perotta B, Arantes-Costa FM, Enns SC, Figueiro-Filho EA, Paro H, Santos IS, Lorenzi-Filho G, Martins MA, Tempski PZ. Sleepiness, sleep deprivation, quality of life, mental symptoms and perception of academic environment in medical students. BMC Med Educ 2021; 21:111. [PMID: 33596885 PMCID: PMC7890911 DOI: 10.1186/s12909-021-02544-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 02/03/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND It has been previously shown that a high percentage of medical students have sleep problems that interfere with academic performance and mental health. METHODS To study the impact of sleep quality, daytime somnolence, and sleep deprivation on medical students, we analyzed data from a multicenter study with medical students in Brazil (22 medical schools, 1350 randomized medical students). We applied questionnaires of daytime sleepiness, quality of sleep, quality of life, anxiety and depression symptoms and perception of educational environment. RESULTS 37.8% of medical students presented mild values of daytime sleepiness (Epworth Sleepiness Scale - ESS) and 8.7% presented moderate/severe values. The percentage of female medical students that presented ESS values high or very high was significantly greater than male medical students (p < 0.05). Students with lower ESS scores presented significantly greater scores of quality of life and perception of educational environment and lower scores of depression and anxiety symptoms, and these relationships showed a dose-effect pattern. Medical students reporting more sleep deprivation showed significantly greater odds ratios of presenting anxiety and depression symptoms and lower odds of good quality of life or perception of educational environment. CONCLUSIONS There is a significant association between sleep deprivation and daytime sleepiness with the perception of quality of life and educational environment in medical students.
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Affiliation(s)
- Bruno Perotta
- Mackenzie Evangelical School of Medicine - Parana, Curitiba, Brazil
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda M Arantes-Costa
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
| | - Sylvia C Enns
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
| | | | - Helena Paro
- Department of Gynecology & Obstetrics, Federal University of Uberlandia, Uberlandia, Brazil
| | - Itamar S Santos
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
| | - Geraldo Lorenzi-Filho
- Department of Cardio-Pneumology, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
| | - Milton A Martins
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil.
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil.
| | - Patricia Z Tempski
- Department of Medicine, School of Medicine of the University of Sao Paulo, Sao Paulo, Brazil
- Center for Development of Medical Education, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil
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Guo Y, Miller MA, Cappuccio FP. Short duration of sleep and incidence of overweight or obesity in Chinese children and adolescents: A systematic review and meta-analysis of prospective studies. Nutr Metab Cardiovasc Dis 2021; 31:363-371. [PMID: 33487495 DOI: 10.1016/j.numecd.2020.11.001] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/29/2020] [Accepted: 11/03/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Overweight and obesity in children have become a global public health problem. Epidemiological studies suggest that sleep duration may contribute to the incidence of overweight and obesity in all stages of life. China has an increasing prevalence of overweight and obesity, and sleep deprivation is common among Chinese children. The aim of this study was to assess the prospective relationship between short sleep duration and overweight or obesity in Chinese children and to gain an estimate of the risk. METHODS AND RESULTS A systematic search was performed on 28/04/2020 by using Medline, PubMed and Web of Science. The exposure was the duration of sleep, and the outcome measure the incidence of overweight or obesity. The odds ratios (OR) and hazard ratios (HR) and 95% confidence intervals (C.I.) were extracted to calculate the pooled relative risk (RR) by a random effect model. Heterogeneity and publication bias of the studies were checked by sensitivity analysis. Seven studies fulfilled the criteria for a systematic review, and 5 studies for a meta-analysis. The total of 33,206 participants included boys and girls, aged 6-17 years old. In Chinese children the pooled RR for short sleep duration and overweight or obesity combined was 1.47 (95% C.I. 1.26, 1.71, p < 0.00001, n = 32,607), and for obesity alone 1.40 (95% C.I. 1.01, 1.95, p = 0.04, n = 17,038). There was no significant heterogeneity or publication bias between studies. CONCLUSION Short sleep duration is associated with the development of overweight and obesity in Chinese children.
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Affiliation(s)
- Yuan Guo
- University of Warwick, Warwick Medical School, Division of Health Sciences (Mental Health & Wellbeing), Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - Michelle A Miller
- University of Warwick, Warwick Medical School, Division of Health Sciences (Mental Health & Wellbeing), Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - Francesco P Cappuccio
- University of Warwick, Warwick Medical School, Division of Health Sciences (Mental Health & Wellbeing), Gibbet Hill Road, Coventry, CV4 7AL, UK; University Hospital Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry, CV2 2DX, UK.
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Lee D, Jang T, Kim H, Kang M. The relationship between working hours and lifestyle behaviors: Evidence from a population-based panel study in Korea. J Occup Health 2021; 63:e12280. [PMID: 34582095 PMCID: PMC8477655 DOI: 10.1002/1348-9585.12280] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 07/10/2021] [Revised: 08/24/2021] [Accepted: 09/08/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the relationship between working hours and lifestyle behaviors using data from a large nationally representative panel survey. METHODS We used the Korea Health Panel Study (KHPS) data from 2011 to 2014. Weekly working hours and lifestyle risk factors were assessed by questionnaires. Comparing to the reference group, the weekly working hours were 40 h per week, odds ratios and 95% confidence intervals for smoking status, alcohol consumption status, and regular exercise status of other weekly working hours groups (<40, 40, 41-52, and >52) were calculated, using generalized estimating equation models considering repeated measures. RESULTS Our findings clearly showed a relationship between long working hours and unhealthy lifestyles, such as cigarette smoking, alcohol consumption, physical inactivity, and insufficient sleep. Additionally, weekly working hours are positively associated with the amount of smoking and drinking, and inversely associated with sleep duration among those who worked 40 h or more per week. CONCLUSION Long working hours are associated with unhealthy lifestyles, such as cigarette smoking, alcohol consumption, physical inactivity, and insufficient sleep.
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Affiliation(s)
- Dong‐Wook Lee
- Department of Preventive MedicineSeoul National University College of MedicineSeoulRepublic of Korea
| | - Tae‐Won Jang
- Department of Occupational and Environmental MedicineHanyang University College of MedicineSeoulRepublic of Korea
| | - Hyoung‐Ryoul Kim
- Department of Occupational and Environmental MedicineSeoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaSeoulRepublic of Korea
| | - Mo‐Yeol Kang
- Department of Occupational and Environmental MedicineSeoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaSeoulRepublic of Korea
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Malloggi S, Conte F, Gronchi G, Ficca G, Giganti F. Prevalence and Determinants of Bad Sleep Perception among Italian Children and Adolescents. Int J Environ Res Public Health 2020; 17:ijerph17249363. [PMID: 33327567 PMCID: PMC7765082 DOI: 10.3390/ijerph17249363] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 12/13/2022]
Abstract
Although sleep problems at young ages are well investigated, the prevalence of bad sleepers and the determinants of sleep quality perception remain unexplored in these populations. For this purpose, we addressed these issues in a sample of children (n = 307), preadolescents (n = 717), and adolescents (n = 406) who completed the School Sleep Habits Survey, addressing sleep quality perception, sleep habits, sleep features, daytime behavior and sleep disturbances, circadian preference, and dreaming. The sample was split in “good sleepers” and “bad sleepers”, based on the answer to the question item assessing overall subjective sleep quality. Being a bad sleeper was reported by 11.7% of the sample, with significant between-groups differences (children: 8.3%; preadolescents: 11.3%; adolescents: 15.3%; p = 0.01). At all ages, relative to good sleepers, bad sleepers showed higher eveningness, sleepiness, and depression, longer sleep latency, more frequent insufficient sleep, nocturnal awakenings, sleep–wake behavioral problems, and unpleasant dreams (all p’s ≤ 0.01). Sleep quality perception was predicted: in children, by depressed mood, eveningness, and unpleasant dreams (all p’s ≤ 0.01); in preadolescents, by sleep latency, awakening frequency, depressed mood, sufficiency of sleep, and unpleasant dreams (all p’s < 0.01); in adolescents, by awakening frequency, depressed mood, and sufficiency of sleep (all p’s < 0.001). In children, bad subjective sleep quality appears to be mainly determined by daytime psychological features, for example, depressed mood, whereas at later ages, sleep characteristics, such as frequent awakenings, add to the former determinants. This could depend on (a) the appearance, with increasing age, of objective sleep modifications and (b) a greater attention paid by adolescents to their sleep characteristics.
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Affiliation(s)
- Serena Malloggi
- Department NEUROFARBA, University of Firenze, 50135 Firenze, Italy; (S.M.); (G.G.)
| | - Francesca Conte
- Department of Psychology, University of Campania L. Vanvitelli, 81100 Caserta, Italy; (F.C.); (G.F.)
| | - Giorgio Gronchi
- Department NEUROFARBA, University of Firenze, 50135 Firenze, Italy; (S.M.); (G.G.)
| | - Gianluca Ficca
- Department of Psychology, University of Campania L. Vanvitelli, 81100 Caserta, Italy; (F.C.); (G.F.)
| | - Fiorenza Giganti
- Department NEUROFARBA, University of Firenze, 50135 Firenze, Italy; (S.M.); (G.G.)
- Correspondence: ; Tel.: +39-055-275-5055
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Trockel MT, Menon NK, Rowe SG, Stewart MT, Smith R, Lu M, Kim PK, Quinn MA, Lawrence E, Marchalik D, Farley H, Normand P, Felder M, Dudley JC, Shanafelt TD. Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors. JAMA Netw Open 2020; 3:e2028111. [PMID: 33284339 DOI: 10.1001/jamanetworkopen.2020.28111] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Sleep-related impairment in physicians is an occupational hazard associated with long and sometimes unpredictable work hours and may contribute to burnout and self-reported clinically significant medical error. OBJECTIVE To assess the associations between sleep-related impairment and occupational wellness indicators in physicians practicing at academic-affiliated medical centers and the association of sleep-related impairment with self-reported clinically significant medical errors, before and after adjusting for burnout. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used physician wellness survey data collected from 11 academic-affiliated medical centers between November 2016 and October 2018. Analysis was completed in January 2020. A total of 19 384 attending physicians and 7257 house staff physicians at participating institutions were invited to complete a wellness survey. The sample of responders was used for this study. EXPOSURES Sleep-related impairment. MAIN OUTCOMES AND MEASURES Association between sleep-related impairment and occupational wellness indicators (ie, work exhaustion, interpersonal disengagement, overall burnout, and professional fulfillment) was hypothesized before data collection. Assessment of the associations of sleep-related impairment and burnout with self-reported clinically significant medical errors (ie, error within the last year resulting in patient harm) was planned after data collection. RESULTS Of all physicians invited to participate in the survey, 7700 of 19 384 attending physicians (40%) and 3695 of 7257 house staff physicians (51%) completed sleep-related impairment items, including 5279 women (46%), 5187 men (46%), and 929 (8%) who self-identified as other gender or elected not to answer. Because of institutional variation in survey domain inclusion, self-reported medical error responses from 7538 physicians were available for analyses. Spearman correlations of sleep-related impairment with interpersonal disengagement (r = 0.51; P < .001), work exhaustion (r = 0.58; P < .001), and overall burnout (r = 0.59; P < .001) were large. Sleep-related impairment correlation with professional fulfillment (r = -0.40; P < .001) was moderate. In a multivariate model adjusted for gender, training status, medical specialty, and burnout level, compared with low sleep-related impairment levels, moderate, high, and very high levels were associated with increased odds of self-reported clinically significant medical error, by 53% (odds ratio, 1.53; 95% CI, 1.12-2.09), 96% (odds ratio, 1.96; 95% CI, 1.46-2.63), and 97% (odds ratio, 1.97; 95% CI, 1.45-2.69), respectively. CONCLUSIONS AND RELEVANCE In this study, sleep-related impairment was associated with increased burnout, decreased professional fulfillment, and increased self-reported clinically significant medical error. Interventions to mitigate sleep-related impairment in physicians are warranted.
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Affiliation(s)
| | - Nikitha K Menon
- Stanford University School of Medicine, Palo Alto, California
| | | | | | - Randall Smith
- Stanford University School of Medicine, Palo Alto, California
| | - Ming Lu
- Stanford University School of Medicine, Palo Alto, California
| | - Peter K Kim
- Physician Affiliate Group of New York, New York, New York
| | | | | | | | | | | | - Mila Felder
- Advocate Christ Medical Center, Oak Lawn, Illinois
| | - Jessica C Dudley
- Brigham and Women's Hospital-Partners HealthCare, Boston, Massachusetts
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Chou YT, Li CH, Shen WC, Yang YC, Lu FH, Wu JS, Chang CJ. Association of sleep quality and sleep duration with serum uric acid levels in adults. PLoS One 2020; 15:e0239185. [PMID: 32941519 PMCID: PMC7497980 DOI: 10.1371/journal.pone.0239185] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/01/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To date, the association between sleep duration or sleep quality and hyperuricemia has remained unclear. In addition, sleep duration and quality were not considered concomitantly in previous studies. Thus, this study was aimed toward an examination of the association of sleep duration and quality with uric acid level in a Taiwanese population. METHODS A total of 4,555 patients aged ≥18 years were enrolled in this study. The sleep duration was classified into three groups: short (<7 h), normal (7-9 h), and long (≥9 h). The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and poor sleep quality was defined as a global PSQI score of >5. RESULTS Poor sleepers were younger and had lower body mass index, blood pressure, uric acid, blood sugar, cholesterol, creatinine level, shorter sleep duration, and engaged in less exercise but had a higher white blood cell count and prevalence of smoking as compared to good sleepers. There were also differences in body mass index, blood pressure, uric acid, blood sugar, lipid profiles, and sleep quality among subjects with different sleep durations. After adjusting for other variables, poor sleep quality was associated with lower uric acid levels. In addition, short sleep duration was positively associated with higher uric acid levels. CONCLUSIONS Poor sleep quality was related to lower uric acid levels, whereas short sleep duration was associated with higher uric acid levels.
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Affiliation(s)
- Yu-Tsung Chou
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Hao Li
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Chen Shen
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou branch, College of Medicine, National Cheng Kung University, Yunlin, Taiwan
- * E-mail: (JSW); (CJC)
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
- * E-mail: (JSW); (CJC)
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Lin YQ, Zhuang WJ, Zheng FH, Zeng ZN, Wu YX, Wu SY, Wei SC. Weekday and weekend sleep deprivation are associated with recurrent nightmare in adolescents: a cross-sectional study. Sleep Med 2020; 76:36-42. [PMID: 33075612 DOI: 10.1016/j.sleep.2020.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/20/2020] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Our study aimed to investigate the association between sleep deprivation and parasomnias including nightmare and sleepwalking in Chinese adolescents. METHODS A total of 19,229 high school students aged 10-20 in Fuzhou were invited to complete questionnaires regarding sleep duration, parasomnias including nightmare and sleepwalking, and emotional problems. Subjects with sleep deprivation (SD) defined as sleeping less than 8 h either on weekdays or on weekends were categorized as three groups: weekday SD, weekend SD and habitual SD. RESULTS The prevalence of recurrent nightmare was significantly higher for subjects with SD (SD vs non sleep deprivation (NSD): 7.6% vs 3.7%). In all subjects, habitual SD was associated with the highest risk of recurrent nightmare [Odds ratio (OR) = 2.19, 95% Confidential interval (95% CI) = 1.73-2.75, P < 0.001], followed by weekday SD (OR = 2.06, 95% CI = 1.64-2.61, P < 0.001) and weekend SD (OR = 1.45, 95% CI = 1.01-2.08, P = 0.045). No significant association was found between sleepwalking and sleep deprivation. In further age-based (10-13/14-17 years) and sex-based subgroup analyses, the findings were consistent except that association between weekend SD and recurrent nightmare disappeared among subjects aged 14-17 or among girls. CONCLUSIONS Our study found a significant association between recurrent nightmare and sleep deprivation either on weekdays or on weekends in adolescents, which was stronger with more deprivation episodes. No significant association was found between sleepwalking and sleep deprivation. Association between weekend SD and recurrent nightmare disappeared among subjects aged 14-17 or among girls.
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Affiliation(s)
- Yi-Qi Lin
- Department of Sleep Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, 350001, China
| | - Wen-Jin Zhuang
- Department of Neurology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, 350001, China
| | - Fu-Hao Zheng
- Department of Epidemiology and Health Statistics, The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350001, China; Department of Scientific Research Management, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, 350001, China
| | - Zhao-Nan Zeng
- Center for Experimental Research in Clinical Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, 350001, China
| | - Yong-Xi Wu
- Department of Sleep Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, 350001, China
| | - Si-Ying Wu
- Department of Epidemiology and Health Statistics, The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350001, China.
| | - Shi-Chao Wei
- Department of Sleep Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, 350001, China.
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Khader WS, Tubbs AS, Haghighi A, Athey AB, Killgore WDS, Hale L, Perlis ML, Gehrels JA, Alfonso-Miller P, Fernandez FX, Grandner MA. Onset insomnia and insufficient sleep duration are associated with suicide ideation in university students and athletes. J Affect Disord 2020; 274:1161-1164. [PMID: 32663946 PMCID: PMC7384749 DOI: 10.1016/j.jad.2020.05.102] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 01/30/2020] [Revised: 04/17/2020] [Accepted: 05/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Previous work has shown that poor sleep is a prospective risk factor for suicide in clinical populations and might contribute to risk in the general population. The present study evaluated whether sleep distress, onset insomnia, and insufficient sleep are associated with suicide ideation in university students and athletes participating in the 2011-2014 National College Health Assessment (NCHA; n = 113,185). METHODS In the NCHA survey, students self-reported the presence or absence of suicide ideation within the past 12 months. SLEEP DISTRESS was assessed with an item indicating that "sleep difficulties" were "particularly traumatic or difficult to handle." ONSET INSOMNIA was assessed as at least 3 nights per week where survey participants reported an "extremely hard time falling asleep." INSUFFICIENT SLEEP was operationalized as the number of days per week where the participants felt they did not get "enough sleep to feel rested." All variables were yes/no except INSUFFICIENT SLEEP, which was categorized as 0-1 (reference), 2-3, 4-5, or 6-7 nights. Binary logistic regression analyses examined suicide ideation as the outcome and sleep variable as a predictor, adjusted for age, sex, year in school, recent depressed mood, and survey year. Associations within student-athletes were likewise assessed. RESULTS 7.4% of students reported suicide ideation within the past 12 months. In adjusted models, this was significantly associated with SLEEP DISTRESS (OR = 3.01, 95% CI [2.86, 3.16], p < 0.0001), ONSET INSOMNIA (OR = 1.95, 95% CI [1.86, 2.04], p < 0.0001), as well as INSUFFICIENT SLEEP (4-5 nights, OR = 1.41, 95% CI [1.28, 1.56], p < 0.0001; 6-7 nights, OR = 1.92, 95% CI [1.74, 2.13], p < 0.0001). Although suicide ideation was less common among athletes, ORs were similar for athletes for all sleep variables of interest. CONCLUSION Sleep distress, onset insomnia, and insufficient sleep were all strongly related to suicide ideation among university students. These relationships were the same among collegiate athletes, even though this group reported less overall suicide ideation. Our findings suggest that university students may benefit from educational materials linking sleep disruption to maladaptive thinking and suicide ideation.
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Affiliation(s)
- Waliuddin Suhaib Khader
- Department of Psychology, University of Arizona, Tucson, AZ, USA; Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Andrew S Tubbs
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Ariana Haghighi
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Amy B Athey
- Athletics Department, University of Arizona, Tucson, AZ, USA
| | | | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Michael L Perlis
- Department of Psychology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jo-Ann Gehrels
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
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Sallinen M, van Dijk H, Aeschbach D, Maij A, Åkerstedt T. A Large-Scale European Union Study of Aircrew Fatigue During Long Night and Disruptive Duties. Aerosp Med Hum Perform 2020; 91:628-635. [PMID: 32693870 DOI: 10.3357/amhp.5561.2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION: We examined aircrew fatigue during the following flight duty periods (FDPs) mentioned in the European Union (EU) Flight Time Limitations (FTLs): night FDPs longer than 10 h and FDPs typical of disruptive schedules (early starts, late finishes, and nights). An alternative way of classifying night FDPs was also examined to reveal possible subcategories that warrant special attention.METHODS: A total of 392 aircrew members (96 women) representing 24 airlines participated in the study. Their FDPs were measured by a diary, sleep by the diary and wrist-actigraphy, and fatigue by the Karolinska Sleepiness Scale (KSS) over 14 consecutive days. The KSS ratings given at top of descent (TOD) served as the main outcome.RESULTS: The probability of high fatigue (KSS ≥ 7) at TOD was 0.41 and 0.32 during long (>10 h) and short night (≤10 h) FDPs, respectively. The corresponding value was 0.19 for early starts, 0.31 for late finishes, 0.34 for night FDPs, and 0.15 for day FDPs (reference). The main predictors of high fatigue were FDP's encroachment on the window of circadian low (WOCL, 02:00 h-05:59 h) and prior sleep. Within the night category, FDPs fully covering the WOCL showed the highest probability of high fatigue at TOD (0.42).DISCUSSION: Late finish and night FDPs warrant special attention in fatigue management. Within the night category, the same holds for FDPs that fully cover the WOCL. To manage fatigue, adjustments of the FTLs seem to be a limited strategy and therefore other measures, including maximizing preflight sleep, are needed.Sallinen M, van Dijk H, Aeschbach D, Maij A, Åkerstedt T. A large-scale European Union study of aircrew fatigue during long night and disruptive duties. Aerosp Med Hum Perform. 2020; 91(8):628-635.
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Abstract
OBJECTIVES To identify epilepsy triggers prevalent in Saudi Arabia with a view to seizure prevention or achieving a reduction in their frequency. METHODS This is part of a cross-sectional study carried out in 2020 in a Saudi population in the Kingdom of Saudi Arabia (KSA). We used an online questionnaire to evaluate the most common seizure trigger factors. RESULTS A total of 546 Saudi patients with epilepsy participated in the study, of which 289 (53%) were women. Of them, 263 (48.1%) had no seizure in the previous 3 months. One hundred and thirty-six (25%) had a family member with epilepsy. The most-reported trigger factor was sleep deprivation reported by 285 (52%), followed by stress 225 (41%), missed medication 210 (38.5%), anxiety 209 (38.3%), and fatigue 184 (33.7%). Conclusions: Sleep deprivation is the most reported trigger factor for seizures in the KSA, followed by stress, followed by missed medication.
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Affiliation(s)
- Foziah J Alshamrani
- Neurology Department, College of Medicine Imam Abdulrahman Bin Faisal University, Al Khobar, Kingdom of Saudi Arabia. E-mail.
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Wilcox ME, McAndrews MP, Van J, Jackson JC, Pinto R, Black SE, Lim AS, Friedrich JO, Rubenfeld GD. Sleep Fragmentation and Cognitive Trajectories After Critical Illness. Chest 2020; 159:366-381. [PMID: 32717265 DOI: 10.1016/j.chest.2020.07.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/30/2020] [Accepted: 07/08/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND ICU survivors can experience both cognitive dysfunction and persistent sleep disturbances after hospitalization. Sleep disturbances have been linked with cognitive impairment in various patient populations, and the apolipoprotein E (APOE) genotype has been linked to sleep-related impairments in cognition. RESEARCH QUESTION Is there an association between sleep, long-term cognition, and APOE status in ICU survivors? STUDY DESIGN AND METHODS We enrolled 150 patients from five centers who had been mechanically ventilated for at least 3 days; 102 patients survived to ICU discharge. Actigraphy and cognitive testing were undertaken at 7 days, 6 months, and 12 months after ICU discharge, and sleep duration, quality, and timing were estimated by actigraphy. APOE single nucleotide polymorphisms were assessed for each patient. RESULTS Actigraphy-estimated sleep fragmentation, but not total sleep time or interdaily stability (estimate of circadian rhythmicity), was associated with worse cognitive impairment at 7 days of ICU discharge. No actigraphy-estimated variable of sleep estimation at 7 days post-ICU discharge predicted cognitive impairment or persistent sleep abnormalities at 6 and 12 months of follow-up in subsequently assessed survivors. Possessing the APOE ε4 allele was not significantly associated with sleep disturbances and its presence did not modify the risk of sleep-related cognitive impairment at follow-up. INTERPRETATION Sleep fragmentation estimated by actigraphy was associated with worse cognitive performance in hospital, but not at later time intervals. Further research is needed to better delineate the relationship between persistent sleep disturbances and cognition in larger numbers of ICU survivors. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT02086877; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Mary Elizabeth Wilcox
- Department of Medicine (Critical Care Medicine), University Health Network, Toronto, ON, Canada; Interdepartment Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
| | - Mary Pat McAndrews
- Krembil Brain Institute, University Health Network and Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Julie Van
- Center for Critical Illness, Brain Dysfunction, and Survivorship (CIBS Center), Nashville, TN; Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt Medical Center, Nashville, TN
| | - James C Jackson
- Center for Critical Illness, Brain Dysfunction, and Survivorship (CIBS Center), Nashville, TN; Department of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt Medical Center, Nashville, TN
| | - Ruxandra Pinto
- Interdepartment Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine (Critical Care Medicine), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Sandra E Black
- Department of Medicine (Critical Care Medicine), Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Andrew S Lim
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada
| | - Jan O Friedrich
- Interdepartment Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Critical Care and Medicine Departments and Li Ka Shing Knowledge Institute, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Gordon D Rubenfeld
- Interdepartment Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine (Critical Care Medicine), Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Jeklin AT, Davies HW, Bredin SSD, Hives BA, Meanwell LE, Perrotta AS, Warburton DER. Fatigue and sleep patterns among Canadian wildland firefighters during a 17-day fire line deployment. J Occup Environ Hyg 2020; 17:364-371. [PMID: 32469682 DOI: 10.1080/15459624.2020.1759809] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The purpose of this investigation was to enhance our understanding of the effects the current British Columbia Wildfire Service (BCWS) firefighting schedule have on the development of fatigue and sleep deprivation. This was a cohort study that objectively and subjectively measured sleep quantity, sleep quality, and fatigue throughout a 17-day British Columbia wildland firefighting deployment. Wildland firefighters (n = 30) conducted daily testing of sleep and fatigue measures during 14 days of activity on the fire line and three days immediately post deployment during their three-day rest period, for a total of 17 days of data collection. Sleep was assessed using wrist-worn actigraphy (ActiGraph LLC, Pensacola, FL) and subjective sleep questionnaires. Fatigue was assessed using subjective fatigue questionnaires and cognitive performance through the psychomotor vigilance test. Total sleep time was less on fire days (M = 6.6 h ± 49.2 min) compared to non-fire days (M = 6.8 h ± 92.2 min). Participants performed poorer on cognitive performance tests, (p = 0.288), and reported being significantly sleepier, (p = 0.038), toward the end of their 17-day deployment compared to day 1. Participants continued to report high levels of sleepiness, fatigue, and poor quality of sleep on their rest days compared to their fire line days. Working 14 consecutive days was associated with increased levels of objective fatigue and suboptimal sleep in wildland firefighters. Wildland firefighters reported significantly higher levels of fatigue and decreased alertness with increasing days on deployment and these levels did not improve following a three-day rest period.
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Affiliation(s)
- Andrew T Jeklin
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- School of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Hugh W Davies
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon S D Bredin
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ben A Hives
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leah E Meanwell
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew S Perrotta
- Department of Kinesiology, Langara College, Vancouver, British Columbia, Canada
| | - Darren E R Warburton
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Experimental Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Jackson TL, Cooper T. Sleep Deprivation among Rhode Island High School Students. R I Med J (2013) 2020; 103:49-52. [PMID: 32122102] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Tracy L Jackson
- Senior Public Health Epidemiologist in the Center for Health Data and Analysis (CHDA) at the Rhode Island Department of Health
| | - Tara Cooper
- Health Program Administrator who leads the Behavioral Risk Factor Surveillance System and Youth Risk Behavior Survey within CHDA at RIDOH
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Abstract
BACKGROUND The Centers for Disease Control and Prevention recently labeled sleep deprivation an epidemic in America with 35% of Americans reporting less than the recommended 7-9 hours of sleep each night. A recent study in France found that people experiencing homelessness sleep less and experience increased daytime fatigue as compared with the general population. Sleep intervention and research are rarely the focus for this population resulting in insufficient literature and knowledge to date on sleep health in people experiencing homelessness. OBJECTIVES The objective of this study was to determine quality, quantity, supports, and barriers to sleep within a homeless population. DESIGN A mixed-methods survey was conducted to obtain data on sleep in the homeless population. PARTICIPANTS 32 English-speaking adults experiencing homelessness were recruited from a local homeless organization. MEASURES A web-based survey and two self-report standardized assessments were administered. Standardized assessments included Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form v1.0-Fatigue 13a and the PROMIS Short Form v1.0-Sleep Disturbance 8b. RESULTS Seventy-five percent of participants report getting less than the 7-9 recommended hours of sleep per night. Participants scored almost one standard deviation above the mean on both PROMIS measures demonstrating greater fatigue and sleep disturbance as compared with the general population. Four themes were identified via qualitative analysis: lack of environmental control, emotion and thought, substance use as a sleep aid, and sleep is important for health and daily function. CONCLUSIONS Results indicate a need for sleep hygiene intervention within the homeless population. Sleep deprivation is a barrier to the population's ability to obtaining housing.
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Affiliation(s)
- Ariana Gonzalez
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO.
| | - Quinn Tyminski
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
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Bertisch SM, Li W, Buettner C, Mostofsky E, Rueschman M, Kaplan ER, Fung J, Huntington S, Murphy T, Stead C, Burstein R, Redline S, Mittleman MA. Nightly sleep duration, fragmentation, and quality and daily risk of migraine. Neurology 2020; 94:e489-e496. [PMID: 31843807 PMCID: PMC7080287 DOI: 10.1212/wnl.0000000000008740] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 03/07/2019] [Accepted: 07/22/2019] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To test the hypotheses that insufficient duration, high fragmentation, and poor sleep quality are temporally associated with migraine onset on the day immediately following the sleep period (day 0) and the following day (day 1). METHODS In this prospective cohort study of 98 adults with episodic migraine, participants completed twice-daily electronic diaries on sleep, headaches, and other health habits, and wore wrist actigraphs for 6 weeks. We estimated the incidence of migraine following nights with short sleep duration, high fragmentation, or low quality compared to nights with adequate sleep with conditional logistic regression models stratified by participant and adjusted for caffeine intake, alcohol intake, physical activity, stress, and day of week. RESULTS Participants were a mean age of 35.1 ± 12.1 years. We collected 4,406 days of data, with 870 headaches reported. Sleep duration ≤6.5 hours and poor sleep quality were not associated with migraine on day 0 or day 1. Diary-reported low efficiency was associated with 39% higher odds of headache on day 1 (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.06-1.81). Actigraphic-assessed high fragmentation was associated with lower odds of migraine on day 0 (wake after sleep onset >53 minutes, OR 0.64, 95% CI 0.48-0.86; efficiency ≤88%, OR 0.74, 95% CI 0.56-0.99). CONCLUSION Short sleep duration and low sleep quality were not temporally associated with migraine. Sleep fragmentation, defined by low sleep efficiency, was associated with higher odds of migraine on day 1. Further research is needed to understand the clinical and neurobiologic implications of sleep fragmentation and risk of migraine.
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Affiliation(s)
- Suzanne M Bertisch
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA.
| | - Wenyuan Li
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Catherine Buettner
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Elizabeth Mostofsky
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Michael Rueschman
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Emily R Kaplan
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Jacqueline Fung
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Shaelah Huntington
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Tess Murphy
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Courtney Stead
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Rami Burstein
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Susan Redline
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
| | - Murray A Mittleman
- From the Program in Sleep Medicine Epidemiology, Division of Sleep and Circadian Disorders, Department of Medicine (S.M.B., M.R., E.R.K., S.R.), Brigham and Women's Hospital; Harvard Medical School (S.M.B., C.B., R.B., S.R., M.A.M.); Department of Epidemiology (W.L., E.M., M.A.M.), Harvard T.H. Chan School of Public Health; Cardiovascular Epidemiology Research Unit (W.L., E.M., M.A.M.), Harvard Catalyst (J.F., S.H., T.M., C.S.), and Department of Anesthesiology (R.B.), Beth Israel Deaconess Medical Center, Boston; and Department of Medicine (C.B.), Mount Auburn Hospital, Cambridge, MA
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Sigursteinsdóttir H, Skúladóttir H, Agnarsdóttir T, Halldórsdóttir S. Stressful Factors in the Working Environment, Lack of Adequate Sleep, and Musculoskeletal Pain among Nursing Unit Managers. Int J Environ Res Public Health 2020; 17:ijerph17020673. [PMID: 31968675 PMCID: PMC7014039 DOI: 10.3390/ijerph17020673] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/05/2020] [Accepted: 01/14/2020] [Indexed: 12/02/2022]
Abstract
Background: Middle managers have not received enough attention within the healthcare field, and little is known how stressful factors in their work environment coupled with a lack of adequate sleep are related to musculoskeletal pain. The aim of this study was to examine the correlation between stressful factors in the work environment, lack of adequate sleep, and pain/discomfort in three body areas. Methods: Questionnaire was sent electronically to all female nursing unit managers (NUM) in Iceland through the outcome-survey system. The response rate was 80.9%. Results: NUM who had high pain/discomfort in the neck area also had very high pain/discomfort in the shoulder area and pain in the lower back. The results also revealed positive a medium-strong correlation between mental and physical exhaustion at the end of the workday and musculoskeletal pain. Stress in daily work, mental strain at work, and being under time-pressures had hardly any correlation with pain/discomfort in the three body parts. Adequate sleep had a significant negative correlation with all stressful factors in the work environment and all three body parts under review. Conclusion: The results will hopefully lead to a better consideration of stressful factors in the work environment, sleep, and musculoskeletal pain in middle managers.
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Affiliation(s)
- Hjördís Sigursteinsdóttir
- School of Business and Science, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland
- Correspondence:
| | - Hafdís Skúladóttir
- School of Health Sciences, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland; (H.S.); (S.H.)
| | - Thórey Agnarsdóttir
- Environmental and Public Health Authority, Furuvellir 1, 600 Akureyri, Iceland
| | - Sigrídur Halldórsdóttir
- School of Health Sciences, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland; (H.S.); (S.H.)
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Brady EM, Hall AP, Baldry E, Chatterjee S, Daniels LJ, Edwardson C, Khunti K, Patel MI, Henson JJ, Rowlands A, Smith AC, Yates T, Davies MJ. Rationale and design of a cross-sectional study to investigate and describe the chronotype of patients with type 2 diabetes and the effect on glycaemic control: the CODEC study. BMJ Open 2019; 9:e027773. [PMID: 31719069 PMCID: PMC6858123 DOI: 10.1136/bmjopen-2018-027773] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION A person's chronotype is their entrained preference for sleep time within the 24 hours clock. It is described by the well-known concept of the 'lark' (early riser) and 'owl' (late sleeper). Evidence suggests that the 'owl' is metabolically disadvantaged due to the standard organisation of our society which favours the 'lark' and places physiological stresses on this chronotype. The aim of this study is to explore cardiometabolic health between the lark and owl in a population with an established metabolic condition - type 2 diabetes. METHODS This cross-sectional, multisite study aims to recruit 2247 participants from both secondary and primary care settings. The primary objective is to compare glycaemic control between late and early chronotypes. Secondary objectives include determining if late-chronotype is associated with poorer cardiometabolic health and other lifestyle factors, including well-being, compared with early-chronotype; describing the prevalence of the five different chronotypes in this cohort and examining the trends in glycaemic control, cardiometabolic health, well-being and lifestyle factors across chronotype. ANALYSIS The primary outcome (glycated haemoglobin (HbA1c)), linear regression analysis will compare HbA1c between early and late chronotypes, with and without adjustment for confounding variables. Chronotype will be modelled as a categorical variable with all five levels (from extreme-morning to extreme-late type), and as a continuous variable to calculate p for trend across the five categories. A number of models will be created; unadjusted through to adjusted with age, sex, ethnicity, body mass index, duration of diabetes, family history of diabetes, current medication and dietary habits. All secondary outcomes will be analysed using the same method. ETHICS Ethical approval from the West Midlands - Black Country Research Ethics Committee (16/WM/0457). DISSEMINATION The results will be disseminated through publication in peer-reviewed medical journal, relevant medical/health conferences and a summary report sent to patients. TRIAL REGISTRATION NUMBER NCT02973412 (Pre-Results).
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Affiliation(s)
- Emer M Brady
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Andrew P Hall
- The Hanning Sleep Laboratory, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Emma Baldry
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Lois J Daniels
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Mubarak I Patel
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Joseph J Henson
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Alex Rowlands
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Alice C Smith
- John Walls Renal Unit, University Hospitals of Leicester NHS Trust, UK and Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Wang C, Liu J, Li Z, Ji L, Wang R, Song H, Mao Y, Bishwajit G, Zhang B, Tang S. Predictor of sleep difficulty among community dwelling older populations in 2 African settings. Medicine (Baltimore) 2019; 98:e17971. [PMID: 31764803 PMCID: PMC6882581 DOI: 10.1097/md.0000000000017971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/25/2022] Open
Abstract
Sleep deprivation is a common phenomenon among older population and is commonly linked to behavioral, physiological, and psychosocial factors. Not much is known about sleep deprivation among older population in Africa. Therefore, in this study we aimed to investigate the basic sociodemographic and psychosocial predictors of self-reported sleep deprivation among older population.In this study we analyzed cross-sectional data on 1495 community dwelling men and women aged 50 years and above. Data were collected from the SAGE Well-Being of Older People Study conducted in South Africa and Uganda. Outcome variable was self-reported sleep difficulty last 30 days. Multivariable logistic regression models were used to identify the variables significantly associated with sleep difficulty.The prevalence of mild-moderate sleep difficulty was 32.6% (27.9, 37.6) and severe/extreme 23.0% (20.3, 26.0) respectively. Multivariable analysis revealed that sleep difficulty was associated with several behavioral, environment, and illness conditions. In South Africa, those who reported dissatisfaction with living condition had 1.592 [1.087, 2.787] times higher odds of reporting mild/moderate sleep difficulty. Poor subjective quality of life (QoL) was associated with higher odds of severe/extreme sleep difficulties (odds ratios [OR] = 4.590, 95% confidence interval [CI] = 2.641, 7.977 for South Africa, and OR = 4.461, 95% CI = 2.048 and 9.716 for Uganda). In Uganda, perceived depression was associated with higher odds of severe/extreme (OR = 2.452, 95% CI = 1.073, 5.602) sleep difficulties among men, and both mild/moderate (OR = 1.717; 95% CI = 1.011, 2.914) and severe/extreme sleep difficulties among women (OR = 2.504, 95% CI = 1.408, 4.453).More than half of the participants had sleep difficulty of certain degrees, emphasising an urgent need for intervention for sleep deprivation in the population. Interventions targeting to promote subjective health, quality of life, and living environment may prove beneficial for improving sleep health in this regard.
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Affiliation(s)
- Chao Wang
- School of Safety Engineering
- School of Public Policy and Management, China University of Mining and Technology, Xuzhou, Jiangsu
| | - Jiaxuan Liu
- Queen Mary School, Nanchang University, Nanchang, Jiangxi
| | - Zhifei Li
- China National Center for Biotechnology Development, Beijing
| | - Lu Ji
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei
| | - Hongxun Song
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei
| | - Yiqing Mao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei
| | - Ghose Bishwajit
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, Ottawa, ON , Canada
| | - Baoming Zhang
- General Hospital of Southern Theater Command, PLA, Guangzhou, P.R. China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei
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Abstract
Objective: Midlife women are at risk of obesity. Poor sleep outcomes including inadequate sleep duration and variable sleep timing are risk factors for obesity, but there is a lack of understanding on how specific sleep constructs uniquely or concurrently are associated with weight outcomes in this population. This study examined the unique association of sleep timing with weight outcomes and how sleep timing works in conjunction with sleep duration to influence weight in midlife women. Materials and Methods: An archival analysis was performed using the Midlife in the United States-II study (MIDUS-II). The sample consisted of 132 midlife women (40-64; M = 52.9, standard deviation = 6.94). Sleep timing (mean sleep time, variability) and duration were measured through actigraphy and daily sleep diaries. Weight was assessed using body mass index (BMI) and waist circumference measures. Results: PROCESS mediation and moderation analyses assessed direct, indirect, and moderating pathways. Sleep duration emerged as an indirect link between sleep timing (mean and variability) and weight outcomes (95% CI = 0.0001-0.0123; 95% CI = 0.0007-0.0378; 95% CI = 0.0079-0.1006). Sleep timing (95% CI = -0.0144 to 0.0076; 95% CI = -0.0358 to 0.0219) and sleep time variability (95% CI = -0.0124 to 0.0438; 95% CI = -0.0533 to 0.0939) were not directly associated with BMI or waist circumference. Also, sleep timing and duration did not interact to influence weight outcomes. Conclusions: Sleep duration, rather than sleep timing, is associated with weight outcomes, and is an indirect link in the sleep timing and weight outcomes association. Future work is needed to further disentangle the impact of sleep on weight in midlife women using prospective studies, implementing daily assessments of sleep behavior.
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Affiliation(s)
- Dana R. Schreiber
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
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Ward AL, Galland BC, Haszard JJ, Meredith-Jones K, Morrison S, McIntosh DR, Jackson R, Beebe DW, Fangupo L, Richards R, Te Morenga L, Smith C, Elder DE, Taylor RW. The effect of mild sleep deprivation on diet and eating behaviour in children: protocol for the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized cross-over trial. BMC Public Health 2019; 19:1347. [PMID: 31640636 PMCID: PMC6805447 DOI: 10.1186/s12889-019-7628-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 09/13/2019] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Although insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger. METHODS The Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8-12 years, with normal reported sleep duration of 8-11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1-2 h per night. DISCUSSION Determining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12618001671257 . Registered 10 October 2018.
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Affiliation(s)
- Aimee L. Ward
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara C. Galland
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | | | | | - Silke Morrison
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Rosie Jackson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Dean W. Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Division of Behavioral Medicine and Clinical Psychology Cincinnati Children’s Hospital Medical Center, Ohio, USA
| | - Louise Fangupo
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Lisa Te Morenga
- School of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Claire Smith
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Dawn E. Elder
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
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Mundt JM, Eisenschenk S, Robinson ME. An Examination of Pain's Relationship to Sleep Fragmentation and Disordered Breathing Across Common Sleep Disorders. Pain Med 2019; 19:1516-1524. [PMID: 29025100 DOI: 10.1093/pm/pnx211] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective Short sleep duration and insomnia have been linked to higher pain and an increased risk of developing chronic pain, but relatively little research has examined the contribution of sleep disordered breathing (SDB) to pain. This study examined the unique contributions of SDB and insomnia to chronic pain. Subjects Adult patients referred to an academic sleep center for overnight polysomnography were invited to participate. Methods Participants (N = 105) completed questionnaires about their sleep and pain, including the Insomnia Severity Index, Medical College of Virginia Pain Questionnaire, and two weeks of sleep/pain diaries. Results Most participants (80.00%) reported chronic pain, and the likelihood of having chronic pain did not differ by sleep disorder. However, there was a significant difference in pain intensity; individuals with comorbid obstructive sleep apnea (OSA)/insomnia reported an average pain intensity that was 20 points (out of 100) higher than individuals with insomnia or no diagnosis and 28 points higher than those with OSA, controlling for participant sex (Ps < 0.05). In a hierarchical regression, pain was unrelated to measures of sleep fragmentation (apnea-hypopnea index, spontaneous arousals, periodic leg movement arousals) and nocturnal hypoxemia (SaO2 nadir, time at or below 88% SaO2). Conclusions Polysomnography measures of SDB severity and sleep fragmentation were unrelated to pain intensity. However, comorbid OSA/insomnia was associated with significantly higher pain (compared with either disorder in isolation), a finding that has implications for the treatment of chronic pain and possibly for understanding the mechanisms of chronic pain.
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Affiliation(s)
| | | | - Michael E Robinson
- Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
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Abstract
As pediatricians, we can all recall an adolescent patient who presents with fatigue. She is groggy in the morning before school, sometimes nods off in class, and then drinks a caffeinated beverage in the afternoon. She sends text messages to friends before going to bed shortly after midnight. After getting a bit of history from her, the parents complain that she has poor sleep habits while the teenage yawns and then rolls her eyes at being outed. For many adolescents, sleep restriction is a conscious choice that is made, as teens are juggling school responsibilities, extracurricular activities, and social interactions. This article is intended to help primary care pediatricians understand the causes of insufficient sleep in teenagers and gives tips on how to address common sleep issues. There is serious morbidity associated with poor sleep in adolescents, including mood disorders such as depression and anxiety, increased obesity risk, and higher rates of drowsy driving. It is my hope that a few tips from this article will help prevent some of these serious sequelae. [Pediatr Ann. 2019;48(8):e292-e295.].
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