Subjective Sleep Quality Measures Research Articles

Active Inflammatory Bowel Disease Is Associated with Short Sleep Duration via Objective Measures.

Poor sleep quality has been associated with inflammatory bowel disease (IBD) activity, although studies incorporating actigraphy suggest that the perception of sleep differs rather than objective difference in sleep quality. Short sleep duration has been associated with increased pro-inflammatory cytokines that have been implicated in the pathogenesis of IBD. An observational study incorporated home-based polysomnography that was conducted within twelve weeks of an objective assessment of IBD activity such as calprotectin, colonoscopy, or MRI. Participants completed a survey on subjective measures of sleep quality, clinical IBD activity, depression, and anxiety. Polysomnography results were normalized by standardized results for a healthy population matched by gender and age. Twenty participants were included in the final analysis. Those with objective evidence of active IBD had shorter stage 2 sleep duration, leading to shorter NREM sleep and total sleep time. Sleep latency was also longer in those with active IBD, leading to worse sleep efficiency-despite no difference in time available for sleep between the two groups. These changes persisted after normalization of polysomnography results by health population age and gender matched norms. Depression scores correlated with sleep latency and stage 2 sleep duration and were associated with objectively active IBD. Objectively confirmed active IBD was associated with shorter sleep duration. Observed sleep changes may, in part, relate to coexistent depression. Further research should consider the utility of changes in sleep duration and quality as a means of longitudinally assessing objective IBD activity.

Objective sleep quality predicts subjective sleep ratings

In both clinical and observational studies, sleep quality is usually assessed by subjective self-report. The literature is mixed about how accurately these self-reports track objectively (e.g. via polysomnography) assessed sleep quality, with frequent reports of little to no association. However, previous research on this question focused on between-subject designs, which may be confounded by trait-level variables. In the current study, we used the novel Budapest Sleep, Experiences and Traits Study (BSETS) dataset to investigate if within-subject differences in subjectively reported sleep quality are related to sleep macrostructure and quantitative EEG variables assessed using a mobile EEG headband. We found clear evidence that self-reported sleep quality in the morning is influenced by within-subject variations in sleep onset latency, wake after sleep onset, total sleep time, and sleep efficiency. These effects were replicated if detailed sleep composition metrics (percentage and latency of specific vigilance states) or two alternative measures of subjective sleep quality were used instead. We found no effect of the number of awakenings or relative EEG delta and sigma power. Between-subject effects (relationships between individual mean values of sleep metrics and subjective sleep quality) were also found, highlighting that analyses focusing only on these may be erroneous. Our findings show that while previous investigations of this issue may have been confounded by between-subject effects, objective sleep quality is indeed reflected in subjective sleep ratings.

Associations between Sleep Quality and Serum Levels of Neurofilament Light in Individuals with Premanifest Huntington Disease

Abstract Objectives To evaluate the associations between sleep quality and serum levels of neurofilament light (NfL) protein in individuals with premanifest Huntington disease (HD). Materials and Methods We recruited 28 individuals with premanifest HD from a pre-existing database (of the Huntington's Environmental Research Optimisation Scheme, HEROs). The participants filled out the Pittsburgh Sleep Quality Index (PSQI), a subjective measure of sleep quality, and blood was collected via routine venepuncture to measure peripheral NfL levels. Results The PSQI scores (median: 5.0; interquartile range: 4.0–7.5) indicated poor sleep quality. General linear modelling revealed no significant (p = 0.242) association between PSQI scores and NfL levels. No significant differences were found between individuals with good and poor sleep quality for any demographic variable collected. Discussion Contrary to studies on other neurological conditions, there was no association between sleep quality and NfL levels in individuals with premanifest HD. This was unexpected, given the influence of environmental factors (such as social network size) on neurodegeneration in individuals with premanifest HD.

NO DIFFERENCE IN SUBJECTIVE SLEEP MEASUREMENTS BETWEEN MIDDLE-AGED AND OLDER ADULTS

Abstract With age, sleep quality tends to decline. Poor sleep quality is associated with adverse physical and mental health outcomes, especially in the aging population. The purpose was to compare subjective sleep quality measurements between middle age (45-64 years) and older adults (over 65 years). Participants (N=200) completed the Pittsburgh Sleep Quality Index (PSQI) and were classified by age as either middle age (MID: n=105, 71.4% female, M±SD: age: 55.5±5.8 years; mass: 85.3±17.4 kg, height: 168.4±9.2 cm, education: 18.2±3.6 years) or older adults (OLD: n=95, 76.8% female, M±SD: age: 69.0±2.9 years; mass: 80.6±14.9 kg, height: 166.2±8.9 cm, education: 17.9±3.5 years). The PSQI Component and Global Scores were calculated. Data were analyzed using descriptive statistics, crosstabulations, and independent samples t-tests (p ≤ .05). The results showed there was no difference (p < .05) between the two age groups on subjective sleep measures, including sleep quality, latency, duration, and disruptions. The average Global score for the MID and OLD adults was 6.3±3.2 and 6.0±3.6, respectively. Only 17% of MID adults and 25% of OLD adults were classified as good quality sleepers (PSQI Global score ≤ 4) and 21.9% and 30.5% rated their sleep quality as very good, respectively. While previous research has shown deterioration in subjective sleep quality measures occurs with age, there was not a difference in subjective measures between middle age and older adults in the present investigation. Further analysis is warranted to examine additional factors impacting sleep quality such as physical activity levels, co-morbidities, and living situation.

Relationship Between P‐tau217 and Subjective Sleep Quality in MCI and Mild AD. A Preliminary Study

AbstractBackgroundPlasma‐tau217 (ptau217) has recently emerged as a biomarker for Alzheimer’s disease (AD). With sleep changes as an established feature of AD, previous studies suggest a link between sleep and tau pathology. We investigated whether overall subjective estimation of sleep quality is associated with p‐tau217 concentration (pg/ml) in a small sample population of older adults with mild cognitive impairment (MCI) or mild Alzheimer’s disease (AD).MethodWe examined participants (mean age = 69) with MCI (n = 14) and mild AD (n = 2). MCI participants had CDR 0.5 and MoCA scores ranging 17‐28. Mild AD participants had CDR of 1.0 and MoCA scores of 17. pTau217 was measured with a novel validated SIMOA assay, developed by one of us (A.J.) for ALZPath, Inc. The Pittsburgh Sleep Quality Index (PSQI) was used as a subjective measure of sleep quality. Pearson correlation coefficient was used to test the association between ptau217 and the global score of PSQI, and spearman’s rho was used for each of the 7 subscales of the PSQI.ResultThe global score (total score) of the PSQI was found to be significantly correlated with ptau217 concentration, such that poorer sleep was associated with increased ptau217 (r = ‐.587, p<.05). Partial correlations revealed that this correlation remained after controlling for age, sex, and years of education (all p<.05).ConclusionGlobal scores on the PSQI were associated with ptau217 concentration in MCI and mild AD participants, such that poor reported sleep quality was associated with increased plasma tau. Future studies in larger samples and longitudinal investigations using objective sleep data (actigraphs) would serve to confirm these findings.

Memory performance mediates subjective sleep quality associations with cerebrospinal fluid Alzheimer's disease biomarker levels and hippocampal volume among individuals with mild cognitive symptoms.

Sleep disturbances are prevalent in Alzheimer's disease (AD), affecting individuals during its early stages. We investigated associations between subjective sleep measures and cerebrospinal fluid (CSF) biomarkers of AD in adults with mild cognitive symptoms from the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study, considering the influence of memory performance. A total of 442 participants aged >50 years with a Clinical Dementia Rating (CDR) score of 0.5 completed the Pittsburgh Sleep Quality Index questionnaire and underwent neuropsychological assessment, magnetic resonance imaging acquisition, and CSF sampling. We analysed the relationship of sleep quality with CSF AD biomarkers and cognitive performance in separated multivariate linear regression models, adjusting for covariates. Poorer cross-sectional sleep quality was associated with lower CSF levels of phosphorylated tau and total tau alongside better immediate and delayed memory performance. After adjustment for delayed memory scores, associations between CSF biomarkers and sleep quality became non-significant, and further analysis revealed that memory performance mediated this relationship. In post hoc analyses, poorer subjective sleep quality was associated with lesser hippocampal atrophy, with memory performance also mediating this association. In conclusion, worse subjective sleep quality is associated with less altered AD biomarkers in adults with mild cognitive symptoms (CDR score 0.5). These results could be explained by a systematic recall bias affecting subjective sleep assessment in individuals with incipient memory impairment. Caution should therefore be exercised when interpreting subjective sleep quality measures in memory-impaired populations, emphasising the importance of complementing subjective measures with objective assessments.

54 Sleep and Circadian Rhythms in Premanifest Huntington’s disease: Relationship with Cognition

Objective:Huntington’s disease (HD) is a neurodegenerative disease characterised by motor, psychiatric and cognitive decline. Currently, no treatments have been identified in HD for slowing down cognitive decline or improving cognitive function. We are interested in identifying potentially modifiable factors in HD that can be targeted to improve or maintain cognitive function. Sleep and circadian disruption stand out as possible modifiable targets because sleep and circadian symptoms are common in HD, and such disruptions are known to impact cognition in the general population. Despite some emerging evidence that sleep quality correlates with cognition in manifest HD, whether these same relationships exist in the premanifest period is unknown. Further, whether circadian rhythms relate to cognition in premanifest HD remains open. Therefore, we aimed to determine whether sleep and circadian parameters relate to cognitive performance in premanifest HD.Participants and Methods:To date, we have recruited 27 premanifest HD participants to a two-week remote sleep study. During the study, participants wore an Actiwatch-2 and completed a sleep diary for 14 consecutive days to assess their sleep and rest-activity patterns. Participants also completed online sleep and mood questionnaires and a cognitive assessment using videoconference. We calculated Pearson correlations to examine whether cognitive performance relates to subjective sleep quality, objective sleep parameters and circadian rest-activity rhythms. Thus far, we have analysed data from 15 female participants with premanifest HD (Mage = 43.20, SD = 11.58).Results:Preliminary results indicate that measures of subjective sleep quality, insomnia severity, daytime sleepiness, and fatigue severity in premanifest HD do not correlate with cognitive performance. Increases in objectively measured sleep efficiency, however, strongly correlated with better performance on the Hopkins-Verbal Learning Test-Revised (HVLT-R) immediate (r = 0.562, p < 0.05) and delayed recall trials (r = 0.597, p < 0.05) and the Trail Making Test Part B (TMT-B; r = 0.550, p < 0.05). More time spent awake (i.e., wake after sleep onset) was strongly linked to reduced performance on the TMT-B (r = -0.542, p < 0.05) and Symbol Digit Modalities Test (r = -0.556, p < 0.05). Further, increases in total sleep time were associated with better performance on the HVLT-R immediate (r = 0.682, p < 0.05) and delayed recall trial (r = 0.616, p < 0.05). For our circadian parameters, less fragmented day-today rest-activity rhythms (i.e., higher intra-daily variability) strongly correlated with higher scores on the HVLT-R immediate (r = 0.768, p < 0.001) delayed recall trials (r = 0.7276, p < 0.05) and TMT-B (r = 0.516, p < 0.05), whereas consistent and stable day-to-day rest-activity rhythms (i.e., higher inter-daily stability) was associated with poorer performance on ERT (r = -0.587, p < 0.05).Conclusions:Preliminary results suggest that fragmented sleep, sleep inefficiency, reduced total sleep time, rest-activity rhythm stability and fragmentation relate to poorer cognitive performance in people with premanifest HD. Should analysis of our whole sample confirm these preliminary findings, targeting sleep in HD (e.g., through sleep hygiene and/or psychoeducation) may be a useful strategy to improve or maintain cognition.

Sleep parameters might affect the attrition of leukocyte telomere length

AbstractBackgroundThe relationship between sleep parameters and longitudinal shortening of telomere length is unclear. This study aimed to investigate the relationship between sleep parameters and the shortening of leukocyte telomere length (LTL) over two years.MethodAmong the participants in the validation cohort of the Korea Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease, participants who measured both baseline and follow‐up (two years later) of LTL were analyzed. They were dichotomized according to the degree of LTL attrition. Clinical characteristics, including sleep duration, sleep latency, Pittsburgh Sleep Quality Index (PSQI), Stanford Sleepiness Scale, and Epworth Sleepiness Scale scores were compared between the two groups.ResultA total of 238 patients were analyzed in current study. Participants with faster LTL shortening had a shorter duration of sleep (P = 0.013) and longer sleep latency (P = 0.007). Among the components of the PSQI, subjective measures of sleep quality, sleep latency, sleep duration, and sleep efficiency were significantly worse in participants with faster LTL shortening. Multivariate logistic regression analysis showed that sleep latency (odds ratio [OR] = 1.015, confidence interval [CI] = 1.001–1.029, P = 0.029), global PSQI score (OR = 1.130, CI = 1.017–1.256, P = 0.023), shortest sleep duration (OR = 5.057, CI = 1.189–21.502; P = 0.028), and lowest sleep efficiency (OR = 8.598, CI = 1.584–46.672, P = 0.013) were independently associated with faster LTL shortening.ConclusionPoor sleep quality, specifically long sleep latency, less than 5 hours of sleep, and low sleep efficiency were associated with faster longitudinal shortening of the LTL.

Contemporary use of wearable activity monitors in prostate cancer survivors: A scoping review.

127 Background: Remote monitoring of daily activity using wearable activity monitors (“wearables”) (e.g., Fitbits) provides an unintrusive method to obtain continuous, objective physical activity (PA) and sleep data outside the clinical setting. Despite their potential for improving PA assessment for cancer survivors, there is currently limited information on how wearables are being used in PCa survivors. Thus, we reviewed the literature to understand how wearables are being integrated into research and interventional studies conducted in PCa survivors. Methods: We searched PubMed, CENTRAL, and Clinicaltrials.gov for randomized controlled trials (RCTs) and observational studies that involve commercially available wearables in PCa survivors, published between 2012 and 2022. Upon screening and full-text review by two independent reviewers, data were extracted from eligible studies, including study and patient characteristics, details on study interventions and outcomes, and purpose of device use. Baseline PA data were abstracted from articles with available quantitative data, including step counts, time spent in moderate-to-vigorous physical activity (MVPA), and sleep duration, and included in a quantitative analysis. Results: Eighty studies were screened and 17 studies met eligibility criteria and were included in this review (8 RCTs; 9 observational), with a total sample size of 1,148 PCa survivors (median age 66 years, range 39-84). Wearables used included: Fitbit: (47%), pedometer (18%), smartphone (6%), Jawbone (6%), and heart rate monitor (6%). Most studies (71%) involved individual or group-based exercise interventions that were either gym-based supervised by an exercise physiologist or home-based (online web-based delivery or written recommendations), as well as remotely delivered behavioral interventions. One study compared objective (actigraphy) and subjective sleep quality measures and one was a validation study comparing Fitbit to the ActiGraph accelerometer. Study durations ranged from 1-48 weeks with median reported adherence to wearing the device of 79.5% (range 63-100%). PA data, as measured with wearables, were available in 13 studies and summarized. Conclusions: Wearables are increasingly being used to assess daily activity and monitor adherence to exercise interventions in PCa survivors. Findings suggest wearables are feasible for use in this population with high levels of adherence. Wearables can provide added value to PA and functional assessment, although more research is needed to understand how wearables can be integrated into routine patient care or used as means to track or deliver tailored interventions for PCa survivors. [Table: see text]

ASSOCIATIONS AMONG PROINFLAMMATORY CYTOKINES, INSULIN RESISTANCE, AND SUBJECTIVE SLEEP QUALITY.

There are 27 million adults in the U.S. diagnosed with type II diabetes mellitus, a condition associated with significant morbidity and mortality due to insulin resistance. Insulin resistance regards the inability of the body to properly respond to insulin at target receptors, leading to increased blood glucose levels from suppressed GLUT transporter expression. The presence of proinflammatory cytokines interleukin-6 (IL-6) and c-reactive protein (CRP) may decrease insulin response. Additionally, as the aging population grows, it is necessary to examine how sleep quality may be associated with disease risk in older adults. Poor sleep quality and inflammation may contribute to the progression of insulin resistance. The PURPOSE of this cross-sectional study was to examine relationships between insulin resistance, inflammation, and subjective sleep quality measures in overweight, older adults. METHODS: In 19 overweight (BMI 27-40) adults (3 male / 16 female) over the age of 55, body composition (bioelectrical impedance), HbA1c (HbA1c analyzer), and subjective sleep quality (Pittsburgh Sleep Quality Index) were measured. Enzyme-Linked Immunosorbent Assays (ELISA) were used for the quantitative measurement of IL-6 and CRP. Partial correlations were conducted controlling for sex to investigate relationships. RESULTS: Mean values were (mean ± sd): age (64.1 ± 4.88 years), HOMA-IR (6.097 ± 4.32), HbA1c (5.4737 ± .19 %), IL-6 (4.988 ± 3.797 ng/mL), CRP (3.8 ± 2.99 mg/dL)PSQI (10.36 ± 2.586), and BMI (34.95 ± 4.79). HOMA-IR was significantly (p < 0.05) correlated with subjective sleep quality (r = 0.537) and HbA1c (r = 0.512). HbA1c was significantly correlated with subjective sleep quality (r = 0.473). CONCLUSION: This data supports that subjective sleep quality measures are associated with both HOMA-IR and HbA1c. The action of insulin in its transduction pathway thus may be affected by quality of sleep. ​​Funded by an NIH grant: 1R15AG055923-01

An exploratory study of pro-inflammatory cytokines in individuals with alcohol use disorder: MCP-1 and IL-8 associated with alcohol consumption, sleep quality, anxiety, depression, and liver biomarkers.

BackgroundHigh levels of sleep disturbances reported among individuals with alcohol use disorder (AUD) can stimulate inflammatory gene expression, and in turn, may alter pro-inflammatory cytokines levels. We aimed to investigate associations between pro-inflammatory cytokine markers with subjective measures of sleep quality, psychological variables and alcohol consumption among individuals with AUD.MethodsThis exploratory study is comprised of individuals with AUD (n = 50) and healthy volunteers (n = 14). Spearman correlation was used to investigate correlations between plasma cytokine levels and clinical variables of interest (liver and inflammatory markers, sleep quality, patient reported anxiety/depression scores, and presence of mood and/or anxiety disorders (DSM IV/5); and history of alcohol use variables.ResultsThe AUD group was significantly older, with poorer sleep quality, higher anxiety/depression scores, and higher average drinks per day as compared to controls. Within the AUD group, IL-8 and MCP-1 had positive significant correlations with sleep, anxiety, depression and drinking variables. Specifically, higher levels of MCP-1 were associated with poorer sleep (p = 0.004), higher scores of anxiety (p = 0.006) and depression (p < 0.001), and higher number of drinking days (p = 0.002), average drinks per day (p < 0.001), heavy drinking days (p < 0.001) and total number of drinks (p < 0.001). The multiple linear regression model for MCP-1 showed that after controlling for sleep status and heavy drinking days, older participants (p = 0.003) with more drinks per day (p = 0.016), and higher alkaline phosphatase level (p = 0.001) had higher MCP-1 level.ConclusionThis exploratory analysis revealed associations with cytokines MCP-1 and IL-8 and drinking consumption, sleep quality, and anxiety and depression in the AUD group. Furthermore, inflammatory and liver markers were highly correlated with certain pro-inflammatory cytokines in the AUD group suggesting a possible relationship between chronic alcohol use and inflammation. These associations may contribute to prolonged inflammatory responses and potentially higher risk of co-morbid chronic diseases.

Inconsistency between objective and subjective comparisons of sleep quality is found between sea level and moderate terrestrial altitude (2,320m) in high-performance swimmers

It is popular for high-performance athletes to attend training camps at natural moderate altitude (1800–2500m), which may have direct and indirect effects on the quantity and quality of sleep athletes obtain. This can potentially influence the ability to maximise training responses and optimise recovery from exercise. This study aimed to compare objective and subjective markers of sleep quality between sea level (SL) and moderate altitude (ALT) in a sample of 14 (male n = 5, female n = 9) high-performance collegiate swimmers. Sleep was objectively (wristwatch actigraphy) and subjectively (Athlete Sleep Screening Questionnaire; ASSQ) assessed at SL and an ALT of 2,320m. A significant increase ( p = 0.028, d = 0.76) in the ‘sleep difficulty score’ calculated from the ASSQ was identified from SL (4.9 ± 1.7 au) to ALT (6.6 ± 2.3 au), with a greater number of the swimmers judged to have a more severe clinical sleep problem at ALT. Of the seven sleep characteristics assessed objectively, there were no significant differences identified between the two environments. Sleep disruption was found to substantially improve following rest/recovery days while at ALT. Although this study highlights possible inconsistencies between objective and subjective measures of sleep quality while at ALT, any suggestion of reduced sleep quality should be considered seriously. Practically, the present study demonstrates the importance of, at altitude, using both objective and subjective measures to monitor athlete sleep quality, and ensuring training schedules are carefully periodised, incorporating rest or recovery days within intense training blocks for optimal sleep quality to be achieved.

Association between sleep parameters and longitudinal shortening of telomere length.

Background: The relationship between sleep parameters and longitudinal shortening of telomere length is unclear. This study aimed to investigate the relationship between sleep parameters and the shortening of leukocyte telomere length (LTL) over a year.Methods: Among the participants in the validation cohort of the Korea Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease, participants who measured both baseline and follow-up (two years later) of LTL were analyzed. They were dichotomized according to the degree of LTL attrition over two years. Clinical characteristics were compared between the faster and slower LTL shortening groups (cut-off points: −0.710 kbp, n = 119 each). Multivariable logistic regression analyses were performed to determine independent relationships between faster shortening of LTL length and sleep parameters.Results: A total of 238 participants, aged 55–88 years, were included. Participants with faster LTL shortening had a shorter duration of sleep (P = 0.013) and longer sleep latency (P = 0.007). Among the components of the PSQI, subjective measures of sleep quality, sleep latency, sleep duration, and sleep efficiency were significantly worse in participants with faster LTL shortening. Multivariate logistic regression analysis showed that sleep duration (per hour, OR = 0.831, 95% CI = 0.698–0.989), sleep latency (per minute, OR = 1.013, 95% CI = 1.002–1.024), global PSQI score (OR = 1.134, 95% CI = 1.040–1.236), shortest sleep duration (OR = 5.173, 95% CI = 1.563–17.126), and lowest sleep efficiency (OR = 7.351, 95% CI = 1.943–27.946) were independently associated with faster LTL shortening.Conclusions: Poor sleep quality, specifically short sleep duration, long sleep latency, and low sleep efficiency were associated with faster longitudinal shortening of LTL.

Subjective Measures of Workload and Sleep in Australian Army Recruits; Potential Utility as Monitoring Tools.

Subjective measures may offer practitioners a relatively simple method to monitor recruit responses to basic military training (BMT). Yet, a lack of agreement between subjective and objective measures may presents a problem to practitioners wishing to implement subjective monitoring strategies. This study therefore aims to examine associations between subjective and objective measures of workload and sleep in Australian Army recruits. Thirty recruits provided daily rating of perceived exertion (RPE) and differential RPE (d-RPE) for breathlessness and leg muscle exertion each evening. Daily internal workloads determined via heart rate monitors were expressed as Edwards training impulse (TRIMP) and average heart rate. External workloads were determined via global positioning system (PlayerLoadTM) and activity monitors (step count). Subjective sleep quality and duration was monitored in 29 different recruits via a customized questionnaire. Activity monitors assessed objective sleep measures. Linear mixed-models assessed associations between objective and subjective measures. Akaike Information Criterion assessed if the inclusion of d-RPE measures resulted in a more parsimonious model. Mean bias, typical error of the estimate (TEE) and within-subject repeated measures correlations examined agreement between subjective and objective sleep duration. Conditional R2 for associations between objective and subjective workloads ranged from 0.18 to 0.78, P < 0.01, with strong associations between subjective measures of workload and TRIMP (0.65-0.78), average heart rate (0.57-0.73), and PlayerLoadTM (0.54-0.68). Including d-RPE lowered Akaike Information Criterion. The slope estimate between objective and subjective measures of sleep quality was not significant. A trivial relationship (r = 0.12; CI -0.03, 0.27) was observed between objective and subjective sleep duration with subjective measures overestimating (mean bias 25 min) sleep duration (TEE 41 min). Daily RPE offers a proxy measure of internal workload in Australian Army recruits; however, the current subjective sleep questionnaire should not be considered a proxy measure of objective sleep measures.

Relationship between Resting State Heart Rate Variability and Sleep Quality in Older Adults with Mild Cognitive Impairment.

Sleep problems can be caused by psychological stress but are also related to cardiovascular and neurodegenerative diseases. Improving lifestyle behaviors, such as good sleep hygiene, can help to counteract the negative effects of neurodegenerative diseases and to improve quality of life. The purpose of this cross-sectional study was to investigate the relationship between subjectively reported measures of sleep quality (via Pittsburgh Sleep Quality Index (PSQI)) and objective measures of cardiac autonomic control (via resting state heart rate variability (HRV)) among individuals with mild cognitive impairment (MCI). The PSQI and resting state HRV data of 42 MCI participants (69.0 ± 5.5; 56–80 years) were analyzed. Nineteen of the participants reported poor sleep quality (PSQI score > 5). Good sleepers showed higher resting heart rate than bad sleepers (p = 0.037; ES = 0.670). Correlation analysis showed a significant correlation between the parameter HF nu and sleep efficiency, contrasting the expected positive association between reduced HRV and poor sleep quality in healthy and individuals with specific diseases. Otherwise, there were no significances, indicating that measures of subjective sleep quality and resting HRV were not related in the present sample of MCI participants. Further research is needed to better understand the complex relationship between HRV and lifestyle factors (e.g., sleep) in MCI.

Sleep quality and emotion recognition in individuals with and without internalizing psychopathologies

Background and objectivesSeparate lines of research indicate sleep quality may impact recognition of facial expressions in anxious or depressed individuals. This study examined facial emotion recognition ability in the context of self-perceived sleep quality and anxiety and depression symptom levels in individuals with and without internalizing psychopathologies. MethodsSeventy anxious and/or depressed patients and 24 demographically matched healthy controls completed the Pittsburgh Sleep Quality Index (PSQI), standard measures of anxiety and depression, and an Emotion Recognition Task comprising negative and positive facial expressions. ResultsAnalyses of variance results revealed patients reported worse sleep quality than controls. Linear mixed-effects models indicated that all participants demonstrated better emotion recognition abilities in identifying positive versus negative emotions. For reaction time, but not accuracy, regression results revealed significant individual differences, with worse sleep quality predicting slower reaction times for positive faces, specifically for happiness. LimitationsThe use of a subjective measure of sleep quality and a specific behavioral paradigm for emotion recognition may impact the generalizability of the findings. ConclusionsAssociations between task performance and emotional valence of facial expression implies that poor sleep quality, beyond internalizing symptom severity, may disrupt emotion processing.

Actigraphic and Self-reported Sleep in Traffic Accident Victims

Background: Some accident victims report poorer sleep during the months after the trauma, which may double the risk for and is a mediator of the development of a PTSD. Furthermore, subjective and objective sleep measures are often discrepant in PTSD-patients, which is why a ‘sleep state misperception’ of PTSD patients is often hypothesized. Objective: The goal of this study is to assess differences in sleep quality in victims of a traffic accident compared to healthy participants without an accident history as well as differences between objective and subjective sleep quality measures. Methods: We recruited 25 hospitalized accident victims within ten days of an accident and 31 age and sex-matched controls without an accident history. Three months later, participants were given a structured clinical interview (SCID), they completed the Pittsburg Sleep Quality Index (PSQI) for the previous two weeks, wore a wrist actigraph, and kept a sleep log for two consecutive nights. Results: At the three-month follow-up, none of the victims met the criteria for any kind of mental disorder, but scored higher on the Posttraumatic Diagnostic Scale. On the PSQI they reported slightly worse sleep than controls for the previous two weeks, although sleep log and actigraphy measures on the two recording nights showed no group differences. Actigraphy measures showed shorter sleep onset latencies compared to log measures. Conclusions: The accident victims suffered only minimal sleep disturbances three months later. The assumption of a ‘sleep state misperception’ in traffic accident victims is questioned by these results.

Improvements in sleep‐disordered breathing during acclimatization to 3800 m and the impact on cognitive function

Sojourners to high altitude often experience poor sleep quality due to sleep‐disordered breathing. Additionally, multiple aspects of cognitive function are impaired at high altitude. However, the impact of acclimatization on sleep‐disordered breathing and whether poor sleep is a major contributor to cognitive impairments at high altitude remains uncertain. We conducted nocturnal actigraphy and polygraphy, as well as daytime cognitive function tests, in 15 participants (33% women) at sea level and over 3 days of partial acclimatization to high altitude (3800 m). Our goal was to determine if sleep‐disordered breathing improved over time and if sleep‐disordered breathing was associated with cognitive function. The apnea–hypopnea index and oxygen desaturation index increased on night 1 (adj. p = 0.026 and adj. p = 0.026, respectively), but both improved over the subsequent 2 nights. These measures were matched by poorer self‐reported sleep quality on the Stanford Sleepiness Scale and PROMIS questionnaires following 1 night at high altitude (adj. p = 0.027 and adj. p = 0.022, respectively). The reaction time on the psychomotor vigilance task was slower at high altitude and did not improve (SL: 199 ± 27, ALT1: 224 ± 33, ALT2: 216 ± 41, ALT3: 212 ± 27 ms). The reaction times on the balloon analog risk task decreased at high altitude (SL: 474 ± 235, ALT1: 375 ± 159, ALT2: 291 ± 102, ALT3: 267 ± 90 ms), perhaps indicating increased risk‐taking behavior. Finally, multiple cognitive function measures were associated with sleep‐disordered breathing and measures of subjective sleep quality, rather than low daytime arterial oxygen saturation. These data indicate that sleep‐disordered breathing at moderately high altitude improves with partial acclimatization and that some aspects of cognitive performance in unacclimatized sojourners may be impacted by poor sleep rather than hypoxemia alone.

Efficacy of Triprolidine in the Treatment of Temporary Sleep Disturbance.

Triprolidine, a first-generation antihistamine for allergic rhinitis, has a shorter half-life and fewer persistent effects relative to other antihistamines and may be useful in the treatment of temporary sleep disturbance. Patients aged ≥18 years old were randomized 1:1:1 to receive either triprolidine 2.5 mg (n = 65), triprolidine 5 mg (n = 66), or placebo (n = 67) on 3 consecutive nights. Sleep disturbance index was monitored via wrist actimeter. Subjective measures were assessed via diary card. Triprolidine 2.5 mg had a significantly lower sleep disturbance index versus placebo on night 1 (P = .02); however, when adjusted for outliers, sleep disturbance index did not significantly differ between either dose of triprolidine versus placebo on night 1. Adjusted sleep disturbance index was significantly lower with triprolidine 2.5 and 5 mg versus placebo on night 3 (P = .0017 and P = .011, respectively) and for the mean of all 3 nights (P = .01 and P = .015, respectively). Sleep latency was significantly improved for triprolidine 2.5 mg versus placebo on nights 2 and 3 and for the mean of all 3 nights and for triprolidine 5 mg versus placebo for the mean of all 3 nights. Subjective measures showed those on both doses of triprolidine felt more refreshed on awakening versus placebo for the mean of all 3 nights, with no increase in daytime sleepiness. The frequency of adverse events was similar across groups. The optimum dose of triprolidine for treatment of temporary sleep disturbance was 2.5 mg. There were improvements in both objective and subjective measures of sleep quality versus placebo, with no safety concerns raised.

Clinical application of mindfulness-oriented meditation in children with ADHD: a preliminary study on sleep and behavioral problems

Objective High incidence of sleep problems in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) has been described. Mindfulness meditation has emerged as a novel approach to sleep disturbances and insomnia remediation. This preliminary study tested the efficacy of Mindfulness-Oriented Meditation (MOM) training on sleep quality and behavioral problems in children with ADHD. Design Twenty-five children with ADHD aged 7-11 years underwent two programs three times per week for eight-weeks: the MOM training (15 children) and an Active Control Condition (10 children). Main Outcome Measures Objective and subjective measures of sleep quality and behavioral measures were collected before and after the programs. Results Positive effects on sleep and behavioral measures were found only in the MOM group. Conclusion Although they are preliminary, our results indicate that MOM training is a promising tool for ameliorating sleep quality and behavioral manifestations in ADHD.