Normal Sleep Research Articles

The effect of sleep restriction, with or without high-intensity interval exercise, on behavioural alertness and mood state in young healthy males.

Mood state and alertness are negatively affected by sleep loss, and can be positively influenced by exercise. However, the potential mitigating effects of exercise on sleep-loss-induced changes in mood state and alertness have not been studied comprehensively. Twenty-four healthy young males were matched into one of three, 5-night sleep interventions: normal sleep (NS; total sleep time (TST) per night = 449 ± 22 min), sleep restriction (SR; TST = 230 ± 5 min), or sleep restriction and exercise (SR + EX; TST = 235 ± 5 min, plus three sessions of high-intensity interval exercise (HIIE)). Mood state was assessed using the profile of mood states (POMS) and a daily well-being questionnaire. Alertness was assessed using psychomotor vigilance testing (PVT). Following the intervention, POMS total mood disturbance scores significantly increased for both the SR and SR + EX groups, and were greater than the NS group (SR vs NS; 31.0 ± 10.7 A.U., [4.4-57.7 A.U.], p = 0.020; SR + EX vs NS; 38.6 ± 14.9 A.U., [11.1-66.1 A.U.], p = 0.004). The PVT reaction times increased in the SR (p = 0.049) and SR + EX groups (p = 0.033) and the daily well-being questionnaire revealed increased levels of fatigue in both groups (SR; p = 0.041, SR + EX; p = 0.026) during the intervention. Despite previously demonstrated physiological benefits of performing three sessions of HIIE during five nights of sleep restriction, the detriments to mood, wellness, and alertness were not mitigated by exercise in this study. Whether alternatively timed exercise sessions or other exercise protocols could promote more positive outcomes on these factors during sleep restriction requires further research.

Actigraphic and self-reported characterization of sleep in systemic lupus erythematosus patients.

In a cross-sectional study, we explored possible differences in sleep parameters between SLE patients and age- and gender-matched healthy controls through actigraphic and self-reported measures. Furthermore, we aimed to identify possible predictors of such disturbances in the patient cohort. Participants' sociodemographic data and sleep parameters were collected. Sleep parameters were evaluated through the Pittsburgh Sleep Quality Index, the Insomnia Severity Index and 7-day actigraphic monitoring. The 10-item Perceived Stress Scale was used to investigate stress. Disease activity and daily glucocorticoid dose were assessed in SLE patients. Possible predictors of the SLE group were explored through two binomial logistic models. Within the SLE group, possible predictors of sleep parameters were tested estimating multiple linear regression models. A total of 40 SLE patients and 33 controls were included in the study. The SLE group showed worse sleep maintenance actigraphic parameters (i.e. sleep efficiency and wake after sleep onset), higher total sleep time and higher perceived stress. Within the SLE cohort, the daily glucocorticoids dose was associated with an impairment in sleep maintenance despite no reduction in sleep duration, typical of normal sleep duration insomnia, whereas perceived stress was associated with short sleep duration insomnia. Compared with healthy controls, SLE patients showed worse sleep quality and greater perceived stress severity. As glucocorticoids and perceived stress are associated with different types of insomnia in these patients, a multidimensional approach to both sleep characterization and therapy might be preferred.

Durative sleep fragmentation with or without hypertension suppress rapid eye movement sleep and generate cerebrovascular dysfunction

Either hypertension or chronic insomnia is the risk factor of developing vascular dementia. Durative hypertension can induce vascular remodeling and is used for modeling small vessel disease in rodents. It remains undetermined if the combination of hypertension and sleep disturbance exacerbates vascular dysfunction or pathologies. Previously, we found chronic sleep fragmentation (SF) dampened cognition in young mice without disease predispositions. In the current study, we superimposed SF with hypertension modeling in young mice. Angiotensin II (AngII)-releasing osmotic mini pumps were subcutaneously implanted to generate persistent hypertension, while sham surgeries were performed as controls. Sleep fragmentation with repetitive arousals (10 s every 2 min) during light-on 12 h for consecutive 30 days, while mice undergoing normal sleep (NS) processes were set as controls. Sleep architectures, whisker-stimulated cerebral blood flow (CBF) changes, vascular responsiveness as well as vascular pathologies were compared among normal sleep plus sham (NS + sham), SF plus sham (SF + sham), normal sleep plus AngII (NS + AngII), and SF plus AngII (SF + AngII) groups. SF and hypertension both alter sleep structures, particularly suppressing REM sleep. SF no matter if combined with hypertension strongly suppressed whisker-stimulated CBF increase, suggesting the tight association with cognitive decline. Hypertension modeling sensitizes vascular responsiveness toward a vasoactive agent, Acetylcholine (ACh, 5 mg/ml, 10 μl) delivered via cisterna magna infusion, while SF exhibits a similar but much milder effect. None of the modeling above was sufficient to induce arterial or arteriole vascular remodeling, but SF or SF plus hypertension increased vascular network density constructed by all categories of cerebral vessels. The current study would potentially help understand the pathogenesis of vascular dementia, and the interconnection between sleep and vascular health.

Sound-based sleep assessment with controllable subject-dependent embedding using Variational Domain Adversarial Neural Network

AbstractSleep quality assessment as an indicator of daily health care plays an important role in our physiological and mental activity. Sound during sleep contains rich information on biological activities, such as body movement, snoring, and sleep bruxism. However, sound features differ depending on individual and environmental differences. In order to develop a wide-rage applicable daily sleep assessment, this paper utilizes deep learning to ease individual and environmental differences of sound features. Firstly, by Variational Domain Adversarial Neural Network (VDANN) encodes sound events into latent representation, simultaneously eliminates subject-dependent features. Then, sleep pattern in the obtained latent space is trained by Long Short-Term Memory (LSTM) with associated sleep assessment of one night. We performed age group estimation from normal sleep as an objective indicator of sleep comparing to their age group. The experiment with more than 100 subjects showed that VDANN is able to extract subject independent features, and the proposed method outperforms the conventional method for age group estimation from sleep sound even for new subjects. In addition, our model is able to personalize by controlling subject-dependent embedding when after data accumulation of the subject.

Antidepressant use patterns in pregnancy

The occurrence of depression during pregnancy and the peripartum period can have an adverse effect on both the mother (affecting proper dietary intake, normal sleep pattern, and general maternal health) and the child (including preterm birth and low birthweight). Maternal depression can also decrease breastfeeding initiation and lower maternal‐infant bonding.

Sleep Patterns, Insomnia, and Well-Being Among Female High School Students: A Population-Based Study

Background and Objective The role of insomnia in the well-being of school children has not been sufficiently examined in the literature. We aimed to explore the prevalence of clinical insomnia and its relationship to the health-related quality of life among female high-school students.Methods In a cross-sectional study in 2018, 300 students from five female high-schools in the Kurdistan Region were randomly included, regardless of age and other socio-demographic characteristics. The Personal Wellbeing Index, General Health Questionnaire–12, and Insomnia Severity Index were used to measure the personal and general well-being, and insomnia of school children, respectively.Results The students were categorized into short sleepers (2.0%), normal sleepers (51.0%), and long sleepers (47.0%), and age range is 14–19 years (mean: 16.22 years). The mean value of general well-being and insomnia severity was 6.89 and 11.42, respectively. We found that 25.0% of the students had no clinically significant insomnia, 47.7% had subthreshold insomnia, 24.0% had clinically moderate insomnia, and 3.3% had clinically severe insomnia. The mean value of the personal well-being of students was 7.91 out of 10. The mean value of personal well-being was significantly lower among students with more severe insomnia. The mean values of personal well-being were 8.61 (no clinically significant insomnia), 7.87 (subthreshold insomnia), 7.49 (clinically moderate insomnia), and 6.91 (clinically severe insomnia). The worse sleep situations and smoking were the main independent controlling factors for lower personal well-being.Conclusions The study documented that female students are at risk of being clinical insomniacs, and are at risk of the development of lower well-being.

The REM microarousal and REM duration as the potential indicator in paradoxical insomnia

ObjectiveAlthough paradoxical insomnia is a prevalent subtype of chronic insomnia, the etiology of it is unclear. Contrary to complaints of little or no sleep, polysomnography (PSG) findings show that paradoxical insomnia patients have near normal sleep macrostructure. The purpose of this study is to determine the changes of microstructure and explore the etiology of paradoxical insomnia. MethodsThe PSG findings of 89 paradoxical insomnia patients were compared with those of 41 gender balanced healthy controls without sleep complaints. All subjects underwent nocturnal PSG recordings. Conventional PSG measures and microarousals were quantified and statistically analyzed. Receiver operating characteristic curve and correlation analysis were used to evaluate the potential of REM sleep microarousals and REM duration as indicators of paradoxical insomnia. ResultsCompared with the controls, paradoxical insomnia patients had no significant differences in sleep macrostructures. Statistical analysis showed that non-rapid eye movement (NREM) microarousals revealed no significant differences between paradoxical insomnia patients and controls. Noticeably, more spontaneous microarousals appeared in rapid eye movement (REM) stage for paradoxical insomnia patients. Based on receiver operating characteristic curve (ROC), the optimal cutoff value of REM sleep microarousals could predict paradoxical insomnia. Furthermore, a positive correlation between microarousals in REM sleep and the duration of REM sleep was presented in paradoxical insomnia patients. ConclusionsThe frequency of REM microarousals and the duration of REM sleep could reflect the real sleep state of paradoxical insomnia patients. That suggested PSG investigation extended to microarousal could be helpful to understand the etiology in paradoxical insomnia.

Associations of Leisure Activities and Sleep Duration with Cognitive Function: A Nationwide Prospective Cohort Study of Chinese Old Adults.

Leisure activities and sleep duration are correlated and have been linked to cognitive function, but most studies have examined only one of these factors. To investigate the independent and joint associations of leisure activities and sleep duration with cognitive function among older adults. We included 7,796 participants aged≥65 years from the Chinese Longitudinal Healthy Longevity Survey during 2008-2018 (waves 5-8). Self-reported leisure activities and sleep duration were assessed at baseline, and cognitive function was measured repeatedly using the Chinese version of the Mini-Mental State Examination (MMSE) at baseline and during follow-up. We used linear mixed models to estimate regression coefficients (β) and 95% confidence intervals (CI). The median follow-up duration was 5.77 years. After adjusting for each other and potential confounders, both lower leisure activity score (each 1-point decrease β= -0.33, 95% CI: -0.36 to -0.30) and longer sleep duration (each 1-hour increase β= -0.17, 95% CI: -0.22 to -0.11) were independently associated with lower MMSE score. Furthermore, we observed an additive interaction between leisure activities and sleep duration (pinteraction < 0.001). A combination of low leisure activity score and long sleep duration was strongly associated with decreased MMSE score (β= -2.51, 95% CI: -2.85 to -2.16) compared with the group with combined high leisure activity score and normal sleep duration. Both leisure activities and sleep duration were independently associated with cognitive function. Moreover, the combination of leisure inactivity and prolonged sleep duration predicted worse cognitive function (a preclinical hallmark of Alzheimer's disease) in an additive manner.

Sex hormone dose escalation for treating abnormal sleep in ovariectomized rats: in vitro GABA synthesis in sleep-related brain areas.

No data in the literature have evaluated sex hormone dose escalation for treating abnormal sleep of ovariectomized rats-nor studies on the role of sex hormones in GABA synthesis of rats' sleep-related areas. The main aim of this study was to determine the maximum tolerated dose (MTD) of estradiol (ET), progesterone (PT), and the mixture of both (EPT) to restore normal sleep in a model of menopause in rats. The second purpose was to describe the in vitro activity of glutamate decarboxylase (GAD) in sleep-related brain areas in the presence or absence of sex hormones. A weekly dose-escalation design of ET, PT, or EPT was implemented in ovariectomized rats (six per group). Dose escalation continued until the dose at which 100% of the rats exhibited a state of "complete somnolence." Doses that were not toxic or did not show side effects were considered. For in vitro experiments, sleep-related brain areas were separated and incubated with radiolabeled glutamate. Estradiol (17β-E2), progesterone (P), and pyridoxal phosphate (PLP) were added to this assay, and GAD activity was determined. Under the same conditions, a second test was carried out, but the P antagonist RU486 was added to assess the role of P in GAD activity. Ovariectomy increased periodic awakenings compared to those determined for the SHAM group. The EPT for ovariectomized rats was very effective by the fifth week in decreasing arousal and achieving a similar sleep behavior to the SHAM-control group. Rats tolerated the ET, PT, and EPT well to the maximum planned dose (0.66mg/kg and 4.4mg/kg, respectively). No lethal events occurred; the MTD was reached. The in vitro studies indicated that the presence of 17β-E2 plus P in the assay triggered the activity of isotype 65 GAD in all the studied brain areas. RU486 in the incubation medium blocked such activity; however, the action of isotype 67 GAD was not blocked by RU486. A dose-escalation model was determined; the MTD coincided with the maximum dose of ET and PT used. However, the EPT combination restored normal sleep in the menopause model compared to the SHAMs without toxic effects. The in vitro model demonstrated that 17β-E2 plus P presence in the assay increased the activity of GAD65 in the studied brain tissues.

Dysfunctional synaptic pruning by microglia correlates with cognitive impairment in sleep-deprived mice: Involvement of CX3CR1 signaling

Microglia are involved in sleep/wake cycles and the response to sleep loss. Synaptic pruning by microglia is necessary for central nervous system circuit refinement and contributes to cognitive function. Here, we investigated whether and how microglia-mediated synaptic pruning may be involved in cognitive deficits induced by sleep deprivation in mice. Mice were deprived of sleep by leaving them in a spontaneously rotating rod for 72 h, after which their cognitive function was assessed using an object location test, Y maze, and novel object recognition test. Sleep deprivation lowered the discrimination index for familiar locations in the object location test and Y maze. Microglial morphology was assessed using immunostaining Iba1, while microglia-mediated synaptic pruning was examined based on immunostaining PSD95, CD68, and Iba1. Sleep deprivation also activated microglial cells in the hippocampus, as reflected in bigger soma as well as fewer and shorter branches than normal sleep. Sleep deprivation downregulated phagocytic markers and internalization of postsynaptic protein 95 (PSD95), suggesting impaired synaptic pruning. CX3C motif chemokine receptor 1 (CX3CR1) signaling was detected in in vitro experiments. Sleep deprivation also downregulated CX3CR1. Activation of CX3CR1 signaling increased phagocytosis activity of BV2 microglia in vitro. Sleep deprivation dysregulates microglial CX3CR1 signaling and inhibits synaptic pruning, contributing to associated cognitive deficits. These findings identify CX3CR1-dependent synaptic pruning as a potential therapeutic target in which sleep deprivation causes recognition impairments.

Relationships Among Short Self-Reported Sleep Duration, Cognitive Impairment, and Insular Functional Connectivity in Late-Life Depression.

Both late-life depression (LLD) and short sleep duration increase the risk of cognitive impairment. Increased insular resting-state functional connectivity (FC) has been reported in individuals with short sleep duration and dementia. This study aimed to investigate whether short sleep duration is associated with impaired cognition and higher insular FC in patients with LLD. This case- control study recruited 186 patients with LLD and 83 normal controls (NC), and comprehensive psychometric assessments, sleep duration reports and resting-state functional MRI scans (81 LLD patients and 54 NC) were conducted. Patients with LLD and short sleep duration (LLD-SS patients) exhibited more severe depressive symptoms and worse cognitive function than those with normal sleep duration (LLD-NS patients) and NC. LLD-SS patients exhibited higher FC between the bilateral insula and inferior frontal gyrus (IFG) pars triangularis than LLD-NS patients and NC, while LLD-NS patients exhibited lower FC than NC. Increased insular FC was correlated with short sleep duration, severe depressive symptoms, and slower information processing speeds. Furthermore, an additive effect was found between sleep duration and LLD on global cognition and insular FC. LLD-SS patients exhibited impaired cognition and increased insular FC. Abnormal FC in LLD-SS patients may be a therapeutic target for neuromodulation to improve sleep and cognitive performance and thus decrease the risk of dementia.

U-Shaped Relationship between Sleep Duration and CKD in US Adults: Data from National Health and Nutrition Examination Survey (NHANES) 2005–2014

Introduction: Short and long sleep durations have been associated with adverse health outcomes. The objective of this study was to examine the association between self-reported sleep duration and chronic kidney disease (CKD) in the general population on the basis of the National Health and Nutrition Examination Survey (NHANES) database. Methods: A total of 28,239 adults aged ≥18 years who participated in the 2005–2014 NHANES were analyzed. CKD was defined as an estimated glomerular filtration rate <60 mL/min per 1.73 m2 or urinary albumin/urine creatinine ratio ≥300 mg/g. Very short sleepers and short sleepers were defined as those who sleep ≤5 h or 5.1–6.9 h per day, respectively. Long sleepers and very long sleepers were defined as those who sleep 9.0–10.9 h or ≥11 h per day, respectively. Normal sleepers were defined as those who sleep 7.0–8.9 h. The association between sleep duration and CKD was assessed using a logistic regression model. Results: Very short (≤5 h) sleep duration was associated with higher odds of CKD (multiadjusted OR, 1.38; 95% confidence interval, 1.17–1.62 comparing normal categories of 7.0–8.9 h; P trend = 0.01), after adjusting for potential confounders. Participants with long (9–10.9 h) sleep duration also tended to have a higher odds of CKD (multiadjusted OR, 1.39; 95% confidence interval, 1.20–1.61 comparing normal categories of 7.0–8.9 h; P trend = 0.01). This risk was further increased in those whose sleep duration exceeded 11 h (multiadjusted OR, 2.35; 95% confidence interval, 1.64–3.37 comparing normal categories of 7.0–8.9; P trend = 0.01). However, there was no statistically significant association between short (≤6.0–7.9 h) sleep duration and CKD (multiadjusted OR, 1.05; 95% confidence interval, 0.96–1.14 comparing normal categories of 7.0–8.9 h; P trend = 0.32). Conclusion: We demonstrated that the higher CKD prevalence estimates were found in very short (≤5 h) and long (9.0–10.9 h) sleep durations in an apparently healthy population aged ≥18 years in the USA. This prevalence of CKD is further increased in those whose sleep duration exceeds 11 h. Our cross-sectional analyses clarified the U-shaped temporal relationship between sleep duration and CKD.

Cognitive Impairments, Neuroinflammation and Blood-Brain Barrier Permeability in Mice Exposed to Chronic Sleep Fragmentation during the Daylight Period.

Obstructive sleep apnea (OSA) is a chronic condition characterized by intermittent hypoxia (IH) and sleep fragmentation (SF). In murine models, chronic SF can impair endothelial function and induce cognitive declines. These deficits are likely mediated, at least in part, by alterations in Blood-brain barrier (BBB) integrity. Male C57Bl/6J mice were randomly assigned to SF or sleep control (SC) conditions for 4 or 9 weeks and in a subset 2 or 6 weeks of normal sleep recovery. The presence of inflammation and microglia activation were evaluated. Explicit memory function was assessed with the novel object recognition (NOR) test, while BBB permeability was determined by systemic dextran-4kDA-FITC injection and Claudin 5 expression. SF exposures resulted in decreased NOR performance and in increased inflammatory markers and microglial activation, as well as enhanced BBB permeability. Explicit memory and BBB permeability were significantly associated. BBB permeability remained elevated after 2 weeks of sleep recovery (p < 0.01) and returned to baseline values only after 6 weeks. Chronic SF exposures mimicking the fragmentation of sleep that characterizes patients with OSA elicits evidence of inflammation in brain regions and explicit memory impairments in mice. Similarly, SF is also associated with increased BBB permeability, the magnitude of which is closely associated with cognitive functional losses. Despite the normalization of sleep patterns, BBB functional recovery is a protracted process that merits further investigation.

Neutrophil activation may trigger tau burden contributing to cognitive progression of chronic sleep disturbance in elderly individuals not living with dementia

BackgroundTo investigate the complex connection between chronic sleep disturbance (CSD) and cognitive progression.MethodsThe Alzheimer’s Disease Neuroimaging Initiative (ADNI) database was used to assign 784 non-dementia elderly into two groups: a normal sleep group (528 participants) and a CSD group (256 participants) via the Neuropsychiatric Inventory (NPI)-sleep subitem. Blood transcriptomics, blood neutrophil, cerebrospinal fluid (CSF) biomarkers of Alzheimer’s disease (AD), and neutrophil-related inflammatory factors were measured. We also investigated gene set enrichment analysis (GSEA), Cox proportional hazards model for risk factors, and mediation and interaction effects between indicators. Cognitive progression is defined as the progression from cognitively normal to mild cognitive impairment (MCI)/dementia or from MCI to dementia.ResultsCSD could significantly affect cognitive function. The activated neutrophil pathways for cognitive progression in CSD were identified by transcriptomics GSEA, which was reflected by increased blood neutrophil level and its correlation with cognitive progression in CSD. High tau burden mediated the influence of neutrophils on cognitive function and exacerbated the CSD-related risk of left hippocampal atrophy. Elevated neutrophil-related inflammatory factors were observed in the cognitive progression of CSD and were associated with brain tau burden.ConclusionsActivated neutrophil pathway triggering tau pathology may underline the mechanism of cognitive progression in CSD.

Effectiveness of internet-based CBT-I for the treatment of chronic subthreshold to moderate insomnia.

To study the effectiveness of the first internet-based cognitive behavioral therapy for insomnia (CBT-i) in Thailand, using the Nitra application, for chronic subthreshold to moderate insomnia treatment. An interventional study without a control group was conducted between January and June 2022. Participants were adults aged 18 years old and older with subthreshold to moderate severity of chronic insomnia (insomnia severity index (ISI) of 8-21) and had mean sleep efficiency <85% from baseline sleep diaries. Baseline sleep characteristics were obtained from questionnaires and sleep diaries from the Nitra application for 2 weeks. Eligible participants continued using the Nitra application for 4 weeks during the intervention period. Interventions including sleep restriction, stimulus control, cognitive restructuring, relaxation techniques, and sleep hygiene education were implemented via the pre-programmed Nitra application. Post-intervention sleep characteristics were also obtained from questionnaires and sleep diaries from the Nitra application for another 1 week. A total of 40 participants completed the study. All participants had a baseline sleep efficiency of less than 85% with the majority of the participants having a sleep-onset insomnia problem (98%). For the primary outcome, sleep efficiency was significantly improved after using the Nitra application (p < 0.001). Self-reported total sleep time, sleep onset latency, wake after sleep onset, early morning awakening, ISI, Pittsburgh Sleep Quality Index (PSQI), and average subjective sleep quality were also significantly improved (p < 0.001 for all parameters except p = 0.017 for total sleep time and p = 0.018 for wake after sleep onset). Participants who had a low baseline ISI and went to bed and woke up within 30 minutes of a designated bedtime and wake-up time recommended by the Nitra application for ≥70% of all nights demonstrated an increased chance of achieving normal sleep efficiency after using the Nitra application. This first internet-based CBT-i in Thailand, using the Nitra application, effectively improved sleep efficiency and other sleep parameters in chronic subthreshold to moderate insomnia.

Association of sleep duration with cognitive performance and structural brain differences: A large population‐based cross‐sectional study

AbstractBackgroundSleep duration has been linked to dementia risk; however, its association with cognitive functioning in specific domains and the underlying mechanisms remain unclear. We aimed to examine the association of sleep duration with cognitive performance and structural brain differences using magnetic resonance imaging (MRI).MethodsWithin the UK Biobank, 43,255 dementia‐free participants (aged ≥44, 52.0% female) were included. Self‐reported sleep duration (hours/day) was recorded following a structured questionnaire and trichotomized as short (≤5), normal (6‐8), and long (≥9) sleep. Cognitive functioning (including fluid intelligence, pairs matching, reaction time, and numeric memory) was evaluated using a touchscreen test battery. MRI scans were performed, and total and regional brain volumes (including white matter, gray matter, and hippocampus), and white matter hyperintensities (WMH) were measured. Data on lifestyle factors and medical conditions were collected. Data were analyzed using linear regression.ResultsOf all participants, 2092 (4.8%) had short, 38,041 (87.9%) had normal, and 3122 (7.2%) had long sleep. In multi‐adjusted linear regression, compared with normal sleep duration, both short (β: ‐0.14, 95%, CI: ‐0.19 to ‐0.10) and long (β: ‐0.06, 95% CI: ‐0.10 to ‐0.03) sleep were related to poorer performance in fluid intelligence. Long sleep was also associated with poorer numeric memory (β: ‐0.06, 95% CI: ‐0.10 to ‐0.01). In MRI data analyses, compared with normal sleep duration, short sleep was related to a smaller hippocampus volume (β: ‐0.05, 95% CI: ‐0.09 to ‐0.01), while long sleep was associated with smaller total brain (β: ‐4.51, 95% CI: ‐6.82 to ‐2.21), gray matter (β: ‐3.32 95% CI: ‐4.70 to ‐1.94), and hippocampus (β: ‐0.06, 95% CI ‐0.09 to ‐0.02) volumes, but greater WMH (β: 0.05, 95% CI: 0.01 to 0.08), after adjusting for confounders.ConclusionsShort and long sleep durations are associated with poorer cognitive performance in different domains. Short sleep may indicate neurodegeneration, and long sleep may implicate both neurodegenerative and vascular changes in the brain.

Association of Objective and Subjective Sleep Duration and Diurnal Cortisol Rhythm among Community‐Dwelling People Living with Dementia

AbstractBackgroundEvidence has shown that both short and long sleep duration have adverse effects on cognitive health in older adults. Although changes in sleep duration have been linked with alterations in the hypothalamic‐pituitary‐adrenal axis, research on the association between sleep duration and various components of diurnal cortisol rhythm is inconsistent. In addition, limited research has examined this association in community‐dwelling people living with dementia. The aim of this study is to examine the association of objective and subjective sleep duration and cortisol rhythm indicators in a community‐dwelling population living with dementia.MethodParticipants in the Healthy Patterns Sleep Study (NCT03682185) provided three saliva samples at wakening, 30 minutes after waking, and bedtime on two consecutive days. Diurnal cortisol rhythm indicators included waking cortisol, cortisol awaking response, diurnal cortisol slope, and bedtime cortisol. Objective sleep duration was measured by averaging actigraphy over three days, and subjective sleep duration was assessed by a single item from the Pittsburgh Sleep Quality Index. The average daily total sleep duration was grouped into three categories: ≤5 (short), ≥9 (long), and &gt;5 &amp; &lt;9 (normal). 195 participants with valid cortisol and sleep data were used for analysis.ResultApproximately 60% (objective) or 45% (subjective) of the participants maintained seven to eight hours of sleep. Normal and long objective and subjective sleep duration preserved an intact diurnal cortisol rhythm. Short objective sleep duration, however, was associated with higher waking cortisol (p = 0.016) and diminished cortisol awaking response (p = 0.049), compared to normal sleep. No significance was found using subjective short sleep duration.ConclusionThis cross‐sectional study showed that objective short sleep duration was associated with disrupted cortisol rhythm. The findings suggest that neuroendocrine disturbance could be one mechanism linking sleep and dementia risk. Future studies are needed to confirm these findings using more sampling points in the morning. Additionally future research needs to consider the confounding sociodemographic and clinical characteristics such as race and dementia severity in a larger sample.

Effect of Sleep Duration on Blood Pressure in Patients with SARS-CoV-2 Infection and Hypertensive Urgencies in Shanghai Fangcang Shelter Hospital.

To evaluate the effect of sleep duration on blood pressure in patients with hypertension urgencies combined with SARS-CoV-2 infection in a Fangcang shelter hospital. From April 10, 2020 to May 20, 2022, we statistically analyzed the blood pressure and sleep conditions of 52 patients with combined hypertension urgencies and SARS-CoV-2 infection admitted in Shanghai National Convention and Exhibition Center Fangcang shelter hospital. They were divided into the short-term (daily sleep duration: <7 h) and normal sleep group (7-9 h). We performed a comparison of the control effects of basic antihypertensive drugs. Additionally, patients in the short-term sleep group underwent drug therapy for sleep regulation and continuous monitoring of blood pressure. Among these patients, the blood pressure was higher in the short-term sleep group than that of the normal sleep group, and also more difficult to control (p <0.05). Furthermore, the blood pressure of the patients in the short-term sleep group was more easily controlled after treatment with drugs for sleep regulation and basic antihypertensive drugs (p <0.05). The blood pressure level in patients with combined SARS-CoV-2 infection and hypertension urgencies was higher in those with a shorter duration of daily sleep, and also more difficult to control in Fangcang shelter hospital. Drug therapy for sleep regulation should be administered early to obtain sufficient blood pressure control effects.

Sleep from Infancy Through Adolescence.

This article describes the changes in normal sleep regulation, structure, and organization and sleep-related changes in respiration from infancy to adolescence. The first 2years of age are striking, with more time asleep than awake. With development, the electroencephalogram architecture has a marked reduction in rapid eye movement sleep and the acquisition of K-complexes, sleep spindles, and slow-wave sleep. During adolescence there is a reduction in slow-wave sleep and a delay in the circadian phase. Infants have a more collapsible upper airway and lower lung volumes than older children, which predisposes them to obstructive sleep apnea and sleep-related hypoxemia.

Development and validation of the Japanese version of the Restorative Sleep Questionnaire in community samples

ObjectiveThis study aimed to validate the Japanese version of the Restorative Sleep Questionnaire Weekly version (RSQ-W-J) and estimate the RSQ-W-J cut-off score to identify the degree of non-restorative sleep (NRS) that interferes with daytime function. MethodsAn online survey was conducted, and 513 participants (241 men, 272 women; mean age, 47.88 ± 16.66 years) completed the questionnaires. The RSQ-W-J, Multidimensional Fatigue Inventory, Athens Insomnia Scale, Patient Health Questionnaire-9, Epworth Sleepiness Scale, Sleep Debt Index, NRS and the degree of daytime dysfunction, and the diagnostic criteria for chronic insomnia were used as implementation scales. ResultsThe RSQ-W-J was confirmed to have a single-factor structure. Both the Cronbach α coefficient and test-retest reliability of RSQ-W-J were high (α = 0.91; intraclass correlation coefficient [ICC]agreement = 0.85). The RSQ-W-J was significantly negatively correlated with the scales of fatigue, insomnia, depressive symptoms, daytime sleepiness, and sleep debt. In addition, the RSQ-W-J scores of the insomnia group, in which participants met the diagnostic criteria for chronic insomnia, NRS group, in which participants had NRS only, and sleep debt group, in which participants had sleep debt, were significantly lower than those in the normal sleep group. Furthermore, the insomnia group scored significantly lower than the sleep debt group. The RSQ-W-J cut-off score, which indicates whether or not NRS interferes with daytime function, was estimated to be 45.8 points. ConclusionsThe RSQ-W-J was shown to be useful for comprehensively measuring the degree of restorative sleep.