Sleep Debt Research Articles

Subjective sleep quality in adolescent girls with menstrual disorders

Background. Menstrual irregularities occupy a leading place among gynecological diseases in girls. It is assumed that there is a connection between reproductive system disorders and sleep in adolescent girls, but to date this issue remains poorly understood.The aim. To study the subjective sleep quality of adolescent girls with irregular and regular menstrual cycles.Materials and methods. A survey of 461 teenage girls living in the city of Irkutsk and the Irkutsk region was conducted in the period from January 2023 to May 2024. Two groups were formed: group 1 – teenage girls with an irregular menstrual cycle (n = 121), group 2 – teenage girls without menstrual disorders (n = 340).Results. Adolescent girls with irregular menstrual cycles had sleep disturbances more often and longer, falling asleep later and taking longer, waking up later, poor sleep and daytime sleepiness. The average duration of sleep on weekdays, regardless of the nature of the menstrual cycle, was below the normal values for this age, which indicates a sleep deficit in adolescent girls.Conclusions. Poor sleep hygiene in adolescent girls, poor quality and short sleep cause disruption of the circadian rhythm that regulates the menstrual cycle. Increasing the duration and improving the quality of sleep are an important component of the formation and maintenance of reproductive health in adolescent girls. Further research is needed to better understand the complex relationships between circadian sleep-wake rhythms and the reproductive system in adolescent girls.

Tired and out of control? Effects of total and partial sleep deprivation on response inhibition under threat and no-threat conditions.

Sleep deprivation may impair top-down inhibitory control over emotional responses (e.g., under threat). The current study examined behavioral consequences of this phenomenon and manipulated the magnitude of individuals' sleep deficit to determine effect thresholds. Twenty-four healthy human participants were provided with 0hr, 2hr, 4hr and 8hr of sleep opportunity and, subsequently, performed a bimanual anticipatory response inhibition task under threat and no-threat conditions. Behavioral responses (button presses) and surface electromyography (EMG) from task effectors were collected to examine going and stopping processes. Bayesian analyses revealed that compared to 8hr sleep, go trial accuracy was reduced with 0hr sleep. Stopping speed was reduced with 0hr and 2hr of sleep, as evidenced by longer stop-signal delays, but only in a selective stopping context. None of the outcome measures were impacted with 4hr sleep. Under threat, go trial accuracy was maintained, whilst responses were slightly delayed and characterized by amplified EMG-bursts. Stopping speed was increased under threat across both stop-all and selective stopping contexts. No evidence was observed for interactions between sleep and threat. Sleep deprivation negatively affected response inhibition in a selective stopping context, with stopping speed reduced following a single night of ≤ 2hr sleep. Performance-contingent threat improved response inhibition, possibly due to a prioritizing of stopping. No evidence was observed for increased threat-related responding after sleep deprivation, suggesting that sleep deprivation and threat may impact inhibitory control via independent mechanisms.

Blood osmolytes such as sugar can drive brain fluid flows in a poroelastic model

The glymphatic system of fluid flow through brain tissue may clear amyloid-β during sleep and as such underlie the need for sleep. Dysfunctional glymphatic transport has been implicated in pathological conditions ranging from stroke and dementia to psychiatric illnesses. To date, the fastest observed in-vivo brain flows have been reported after the manipulation of blood osmotic pressures. Surprisingly, the brain seems to shrink while receiving more influx. Though influx of an incompressible fluid might expand the tissue, no physical theory for these observations has been proposed. We here present a minimal mathematical model of brain pressure, deformation, and fluid flows due to vascular osmotic pressures. The model is based on Darcy flow, linear poroelasticity theory and conservation of mass. We propose that a screened Poisson equation holds for interstitial pressure because vascular filtration corresponds to fluid divergence. The model resolves the apparent paradox of combined fluid influx with tissue shrinkage by showing that fluid absorption into the blood can drive both. In this model, small glucose concentration differences between plasma and brain can drive brain flow velocities observed in recent in-vivo assays. Osmosis may therefore drive brain fluid flow under physiological conditions and provide an explanation for the known correlations between diabetes and dementia.

Using actigraphy to assess chronotype: Simpler is better

ABSTRACT Actigraphy provides a unique method for objectively measuring sleep activity patterns, but confusion remains about how to use actigraphy data to determine chronotype. To determine the most suitable parameter, this study made a systematic comparison of actigraphy-derived parameters: the average midpoint of sleep of all record days (aMS-acti), cosine parameter (Bathyphase), and non-parametric parameter (L5-mid) in terms of the consistency with subjective chronotype parameters, test–retest reliability, and external validity. More importantly, we proposed multiple Munich Chronotype Questionnaire (MCTQ)-based actigraphy parameters: considering the difference between weekday (MSW-acti) with weekends (MSF-acti) and the sleep debt (MSFsc-acti). The study collected 5 days of actigraphy and scale data from 1,055 young adults, 138 of whom participated in the retest 2 years later. The results showed that, in terms of consistency with subjective chronotype, aMS-acti generally performed better than other actigraphy parameters. In addition, aMS-acti had the highest test–retest reliability and was more closely related to the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Self-Rating Depression Scale (SDS). The results suggest that the simplest parameter (aMS-acti) is superior to traditional cosine and non-parametric parameters and MCTQ-derived parameters for short-term assessment of chronotype.

Use of Basket Trials to Solve Sleep Problems in Patients with Rare Diseases.

The need for sleep is universal, and the ability to meet this need impacts the quality of life for patients, families, and caregivers. Although substantial progress has been made in treating rare diseases, many patients have unmet medical sleep needs, and current regulatory policy makes it prohibitively difficult to address those needs medically. This opinion reviews the rare disease experience with sleep disorders and explores potential solutions. First, we provide case profiles for the rare diseases Wilson's Disease, Angelman Syndrome, and Prader-Willi Syndrome. These profiles highlight challenges in rare disease diagnosis and barriers to pinpointing disease pathophysiology, including biomarkers that intersect with sleep disorders. Second, we transition to a bird's eye view of sleep disorders and rare diseases by reporting input from a stakeholder discussion with the U.S. Food and Drug Administration regarding abnormal sleep patterns in various rare diseases. Last, in response to the profound unmet medical needs of patients with rare diseases and sleep disorders, we propose adapting and using the clinical trial design known as a "basket trial". In this case, a basket trial would include patients with different rare diseases but the same debilitating symptoms. This research approach has the potential to benefit many rare disease patients who are otherwise left with profound unmet medical needs.

Quality of life, physical symptoms, and psychological symptoms according to the status of chronic vestibulopathy.

Symptomatic vestibulopathy impairs patients' lives. However, few studies have explored the lives of patients with compensated or asymptomatic vestibulopathy. This study investigated the quality of life (QOL), psychological health, and physical function of patients with vestibulopathy. Using the eighth Korea National Health and Nutrition Examination Survey database, we included individuals with data on demographic factors, diabetes, hypertension, dizziness experiences, pure-tone audiometry, video head impulse test (vHIT), Health-related Quality of Life Instrument with 8 Items, General Anxiety Disorder 7-item scale, stress, and walking and sitting times. Participants were classified into the following groups: an uncompensated group with abnormal vHIT result and chronic dizziness, a compensated group with abnormal vHIT result and a history of dizziness, an asymptomatic group with abnormal vHIT result and no history of dizziness, and a normal group without abnormal vHIT result or a history of dizziness. Uncompensated vestibulopathy was more common in older individuals and women. The uncompensated group showed impairments in climbing stairs (P < 0.001), pain (P < 0.001), vitality (P = 0.001), working (P < 0.001), depression (P < 0.001), sleep (P = 0.001), happiness (P = 0.002), anxiety (P = 0.006), and stress (P = 0.003). The compensated group showed deficits in pain (P < 0.001), work (P = 0.006), sleep (P = 0.001), and happiness (P = 0.001). The asymptomatic group had no deficits in QOL, psychological health, or physical function. These tendencies were similar after controlling for age and gender. Vestibulopathy with a history of dizziness has a long-lasting impact on QOL and emotional status, even after compensation. Uncompensated vestibulopathy has a significant effect on QOL and mental health. Notably, though, the compensated group also showed a reduction in QOL. Appropriate interventions for each category of patients should be provided based on their impaired functions.

Elucidating the alcohol-sleep-hangover relationship in college students using a daily diary approach.

This daily diary study expands knowledge of the pharmacological alcohol-sleep relationship using a multilevel modeling approach. The interplay between alcohol and sleep on hangover susceptibility is also explored. College students (n = 337; 52 % female) provided 2976 days of self-reported alcohol use. We regressed sleep duration onto accumulated sleep debt, prior night sleep duration, and estimated blood alcohol concentration (eBAC) at bedtime; linear mixed models disaggregated day and person-level effects. Binomial models, assessing days after drinking when eBAC = 0 % versus when eBAC>0 % at waketime, regressed hangover susceptibility onto the same predictors plus sleep duration. More accumulated sleep debt predicted slightly longer same-night sleep. Greater than average bedtime intoxication predicted longer than average same-night sleep when drinking ceased early, but later drinking attenuated the relationship. People who typically stopped drinking later in the night reported typically shorter sleep durations on drinking nights. When waketime eBAC = 0 %, higher eBAC at bedtime and drinking later on a given night predicted greater next-day hangover susceptibility. Typical bedtime eBAC and typically later drinking predicted typically greater hangover susceptibility. When waketime eBAC>0 %, longer sleep duration predicted more likely hangovers. Bedtime eBAC and sleep debt interacted, such that more sleep debt attenuated the positive association between intoxication and next-day hangover susceptibility. Late-night drinking appeared to reduce sleep duration and increase hangover susceptibility. Accumulated sleep debt complicated the alcohol-sleep-hangover relationship. External factors influencing sleep behaviors were not assessed, but the results highlight the need to deconstruct sleep into acute and chronic processes. Future studies should better subdivide physiological processes related to hangovers.

The impact of long-haul travel and 13h time change on sleep and rest activity circadian rhythm in speed skaters during World Cup competitions.

Athletes frequently compete only a few days after long-haul travel. Longitudinal real-world data on athletes' sleep and sleep-wake cycle in competitive settings remain scarce. This study assessed the impact of a long-haul travel across ∼13 time zones on sleep patterns, rest-activity circadian rhythms (RAR), and their subsequent effects on neuromuscular function and race performance in the Canadian Short-Track Speed Skating Team. Nineteen athletes (24±4years, 11 women) travelled from Montréal (UTC-5) to Asia (UTC+8, UTC+9) for World Cup races between 2017 and 2019. Actigraphy data were collected before (Baseline) and during travel, during the stay in Asia (SIA), and during competition days. RAR were computed using cosinor analyses on accelerometry data with 24h phase periods. Countermovement jump height (CMJ) was measured in a subsample (n=10). Compared to baseline (7:08±0:53), athletes obtained less sleep during travel (6:16±1:27) and competition days (6:35±1:10), and more during SIA (7:32±0:46; time effect P<0.0001). Sleep efficiency and CMJ were greater in SIA than baseline (P=0.007 and P=0.0004, respectively). During SIA, sleep time increased by 9 min per night until the fifth day (P<0.0001), with a slight decrease in sleep efficiency (P=0.005) and an increase in CMJ (P<0.0001). For RAR, mean activity peaked on day 2, shifting from late evening to ∼15:00. Race performance was not different from other races of the same season (P>0.254). Our results demonstrated that, despite the possible sleep debt from the long-haul travel, athletes recovered within 5 days, highlighting their adaptability to manage sleep debt and jetlag without impacting competitive outcomes.

Association between a healthy lifestyle and the prevalence of depression in radiology residents in China: findings from a nationwide survey

ObjectiveThe relationship between a healthy lifestyle and depression in radiology residents remains poorly understood. This study aims to investigate the relationship between a healthy lifestyle and depressive symptoms in radiology...

Hypersomnia secondary to severe acute respiratory syndrome coronavirus-2 infection

Excessive daytime sleepiness (EDS), with or without an excessive need for sleep, is a primary reason for patients seeking consultation at the sleep unit. EDS is observed in ~5% of the general population. Common causes of EDS include obstructive sleep apnea, sleep deprivation, effects of medication, psychiatric disease (especially depression), and circadian rhythm disorders. Coronavirus disease 2019 (COVID-19) infection is a rare cause of EDS. We present a case of mild COVID-19 infection as an unusual cause of hypersomnolence.

Sex differences in sleep deficits in mice with an autism-linked Shank3 mutation

BackgroundInsomnia is more prevalent in individuals with Autism Spectrum Disorder (ASD), can worsen core-symptoms and reduces quality of life of both individuals and caregivers. Although ASD is four times more prevalent in males than females, less is known about sex specific sleep differences in autistic individuals. Recent ASD studies suggest that sleep problems may be more severe in females, which aligns with the sex bias seen in insomnia for the general population. We have previously shown that male mice with a mutation in the high confidence ASD gene Shank3, Shank3∆C, recapitulate most aspects of the ASD insomnia phenotype. The objective of the present study was to leverage the Shank3∆C model to investigate sex-specific effects in sleep using polysomnography.MethodsAdult male and female Shank3∆C and wildtype (WT) littermates were first recorded for 24 h of baseline recordings. Subsequently, they were sleep deprived (SD) for five hours via gentle handling and allowed 19 h of recovery sleep to characterize the homeostatic response to SD. Vigilance states (rapid eye movement (REM) sleep, non-rapid eye movement (NREM) sleep and wake) were assigned by manual inspection using SleepSign. Data processing, statistical analysis and visualization were conducted using MATLAB.ResultsSex and genotype effects were found during baseline sleep and after SD. At baseline, male Shank3∆C mice sleep less during the dark period (active phase) while female Shank3∆C mice sleep less during the light period (rest phase) and sleep more during the dark period. Both male and female Shank3∆C mice show reduced spectral power in NREM sleep. We detect a significant effect of sex and genotype in sleep onset latency and homeostatic sleep pressure (sleepiness). In addition, while male Shank3∆C mice fail to increase sleep time following SD as seen in WT, female Shank3∆C mice decrease sleep time.ConclusionsOverall, our study demonstrates sex differences in sleep architecture and homeostatic response to SD in adult Shank3∆C mice. Thus, our study demonstrates an interaction between sex and genotype in Shank3∆C mice and supports the use of the Shank3∆C model to better understand mechanisms contributing to the sex differences in insomnia in ASD in clinical populations.

The Circadian Brain and Cognition.

Circadian rhythms are inherent to living organisms from single cells to humans and operate on a genetically determined cycle of approximately 24hours. These endogenous rhythms are aligned with the external light/dark cycle of the Earth's rotation and offer the advantage of anticipating environmental changes. Circadian rhythms act directly on human cognition and indirectly through their fundamental influence on sleep/wake cycles. The strength of the circadian regulation of performance depends on the accumulated sleep debt and the cognitive domain, and it has been suggested to involve the activation of ascending arousal systems and their interaction with attention and other cognitive processes. In addition, attention-related cortical responses show extensive circadian rhythms, the phases of which vary across brain regions. This review discusses the impact of the circadian system on sleep/wake regulation and cognitive performance. It further addresses the health implications of circadian disruption, particularly in relation to mental and neurological disorders.

The show must go on: fostering residents’ sustainable employability in medical education – a qualitative exploration of the Resident Leadership Program

BackgroundResidents’ sustainable employability (SE) is threatened by high burn-out rates, sleep deficits, and career dissatisfaction. Medical education may contribute to residents’ SE by providing them with opportunities to influence their employment contexts and to develop conscious self-regulation. This paper explores how residents, participating in the Resident Leadership Program (RLP), are enabled to work on, and learn about, their SE.MethodsThe RLP took place between February and July 2021 and consisted of lectures on, and practice in, quality improvement (QI) work. SE was the theme that governed residents’ QI projects. In this study, residents were interviewed individually before the program (n = 8), were observed while participating in the program (45 h) and were interviewed in three groups after the program (n = 8). The data were analysed in accordance with the ‘flexible-coding’ method.ResultsThe findings are presented in four ‘acts’ mirroring an unfolding play as a metaphor to show how residents’ understanding of context, self-regulations, and quality improvement work—relevant to their SE—changed in the RLP. The acts include ‘setting the stage’, describing how residents experienced the context of medicine; ‘acting the part’, depicting how residents managed their employment contexts using self-regulation; ‘changing the décor’, elaborating on residents’ QI projects; and ‘growing one’s role’, presenting residents’ take-aways from participating in the RLP that may benefit their SE. These take-aways encompassed awareness of the importance of SE, a reconsideration and/or adjustment of self-regulation, feeling better equipped to navigate employment contexts, and increased joy in work because of contributing to peers’ SE through QI work.ConclusionsOur results indicate that medical education is a fruitful environment for providing important lessons and tools for residents to work on and learn about their SE, likely benefiting their SE throughout their careers.

Dietary Habits of Young Poles and Their Selected Determinants: A Review and Implications for Public Health.

This study investigates the dietary patterns, health behaviors, and related determinants among young people in Poland, amid increasing lifestyle-related health concerns like obesity and poor nutrition. Understanding the factors influencing these behaviors is crucial for crafting effective public health strategies. The objective was to analyze young Poles' eating habits, their perceptions of health, and the role of various determinants in shaping these behaviors. A survey was conducted among a representative sample of young Poles, gathering data on eating habits, health perceptions, and lifestyle choices. The survey focused on the respondents' understanding of healthy eating, sources of nutrition knowledge, and the influence of family, social media, and public health campaigns. Data were analyzed using descriptive statistics, and correlations between health behaviors and socio-demographic factors were examined. The study revealed that 88% of young respondents prioritize health, with 73% acknowledging a link between nutrition and health. While most participants accurately described healthy eating and reported adherence to dietary guidelines, 43% engaged in emotional eating, which often led to compulsive behaviors associated with obesity. Social media, internet articles, and family were primary sources of nutrition knowledge. Despite their knowledge, fruit and vegetable consumption was below recommended levels, and physical activity levels were insufficient in nearly half of the respondents. Only 36% regularly read food labels, with many choosing products containing additives. Appearance-related stress was prevalent among 52% of respondents, while sleep deficits and lack of sufficient physical activity were common. The findings suggest that while young Poles possess a high level of awareness regarding healthy eating, gaps remain in the application of this knowledge, particularly concerning emotional eating and inadequate fruit and vegetable consumption. Public health campaigns should be more effectively targeted to address these gaps and promote sustainable health behaviors from early childhood. Addressing emotional eating, enhancing physical activity, and improving nutrition education through effective channels like social media are key to improving public health outcomes.

Sleeping on the edge: Adolescents living at moderate altitude report greater sleep need

PurposeResearch in adults suggests that altitude impacts the restorative properties of sleep and increases risk for mental health concerns. The aim of this study was to extend this research to an adolescent sample to examine how living at altitude may be associated with greater sleep need and mental health symptoms during a period of the life-span when risk for insufficient sleep and mental health difficulties is high. MethodsData were collected from 105 adolescents aged 10–17 years residing at moderate-high altitudes. Parents reported on sociodemographics and adolescent depressive and anxiety symptoms, and adolescents reported on their subjective sleep need and sleep duration. Altitude was calculated using U.S. Geological Survey data. ResultsAdjusting for age, sex, socioeconomic status, rurality, and sleep duration, living at higher altitude was associated with reports of greater sleep need. Altitude was unrelated to mental health symptoms. DiscussionThe majority of adolescents do not obtain the recommended amount of sleep. These findings suggest that adolescents living at moderate-high altitudes may be at further risk due increased sleep need at higher elevations.

The role of circadian clock gene Arntl in the winter depression-like behavior in melatonin-proficient female CBA/N mice

Seasonal affective disorder (SAD), also known as winter depression, is a subtype of depression typically manifesting in winter. Typical symptoms of SAD, such as an increased need for sleep and carbohydrate cravings associated with increased appetite and weight, are distinct from those of major depression, and the underlying mechanisms of SAD remain unclear. Although laboratory mice are generally considered non-seasonal animals, we observed depression-like behaviors in melatonin-proficient female CBA/N mice maintained under winter-mimicking conditions. Transcriptome analysis of the brains of CBA/N mice maintained under winter- and summer-mimicking conditions revealed changes in the expression of circadian clock genes, including Arntl (also known as Bmal1). We generated Arntl-deficient, melatonin-proficient CBA/N mice using the speed congenic method to examine the role of Arntl in depressive behavior. The tail suspension test in these mice revealed a depressive phenotype. These results suggested that the circadian clock gene Arntl may be involved in winter depression-like behavior.

Sleep Habits and Disturbances in Healthcare Workers: A Cross-Sectional Survey in French Public Hospitals.

To describe the sleep habits (bedtime hours, waking hours, sleep duration) and to assess the prevalence of sleep disturbances (acute and chronic insomnia, insufficient sleep, perceived sleep debt) among French healthcare workers. Nurses and assistant nurses working in public hospitals from the Loire department at different work schedules (2x12h, 2x8h, fixed daytime, fixed nighttime) were asked about their socioprofessional and demographic information, their sleep habits and disturbances during night shifts, and the acceptability of a 20-min nap opportunity. A total of 297healthcare workers completed the survey with 76% reporting a sleep debt with a lower prevalence for fixed nighttime workers (62%) and a higher prevalence for 2x12h (84%) workers. The prevalence of acute insomnia was 76% with a significant difference between fixed nighttime (60%) and 2x12h (82%); whereas the prevalence of chronic insomnia was 35% without any significant difference between working schedules. Moreover, 18% of healthcare workers reported excessive daytime sleepiness, while 13% admitted to using sleep medication at least once a week. French healthcare workers reported poor sleep quality with a high prevalence of sleep debt, acute and chronic insomnia symptoms without an obvious impact of working schedules.

Sleepless nights and social plights: medial septum GABAergic hyperactivity in a neuroligin 3-deficient autism model.

Social deficits represent a core symptom domain of autism spectrum disorder (ASD), which is often comorbid with sleep disturbances. In this issue of the JCI, Sun et al. explored a medial septum (MS) circuit linking these behaviors in a neuroligin 3 conditional knockout model of autism. They identified GABAergic neuron hyperactivity following neuroligin 3 deletion in the MS. This hyperactivity resulted in the inhibition of the downstream preoptic area (POA) and hippocampal CA2 region, resulting in sleep loss and social memory deficits, respectively. Inactivating the hyperactive MS GABA neurons or activating the POA or CA2 rescued the behavioral deficits. Together, these findings deepen our understanding of neural circuits underlying social and sleep deficits in ASD.

Sleep as a social and cultural practice in Aotearoa: a scoping review

ABSTRACT Traditionally, sleep science is grounded in biology, physiology, and medicine. But socio-cultural considerations provide a crucial lens into sleep health. Exploring the sociology of sleep in Aotearoa New Zealand (AoNZ) could broaden our understandings and better represent sleep-related practices among our diverse communities. This scoping review represents the pre-existing literature concerning sleep as a social or cultural practice in AoNZ. The initial search (via Discover and Scopus) search yielded 2,442 results. Of these results, 113 manuscripts were characterised of interest, but only 20 were directly related and included in the review. This literature was presented in relation to Meadows’ (2005) modes of ‘sleep embodiment’ including sleep practice norms, the pragmatics of sleep and social roles, individual experiences and feelings related to sleep, and the visceral need for sleep. The findings highlight the progress of sleep literature in AoNZ. This covers diverse sleep practices, perspectives and experiences of sleep and sleeping, as well as the broader socio-cultural factors and unique AoNZ context that influence sleep. However, gaps in the field of local sleep research are also identified. Findings lay the foundation for further research in AoNZ to explore sleep-related discourses and practices that will ultimately broaden existing perspectives.

An integrative analysis of cell-specific transcriptomics and nuclear proteomics of sleep-deprived mouse cerebral cortex.

Sleep regulation follows a homeostatic pattern. The mammalian cerebral cortex is the repository of homeostatic sleep drive and neurons and astrocytes of the cortex are principal responders of sleep need. The molecular mechanisms by which these two cell types respond to sleep loss are not yet clearly understood. By combining cell-type specific transcriptomics and nuclear proteomics we investigated how sleep loss affects the cellular composition and molecular profiles of these two cell types in a focused approach. The results indicate that sleep deprivation regulates gene expression and nuclear protein abundance in a cell-type-specific manner. Our integrated multi-omics analysis suggests that this distinction arises because neurons and astrocytes employ different gene regulatory strategies under accumulated sleep pressure. These findings provide a comprehensive view of the effects of sleep deprivation on gene regulation in neurons and astrocytes.