Sleep Variables Research Articles

Sleep architecture in idiopathic hypersomnia: the influence of age, sex, and body mass index

This study aimed to progress the understanding of idiopathic hypersomnia (IH) by assessing the moderating influence of individual characteristics, such as age, sex, and body mass index (BMI) on sleep architecture. In this retrospective study, 76 IH participants (38.1 ± 11.3 years; 40 women) underwent a clinical interview, an in-laboratory polysomnography with a maximal 9-h time in bed and a multiple sleep latency test (MSLT). They were compared to 106 healthy controls (38.1 ± 14.1 years; 60 women). Multiple regressions were used to assess moderating influence of age, sex, and BMI on sleep variables. We used correlations to assess whether sleep variables were associated with Epworth Sleepiness Scale scores and mean sleep onset latency on the MSLT in IH participants. Compared to controls, IH participants had shorter sleep latency (p = 0.002), longer total sleep time (p < 0.001), more time spent in N2 sleep (p = 0.008), and showed trends for a higher sleep efficiency (p = 0.023) and more time spent in rapid eye movement (REM) sleep (p = 0.022). No significant moderating influence of age, sex, or BMI was found. More severe self-reported sleepiness in IH patients was correlated with shorter REM sleep latency and less N1 sleep in terms of proportion and duration (ps < 0.01). This study shows that, when compared to healthy controls, patients with IH had no anomalies in their sleep architecture that can explain their excessive daytime sleepiness. Moreover, there is no moderating influence of age, sex, and BMI, suggesting that the absence of major group differences is relatively robust.

Evaluation of Prenatal Comfort, Sleep, and Quality of Life in Pregnant Women with Cholestasis: A Cross-Sectional Study.

Associated with adverse pregnancy outcomes, intrahepatic cholestasis of pregnancy is the most prevalent liver disease that women typically experience during pregnancy. This study aimed to evaluate prenatal comfort, sleep, and quality of life in pregnant women with cholestasis. This cross-sectional study was implemented between November 2022 and June 2023 at Mardin Training and Research Hospital with 150 pregnant women who received a diagnosis of pregnancy-induced intrahepatic cholestasis and agreed to participate. The following tools were utilized to collect data: A personal information form exploring socio-demographic and obstetric characteristics of participants, the Prenatal Comfort Scale (PCS), the Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life-Brief Form (WHOQOL-BREF). The mean age of participants was 27.79 ± 6.33 years. The mean PCS and PSQI scores were 61.20 ± 5.84 and 9.52 ± 3.02, respectively. The mean scores of "physical health, psychological health, social relationships, and environmental health" sub-dimensions in WHOQOL-BREF were 10.63 ± 2.18, 10.48 ± 2.10, 11.31 ± 3.28, and 11.27 ± 2.10, respectively. A significant difference was found for PSQI regarding hospitalization status and change in sleep quality variables (p = 0.025 and p = 0.035, respectively). Cholestasis of pregnancy creates problems such as pruritus, body image changes, hospitalization, and poor sleep quality in women. This study showed that pregnant women with cholestasis had low levels of sleep quality and quality of life, implying that cholestasis affects their sleep quality, prenatal comfort levels, and quality of life in general. In addition, it is seen that women with this problem do not want to fall pregnant again.

Sleep profiles of different psychiatric traits

Disturbed sleep comes in many forms. While the key role of sleep in mental health is undisputed, our understanding of the type of sleeping problems that manifest in the early stages of psychiatric disorders is limited. A sample without psychiatric diagnoses (N = 440, 341 women, 97 men, 2 non-binaries; Mage = 32.1, SD = 9.4, range 18–77) underwent a comprehensive assessment, evaluating eight sleep features and 13 questionnaires on common psychiatric complaints. Results revealed that traits of affect disorders, generalized anxiety, and ADHD had the worst sleep profiles, while autism disorder, eating disorder, and impulsivity traits showed milder sleep issues. Mania was the only trait associated with an overall better sleep profile. Across traits, insomnia and fatigue dominated and sleep variability was least prominent. These findings provide support for both transdiagnostic and disorder-specific targets for prevention and treatment.

Sleep duration, chronotype, health and lifestyle factors affect cognition: a UK Biobank cross-sectional study

ObjectiveTo explore the nuanced relationship between sleep patterns, chronotype, quality and the influence of health and lifestyle factors on cognitive performance.Design, setting, participantsThis cross-sectional analysis used ordinary least squares regression...

Alcohol Use Predicts Longer But More Fragmented Sleep: A Daily Diary Study of Alcohol, Sleep, and PTSD in Nurses.

Due to the demanding nature of their profession, nurses are at risk of experiencing irregular sleep patterns, substance use, and fatigue. Evidence supports a reciprocal relationship between alcohol use and sleep disturbances; however, no research has examined such a link in a sample of nurses. One factor that may further impact the dynamic between alcohol and sleep patterns is posttraumatic stress disorder (PTSD) symptoms. We investigated the daily bidirectional associations between alcohol use and several sleep domains (i.e., self-report and actigraphy-determined sleep), and moderation by baseline PTSD symptom severity. Over a 14-day period, 392 nurses (92% female; 78% White) completed sleep diaries and actigraphy to assess alcohol use and sleep patterns. Within-person bidirectional associations between alcohol and sleep were examined using multilevel models, with symptoms of PTSD as a cross-level moderator. Daily alcohol use (i.e., ≥ 1 alcoholic beverage; 25.76%) was associated with shorter self-reported sleep onset latency (b = -4.21, p = .003) but longer self-reported wake after sleep onset (b = 2.36, p = .009). Additionally, days with any alcohol use were associated with longer self-reported sleep duration (b = 15.60, p = .006) and actigraphy-determined sleep duration (b = 10.06, p = .037). No sleep variables were associated with next-day alcohol use. Bidirectional associations between alcohol consumption and sleep were similar regardless of baseline PTSD symptoms. Our results suggested that on days when nurses drank alcohol, they experienced longer but also more fragmented sleep.

Effect of Training Load Intensification on the Sleep Pattern of Young Soccer Players

ABSTRACT Purpose: The aim of this study was to examine how intensifying training loads over a week affects the sleep patterns of young soccer players on the nights immediately following the intensified training sessions. Methods: Quasi-experimental study. Fifteen young athletes participants of a team engaged in national level competition, underwent two weeks of training with varying load magnitudes—Week 1: low accumulated training load and Week 2: intensified training loads [40% increase in external training load(ETL)]. To characterize the intensification of the workload, the methods PlayerLoad and RPE-Session were employed to measure ETL and internal training load(ITL), respectively. Total sleep time(TST), total time in bed(TTB), sleep efficiency(SE), sleep latency(SL), and wake after sleep onset(WASO) were obtained using actigraphy and daily sleep log. The variables were compared among the days of week (e.g. Monday of week 1 with Monday of week 2, and so forth). Results: Acute training intensification in week 2 led to significant increases in ETL and ITL on Monday and on Wednesday(p < .05), and ETL(p < .05) on Friday on the second week. Improvements in sleep were observed (Tuesday—TST:+80 min, WASO:-29.3 min, SL:-8 min, SE:+9%; Thursday—TST:+86 min, SL:-4 min, SE:+4%; Saturday—TST:+40 min, SL:+1 min) compared to the same day of the previous week. Correlations between ETL and ITL(r = 0.637), ITL and TST(r = 0.572), ITL and SE(r = 0.548) were found. Conclusion: Intensification of training loads results in alterations in sleep variables, notably an elevated TST and SE in the days subsequent to the acute load increment.

A holistic lifestyle mobile health intervention for the prevention of type 2 diabetes and common mental disorders in Asian women with a history of gestational diabetes: a randomised control trial with 3-year follow-up protocol

BackgroundWomen with a history of gestational diabetes mellitus (GDM) are 12-fold more likely to develop type 2 diabetes (T2D) 4–6 years after delivery than women without GDM. Similarly, GDM is associated with the development of common mental disorders (CMDs) (e.g. anxiety and depression). Evidence shows that holistic lifestyle interventions focusing on physical activity (PA), dietary intake, sleep, and mental well-being strategies can prevent T2D and CMDs. This study aims to assess the effectiveness of a holistic lifestyle mobile health intervention (mHealth) with post-GDM women in preventing T2D and CMDs in a community setting in Singapore.MethodsThe study consists of a 1-year randomised controlled trial (RCT) with a 3-year follow-up period. Post-GDM women with no current diabetes diagnosis and not planning to become pregnant will be eligible for the study. In addition, participants will complete mental well-being questionnaires (e.g. depression, anxiety, sleep) and their child’s socio-emotional and cognitive development. The participants will be randomised to either Group 1 (Intervention) or Group 2 (comparison). The intervention group will receive the “LVL UP App”, a smartphone-based, conversational agent-delivered holistic lifestyle intervention focused on three pillars: Move More (PA), Eat Well (Diet), and Stress Less (mental wellbeing). The intervention consists of health literacy and psychoeducational coaching sessions, daily “Life Hacks” (healthy activity suggestions), slow-paced breathing exercises, a step tracker (including brisk steps), a low-burden food diary, and a journaling tool. Women from both groups will be provided with an Oura ring for tracking physical activity, sleep, and heart rate variability (a proxy for stress), and the “HAPPY App”, a mHealth app which provides health promotion information about PA, diet, sleep, and mental wellbeing, as well as display body mass index, blood pressure, and results from the oral glucose tolerance tests. Short-term aggregate effects will be assessed at 26/27 weeks (midpoint) and a 1-year visit, followed by a 2, 3, and 4-year follow-up period.DiscussionHigh rates of progression of T2D and CMDs in women with post-GDM suggest an urgent need to promote a healthy lifestyle, including diet, PA, sleep, and mental well-being. Preventive interventions through a holistic, healthy lifestyle may be the solution, considering the inextricable relationship between physical and psychological health. We expect that holistic lifestyle mHealth may effectively support behavioural changes among women with a history of GDM to prevent T2D and CMDs.Trial statusThe protocol study was approved by the National Healthcare Group in Singapore, Domain Specific Review Board (DSRB) [2023/00178]; June 2023. Recruitment began on October 18, 2023.Trial registrationClinicalTrials.gov NCT05949957. The first submission date is June 08, 2023.

Bedtime Screen Use Behaviors and Sleep Outcomes in Early Adolescents: A Prospective Cohort Study

PurposeTo determine prospective associations between bedtime screen use behaviors and sleep outcomes one year later in a national study of early adolescents in the United States. MethodsWe analyzed prospective cohort data from 9,398 early adolescents aged 11–12 years (48.4% female, 45% racial/ethnic minority) in the Adolescent Brain Cognitive Development Study (Years 2–3, 2018–2021). Regression analyses examined the associations between self-reported bedtime screen use (Year 2) and sleep variables (Year 3; self-reported sleep duration; caregiver-reported sleep disturbance), adjusting for sociodemographic covariates and sleep variables (Year 2). ResultsHaving a television or Internet-connected electronic device in the bedroom was prospectively associated with shorter sleep duration one year later. Adolescents who left their phone ringer activated overnight had greater odds of experiencing sleep disturbance and experienced shorter sleep duration one year later, compared to those who turned off their phones at bedtime. Talking/texting on the phone, listening to music, and using social media were all prospectively associated with shorter sleep duration, greater overall sleep disturbance, and a higher factor score for disorders of initiating and maintaining sleep one year later. DiscussionIn early adolescents, several bedtime screen use behaviors are associated with adverse sleep outcomes one year later, including sleep disturbance and shorter weekly sleep duration. Screening for and providing anticipatory guidance on specific bedtime screen behaviors in early adolescents may be warranted.

Association Between Perceived Noise Pollution and Sleep Quality: Findings from the 2018 Community Health Survey.

This study aimed to investigate the potential relationship between sleep quality and perceived noise. A cross-sectional study involving 185,246 adults (81,854 men and 103,392 women) participating in the 2018 Korea Community Health Survey (KCHS) was conducted. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while perceived noise pollutants were categorized into two groups: perceived noise pollution (n = 43,638) and perceived non-noise pollution (n = 141,608). We used chi-square tests and independent sample t tests to compare differences between the perceived noise group and the non-perceived noise group, as well as multivariate logistic regression analysis to calculate adjusted odds ratios (OR) for sleep quality variables. The perceived noise pollution group had significantly poor psychosocial variables (stress, depression assessed by Patient health questionnaire-9 (PHQ-9)) than the perceived non-noise pollution group. Poor sleep quality (PSQI > 5) was associated with perceived noise pollution (OR 1.33, 95% confidence interval (CI) 1.30-1.36, P < 0.001). In addition, sleep quality (OR 1.09; 95% CI 1.06-1.13, P < 0.001); sleep latency (OR 1.11; 95% CI 1.09-1.14, P < 0.001); sleep duration (OR 1.10; 95% CI 1.07-1.13, P < 0.001); sleep efficiency (OR 1.20; 95% CI 1.16-1.25, P < 0.001); sleep disturbance (OR 1.46; 95% CI 1.42-1.51, P < 0.001); sleep medication use (OR 1.13; 95% CI 1.07-1.20, P = 0.002); and daytime dysfunction (OR 1.23; 95% CI 1.20-1.26, P < 0.001) were associated with perceived noise pollution after confounding variables. Perceived noise pollution was significantly associated with poor sleep quality. Perceived noise annoyance could be used as a signal of health effects in the public community.

Lifestyle Clusters of Diet Quality, Sleep, and Screen Time and Associations with Weight Status in Children from Madrid City: ENPIMAD Study.

Childhood overweight and obesity is a global concern and has increased in Spain over the last decades. Combinations of lifestyle behaviors (i.e., diet, sleep, and sedentarism) are highly related to weight status. Therefore, this study aimed to identify lifestyle patterns among children from Madrid City, and analyze associations with the prevalence of overweight, obesity, and abdominal obesity, considering socio-economic factors. A cross-sectional analysis was conducted on 4545 children from the ENPIMAD study with data on diet, sleep, anthropometric, and socio-economic variables. K-means cluster analysis was used to identify lifestyle clusters, and logistic regressions were used to examine the associations between socio-economic indicators and cluster membership, and between clusters and weight status. Findings show three lifestyle clusters (healthy, mixed, and unhealthy), with boys and older children more represented in the unhealthy cluster. Food insecurity and low socio-economic status were associated with unhealthier clusters in boys and girls. Children in unhealthier clusters were more likely to have obesity and abdominal obesity. However, these associations disappeared in girls after controlling for food insecurity. These results provide insight into the combination of behaviors and socio-economic factors associated with childhood obesity that may aid in the design of future interventions.

Impact of spa therapy on physical activity, sleep and heart rate variability among individuals with fibromyalgia: Results of an ancillary study

Spa therapy is recommended to manage symptoms of fibromyalgia, but the physiological mechanisms underlying this improvement have been poorly studied. In an original study, we explored the effect of a 3-week rheumatology spa treatment for fibromyalgia patients on quality of life and with a symptom severity questionnaire. We present here the results of an ancillary study which explored three secondary criteria using objective measurement methods: diurnal actimetry for physical activity analysis, nocturnal actimetry for sleep analysis and heart rate variability. Eighty-three fibromyalgia patients were randomized to participate in an immediate 3-week rheumatological spa therapy, either a start within 6 weeks after inclusion (interventional group, n = 39) or a delayed, start 6 months after inclusion (control group, n = 44). Patients were asked to wear an actimeter (n = 56) to assess diurnal physical activity and sleep quality and a 24-h Holter ECG (n = 60) to assess nocturnal heart rate variability at baseline, 3 months and 6 months after inclusion. Time spent in sedentary and light physical activity was reduced to ∼30 min at 6 months in the interventional group (P = 0.027). Sleep quality and heart rate variability were not improved. Spa therapy made it possible to reduce sedentary activities in patients’ daily life for up to 6 months afterwards, concomitant with the improvement in quality of life, pain and fatigue as highlighted in the original Thermalgi study.

Longitudinal Assessment of Seasonal Impacts and Depression Associations on Circadian Rhythm Using Multimodal Wearable Sensing: Retrospective Analysis.

Previous mobile health (mHealth) studies have revealed significant links between depression and circadian rhythm features measured via wearables. However, the comprehensive impact of seasonal variations was not fully considered in these studies, potentially biasing interpretations in real-world settings. This study aims to explore the associations between depression severity and wearable-measured circadian rhythms while accounting for seasonal impacts. Data were sourced from a large longitudinal mHealth study, wherein participants' depression severity was assessed biweekly using the 8-item Patient Health Questionnaire (PHQ-8), and participants' behaviors, including sleep, step count, and heart rate (HR), were tracked via Fitbit devices for up to 2 years. We extracted 12 circadian rhythm features from the 14-day Fitbit data preceding each PHQ-8 assessment, including cosinor variables, such as HR peak timing (HR acrophase), and nonparametric features, such as the onset of the most active continuous 10-hour period (M10 onset). To investigate the association between depression severity and circadian rhythms while also assessing the seasonal impacts, we used three nested linear mixed-effects models for each circadian rhythm feature: (1) incorporating the PHQ-8 score as an independent variable, (2) adding seasonality, and (3) adding an interaction term between season and the PHQ-8 score. Analyzing 10,018 PHQ-8 records alongside Fitbit data from 543 participants (n=414, 76.2% female; median age 48, IQR 32-58 years), we found that after adjusting for seasonal effects, higher PHQ-8 scores were associated with reduced daily steps (β=-93.61, P<.001), increased sleep variability (β=0.96, P<.001), and delayed circadian rhythms (ie, sleep onset: β=0.55, P=.001; sleep offset: β=1.12, P<.001; M10 onset: β=0.73, P=.003; HR acrophase: β=0.71, P=.001). Notably, the negative association with daily steps was more pronounced in spring (β of PHQ-8 × spring = -31.51, P=.002) and summer (β of PHQ-8 × summer = -42.61, P<.001) compared with winter. Additionally, the significant correlation with delayed M10 onset was observed solely in summer (β of PHQ-8 × summer = 1.06, P=.008). Moreover, compared with winter, participants experienced a shorter sleep duration by 16.6 minutes, an increase in daily steps by 394.5, a delay in M10 onset by 20.5 minutes, and a delay in HR peak time by 67.9 minutes during summer. Our findings highlight significant seasonal influences on human circadian rhythms and their associations with depression, underscoring the importance of considering seasonal variations in mHealth research for real-world applications. This study also indicates the potential of wearable-measured circadian rhythms as digital biomarkers for depression.

The role of psychiatric symptoms, sociodemographic factors, and baseline sleep variables on pediatric insomnia treatment outcomes in a clinically referred population.

The current study aimed to examine clinically relevant psychiatric and sociodemographic predictors of insomnia treatment outcomes in pediatric patients clinically referred for insomnia. Pediatric patients (N = 1428; ages 1.5 - 18 years), presenting for insomnia evaluation in a medical/sleep center-based behavioral sleep clinic were followed for treatment as clinically indicated. According to patient age, parent/patients completed validated measures of insomnia severity, psychiatric symptoms, and sociodemographic measures. Patients were also categorized by treatment outcome status (i.e., not recommended to follow-up after initial evaluation and treatment session, successful treatment completion, lost to follow-up after initial evaluation and treatment session, and early termination) according to the clinically indicated treatment recommended and dose of treatment received. Youth had elevated scores on psychiatric screening indexes with affective problems being highest for all age groups. Other co-morbid sleep disorders were present in nearly 25% of insomnia patients and use of sleep aids (melatonin; hypnotics) was commonplace. Baseline insomnia severity significantly predicted sleep treatment trajectories and post-treatment insomnia severity with large effects for all age groups. Other clinically relevant predictors of insomnia treatment outcomes included medication use and externalizing mental health concerns in younger patients and internalizing mental health concerns and chronological age in older patients. Lack of treatment follow-up and premature treatment termination was observed for patients with the worst insomnia symptoms at time of initial evaluation. Pediatric health providers delivering insomnia treatment should take a developmentally sensitive approach that is proactive with regards to managing treatment barriers that are likely influenced by severity of insomnia and co-morbid mental health concerns.

Sleep Health Analysis Through Sleep Symptoms in 35,808 Individuals Across Age and Sex Differences: Comparative Symptom Network Study.

Sleep health is a multidimensional construct that includes objective and subjective parameters and is influenced by individual sleep-related behaviors and sleep disorders. Symptom network analysis allows modeling of the interactions between variables, enabling both the visualization of relationships between different factors and the identification of the strength of those relationships. Given the known influence of sex and age on sleep health, network analysis can help explore sets of mutually interacting symptoms relative to these demographic variables. This study aimed to study the centrality of symptoms and compare age and sex differences regarding sleep health using a symptom network approach in a large French population that feels concerned about their sleep. Data were extracted from a questionnaire provided by the Réseau Morphée health network. A network analysis was conducted on 39 clinical variables related to sleep disorders and sleep health. After network estimation, statistical analyses consisted of calculating inferences of centrality, robustness (ie, testifying to a sufficient effect size), predictability, and network comparison. Sleep clinical variable centralities within the networks were analyzed by both sex and age using 4 age groups (18-30, 31-45, 46-55, and >55 years), and local symptom-by-symptom correlations determined. Data of 35,808 participants were obtained. The mean age was 42.7 (SD 15.7) years, and 24,964 (69.7%) were women. Overall, there were no significant differences in the structure of the symptom networks between sexes or age groups. The most central symptoms across all groups were nonrestorative sleep and excessive daytime sleepiness. In the youngest group, additional central symptoms were chronic circadian misalignment and chronic sleep deprivation (related to sleep behaviors), particularly among women. In the oldest group, leg sensory discomfort and breath abnormality complaint were among the top 4 central symptoms. Symptoms of sleep disorders thus became more central with age than sleep behaviors. The high predictability of central nodes in one of the networks underlined its importance in influencing other nodes. The absence of structural difference between networks is an important finding, given the known differences in sleep between sexes and across age groups. These similarities suggest comparable interactions between clinical sleep variables across sexes and age groups and highlight the implication of common sleep and wake neural circuits and circadian rhythms in understanding sleep health. More precisely, nonrestorative sleep and excessive daytime sleepiness are central symptoms in all groups. The behavioral component is particularly central in young people and women. Sleep-related respiratory and motor symptoms are prominent in older people. These results underscore the importance of comprehensive sleep promotion and screening strategies tailored to sex and age to impact sleep health.

Could a Habitual Sleep Restriction of One-two Hours Be Detrimental to the Benefits of Resistance Training?

The absence or decrease in sleep time can affect different mechanisms associated with changes in body composition and physical exercise performance. However, it is unclear in the literature how chronically sleep-restricted individuals respond to strength training. Thus, this study aimed to evaluate the effects of reducing between one and two hours of recommended sleep time (7 hours) on the response to resistance training. The study included 12 subjects who slept on average 2 hours less than the recommended 7 hours per day (42 ± 8 years; 84.9 ± 11.6 kg; 27.9 ± 3.5 kg/m 2 ; 6:17 ± 22 total sleep time/day and 5: 47 ± 29 sleep time/night) and 12 subjects with recommended sleep time (38 ± 11 years; 78.3 ± 9.5 kg; 25.1 ± 3.5 kg/m 2 ; 7:47 ± 38 total sleep time/day and 7:16 ± 54 sleep time/night) and a control group (42 ± 7 years; 81 ± 12.2 kg; 26.2 ± 4.0 kg/m 2 ; 7:30 ± 40 total sleep time/day and 7: 17 ± 51 sleep time/night) that did not perform resistance training. A total of 16 resistance training sessions were performed, 3 times a week (Sessions= 4 exercises; 2 sets; maximum repetitions to failure). The maximum number of repetitions, arm circumference, and arm muscle area increased, while triceps skinfold decreased after training in the experimental groups ( p < 0.05), with no changes for the control group. There was no difference in muscle mass, body mass index, or sleep variables (sleep time, latency, efficiency) after the training period in either group (p> 0.05). Thus, the chronic 1-2-hour reduction in average recommended sleep time was not able to affect the positive effects of resistance training.

Evaluation of adropin indices and PCSK9 in non-diabetic men with severe obstructive sleep apnea

Abstract Objectives We aimed to investigate the relationship among proprotein convertase subtilisin/kexin type 9 (PCSK9), adropin levels, inflammation, and sleep variables in non-diabetic males with severe obstructive sleep apnea (OSA). Methods This cross-sectional study included adults aged 18 to 65 who underwent polysomnography due to sleep problems between July 2019 and August 2020. Participants were grouped based on their apnea-hypopnea index (AHI). We included 32 males with simple snoring (AHI&lt;5 events/h) as the controls and 48 males with severe OSA (AHI≥30 events/h). Furthermore, patients with severe OSA were divided into two groups based on body mass index (BMI), resulting in three groups in total. Adropin and PCSK9 were analyzed using the enzyme-linked immunosorbent assay method. Results In severe OSA with BMI≥30 kg/m2, compared to the controls, blood pressure values, interleukin-6 (IL-6), white blood cell (WBC) count, systemic inflammation response index, neutrophil, monocyte counts were found to be higher, but adropin/BMI, adropin/waist circumference, adropin/neck circumference were significantly lower. Adropin/BMI had the highest correlation coefficient with IL-6. Although there was no significant difference in PCSK9 levels among the groups, PCSK9 was independently correlated with the WBC and its subsets. Conclusions Our study is of clinical importance as it is the first to show a relationship between PCSK9 and inflammation markers in severe OSA. Also, this study demonstrated the potential value of adropin, in combination with BMI, as a valuable indicator for assessing inflammation and OSA severity.

Functional changes in sleep-related arousal after ketamine administration in individuals with treatment-resistant depression

The glutamatergic modulator ketamine is associated with changes in sleep, depression, and suicidal ideation (SI). This study sought to evaluate differences in arousal-related sleep metrics between 36 individuals with treatment-resistant major depression (TRD) and 25 healthy volunteers (HVs). It also sought to determine whether ketamine normalizes arousal in individuals with TRD and whether ketamine’s effects on arousal mediate its antidepressant and anti-SI effects. This was a secondary analysis of a biomarker-focused, randomized, double-blind, crossover trial of ketamine (0.5 mg/kg) compared to saline placebo. Polysomnography (PSG) studies were conducted one day before and one day after ketamine/placebo infusions. Sleep arousal was measured using spectral power functions over time including alpha (quiet wakefulness), beta (alert wakefulness), and delta (deep sleep) power, as well as macroarchitecture variables, including wakefulness after sleep onset (WASO), total sleep time (TST), rapid eye movement (REM) latency, and Post-Sleep Onset Sleep Efficiency (PSOSE). At baseline, diagnostic differences in sleep macroarchitecture included lower TST (p = 0.006) and shorter REM latency (p = 0.04) in the TRD versus HV group. Ketamine’s temporal dynamic effects (relative to placebo) in TRD included increased delta power earlier in the night and increased alpha and delta power later in the night. However, there were no significant diagnostic differences in temporal patterns of alpha, beta, or delta power, no ketamine effects on sleep macroarchitecture arousal metrics, and no mediation effects of sleep variables on ketamine’s antidepressant or anti-SI effects. These results highlight the role of sleep-related variables as part of the systemic neurobiological changes initiated after ketamine administration. Clinical Trials Identifier: NCT00088699.

Abnormal sleep patterns are associated with depressive symptoms in Chinese community-dwelling older adults

ObjectiveDepression is an important public health issue among older adults, often associated with their sleep-related problems. We aimed to investigate the association between sleep-related problems and depressive symptoms among Chinese community-dwelling older adults. MethodsThis cross-sectional study utilized self-reported data from 2896 participants (aged ≥60 years) from Shanghai, China. Nocturnal sleep duration and difficulty initiating sleep (DIS) symptoms were obtained through face-to-face questionnaires. Nocturnal sleep duration was categorized as ‘short’ (<7 h), ‘normal’ (7–8 h), and ‘long’ (>8 h). Subsequently, the 3 groups were further divided into 6 groups based on the presence of DIS, and the combined sleep behaviors were termed ‘sleep patterns'. Logistic regression was conducted to assess the association of sleep variables and sleep patterns with the risk of depressive symptoms. ResultsCompared to the reference group, ‘short sleep duration’ and DIS symptoms were associated with depressive symptoms (with odds ratios (OR) of 1.50 and 1.79, respectively, with 95% confidence intervals (CI) of 1.14–1.97 and 1.39–2.31). When compared to ‘normal sleep duration without DIS', both ‘short sleep duration with DIS' (OR = 2.60, 95% CI: 1.81–3.72) and ‘normal sleep duration with DIS' (OR = 1.60, 95% CI: 1.03–2.49) were statistically associated with depressive symptoms in adjusted regression models. ConclusionShort sleep duration and DIS symptoms were found to be associated with depressive symptoms. Combining DIS symptoms with sleep duration, DIS was identified as a risk factor for elevated depressive symptoms in individuals with short and normal sleep durations. In managing depressive symptoms, it is imperative to thoroughly evaluate insomnia and nighttime sleep, which can provide valuable insights for nursing and medical policy.

Effects of the low Fowler's sleep position and methazolamide treatment on sleep bruxism: A randomized controlled trial.

Intracranial pressure is one of the determinants of sympathetic activities, and sleep bruxism is associated with increased sympathetic activities. This study aimed to investigate effects of the low Fowler's sleep position and methazolamide treatment on the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes in patients with sleep bruxism in a randomized controlled trial. Polysomnographic recordings were performed on the patients with sleep bruxism sleeping in the low Fowler's (15°-30°) or supine position (n = 11), and with methazolamide or placebo treatment (100 mg, 3-4 hr before bedtime, P.O., n = 9), and changes in sleep variables and heart rate variance during sleep in the low Fowler's position or with methazolamide treatment were determined. Sleep bruxism index, number of masseter muscle electromyographic bursts per hour of sleep, ratio of rhythmic masticatory muscle activities/sleep bruxism duration to the total sleep duration, index of total limb movements, index of limb movements with rhythmic masticatory muscle activities, and number of sleep bruxism clusters per hour of sleep in the low Fowler's position and after methazolamide intake were significantly smaller (p < 0.05-0.001) than those in the supine position and after placebo intake, respectively. The low-frequency heart rate variance powers during non-rapid eye movement sleep stage 2 (N2) in the low Fowler's position and with methazolamide treatment were significantly lower (p < 0.05) than those during sleep in the supine position and with placebo treatment, respectively. In conclusion, sleep in the low Fowler's position and methazolamide treatment were associated with significant decreases in the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes, which might be due to a reduction in intracranial pressure and sympathetic activities mainly during non-rapid eye movement sleep stage 2.

Associations between multiple sleep dimensions and suicide and non-suicidal self-injury: a cross-sectional study of 3828 Chinese young people.

Suicide and non-suicidal self-injury (NSSI) are preventable concerns in young people. Suicidal ideation (SI), suicidal plans (SP) and suicidal attempt (SA) are closely related to death. Sleep problems are known risk factors for suicide and NSSI. This study aimed to explore the relationship between sleep, suicidality and NSSI. Participants were 3,828 middle school and college students aged 11-23 years from urban and rural areas of Henan Province. Sleep, suicidal phenomena and NSSI were assessed by applying self-reported questionnaires. Chi-squared tests were utilized to demonstrate the demographic data and sleep variables. The correlation between sleep, suicidality and NSSI were explored by using binary logistic regression, while adjusting socio-demographic characteristics with multivariate models. Sleep variables except mid-sleep time were related to suicidal phenomena (P < 0.05). Greater social jet lag (SJL) [≥ 2h (h)] was associated with increased risk of SI [Odds ratios (OR) = 1.72, 95% confidence intervals (CI):1.40-2.11], SP (OR = 2.10, 95%CI:1.59-2.79) and SA (OR = 1.50, 95%CI:1.00-2.26). Non-only child participants with SJL (≥ 2h) had significantly increased odds of SI (OR = 1.75, 95%CI: 1.41-2.18) and SP (OR = 2.25, 95%CI: 1.66-3.05). Eveningness chronotype had the strongest correlation with SI (OR = 3.87, 95%CI:2.78-5.38), SP (OR = 4.72, 95%CI:2.97-7.50), SA (OR = 6.69, 95%CI:3.08-14.52) and NSSI (OR = 1.39, 95%CI:1.02-1.90). Overlong or short sleep duration, SJL, eveningness chronotype and other sleep abnormalities (e.g., daytime dysfunction, low sleep efficiency) were associated with a higher prevalence of SI, SP and SA. Additionally, eveningness was significantly correlated with NSSI among young people. These findings suggested the importance of assessing and intervening in sleep habits to prevent suicide and NSSI in young people.