Subjective Sleep Research Articles

Lifestyle factors associated with presenteeism among city government office workers: a cross-sectional study.

Presenteeism is a critical issue in occupational health. This study aimed to examine the association between presenteeism and subjective sleep quality, smoking status, and alcohol consumption. Anonymous data of 777 workers in a Japanese city were retrospectively obtained from City Government Office A. They included variables like absolute presenteeism scores (measured using the Japanese version of the World Health Organization Health and Work Performance Questionnaire short form), gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption. A binary logistic regression analysis was performed with gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption as the independent variables, and absolute presenteeism scores equal to or below 40 as the dependent variable. A gender-stratified binary logistic regression analysis was also performed. The logistic regression analysis results revealed that absolute presenteeism was positively associated with poor subjective sleep quality among all respondents (odds ratio [OR], 1.70; 95% CI, 1.18-2.44) and men (OR, 1.85; 95% CI, 1.12-3.05) and with current drinkers among women (OR, 3.49; 95% CI, 1.36-8.92); it was negatively associated with age among those who were ≥50years old (OR, 0.50; 95% CI, 0.27-0.93) and with current drinkers among men (OR, 0.43; 95% CI, 0.20-0.92). The factors associated with presenteeism differed between men and women office workers, suggesting that gender differences need to be considered when working toward improving workers' productivity.

Improved sleep, cognitive processing and enhanced learning and memory task accuracy with Yoga nidra practice in novices

Complementary and Alternative medicine is known to have health benefits. Yoga nidra practice is an easy-to-do practice and has shown beneficial effects on stress reduction and is found to improve sleep in insomnia patients. Effect of yoga nidra practice on subjective sleep is known but its effect on sleep and cognition objectively is not documented. The aim of the study was to study the effect of yoga nidra practice on cognition and sleep using objective parameters. 41 participants were enrolled, and baseline sleep diary (SD) collected. Participants volunteered for overnight polysomnography (PSG) and cognition testing battery (CTB) comprising of Motor praxis test, emotion recognition task (ERT), digital symbol substitution task, visual object learning task (VOLT), abstract matching (AIM), line orientation task, matrix reasoning task, fractal-2-back test (NBACK), psychomotor vigilance task and balloon analog risk task. Baseline CTB and after one and two weeks of practice was compared. Power spectra density for EEG at central, frontal, and occipital locations during CTB was compared. Repeat SD and PSG after four weeks of practice were done. After yoga nidra practice, improved reaction times for all cognition tasks were seen. Post intervention compared to baseline (95%CI; p-value, effect size) showed a significant improvement in sleep efficiency of +3.62% (0.3, 5.15; p = 0.03, r = 0.42), -20min (-35.78, -5.02; p = 0.003, d = 0.84) for wake after sleep onset and +4.19 μV2 (0.5, 9.5; p = 0.04, r = 0.43) in delta during deep sleep. Accuracy increased in VOLT (95% CI: 0.08, 0.17; p = 0.002, d = 0.79), AIM (95% CI: 0.03, 0.12; p = 0.02, d = 0.61) and NBACK (95% CI: 0.02, 0.13; p = 0.04, d = 0.56); ERT accuracy increased for happy, fear and anger (95% CI: 0.07, 0.24; p = 0.004, d = 0.75) but reduced for neutral stimuli (95% CI: -0.31, -0.12; p = 0.04, r = 0.33) after yoga nidra practice. Yoga Nidra practice improved cognitive processing and night-time sleep.

Comparison of Polysomnography, Single-Channel Electroencephalogram, Fitbit, and Sleep Logs in Patients With Psychiatric Disorders: Cross-Sectional Study.

Sleep disturbances are core symptoms of psychiatric disorders. Although various sleep measures have been developed to assess sleep patterns and quality of sleep, the concordance of these measures in patients with psychiatric disorders remains relatively elusive. This study aims to examine the degree of agreement among 3 sleep recording methods and the consistency between subjective and objective sleep measures, with a specific focus on recently developed devices in a population of individuals with psychiatric disorders. We analyzed 62 participants for this cross-sectional study, all having data for polysomnography (PSG), Zmachine, Fitbit, and sleep logs. Participants completed questionnaires on their symptoms and estimated sleep duration the morning after the overnight sleep assessment. The interclass correlation coefficients (ICCs) were calculated to evaluate the consistency between sleep parameters obtained from each instrument. Additionally, Bland-Altman plots were used to visually show differences and limits of agreement for sleep parameters measured by PSG, Zmachine, Fitbit, and sleep logs. The findings indicated a moderate agreement between PSG and Zmachine data for total sleep time (ICC=0.46; P<.001), wake after sleep onset (ICC=0.39; P=.002), and sleep efficiency (ICC=0.40; P=.006). In contrast, Fitbit demonstrated notable disagreement with PSG (total sleep time: ICC=0.08; wake after sleep onset: ICC=0.18; sleep efficiency: ICC=0.10) and exhibited particularly large discrepancies from the sleep logs (total sleep time: ICC=-0.01; wake after sleep onset: ICC=0.05; sleep efficiency: ICC=-0.02). Furthermore, subjective and objective concordance among PSG, Zmachine, and sleep logs appeared to be influenced by the severity of the depressive symptoms and obstructive sleep apnea, while these associations were not observed between the Fitbit and other sleep instruments. Our study results suggest that Fitbit accuracy is reduced in the presence of comorbid clinical symptoms. Although user-friendly, Fitbit has limitations that should be considered when assessing sleep in patients with psychiatric disorders.

Timed Activity to Minimize Sleep Disturbance in People With Cognitive Impairment.

Sleep disturbances occur in >60% of persons living with cognitive impairment, affecting their quality of life (QOL). Regulating the sleep-wake cycle through engaging cognitive, physical, and sensory-based activities delivered at strategic times may reduce sleep disturbances and be a feasible nonpharmacological treatment for sleep problems. The objective of this trial was to test the efficacy of a timed-activity intervention in improving QOL and sleep disturbances in persons living with cognitive impairment. Randomized 2-group parallel design involving 209 dyads of community-residing persons living with cognitive impairment and care partners. Dyads were randomly assigned (1:1) to 1-hr home activity sessions administered weekly in the morning, afternoon, or evening over 4 weeks (the Healthy Patterns Sleep Program), or to an attention-control condition consisting of sleep hygiene training plus education on home safety and health promotion. QOL, objective and subjective sleep quality, and neuropsychiatric symptoms were assessed at baseline and 4 weeks later. QOL was significantly improved in the intervention group compared to control (p = .0491). There were no significant effects on objective or subjective sleep or neuropsychiatric symptoms. In a subgroup analysis, subjective sleep as measured by the PROMIS (Patient Reported Outcomes Measurement Information System) Sleep-Related Impairment survey was significantly improved in the intervention group compared to the control group for individuals with symptoms of depression (p = .015) or poor observed sleep at baseline (p = .005). The Healthy Patterns Intervention may benefit QOL for persons living with cognitive impairment and those with poor subjective sleep. A longer dose may be necessary to elicit improvement in actigraphically measured sleep-wake activity. NCT0368218 5.

Relationship between subjective and objective fatigue and sleep characteristics in individuals with anxiety and mood disorders: An exploratory study

ObjectiveFatigue and sleep disturbances are important symptoms of anxiety and mood disorders (AMD). Studies about the relationship between these variables usually rely on self-report assessments. Therefore, the aim of our exploratory study was to investigate the independent correlations between subjective and objective fatigue and sleep characteristics in individuals with AMD. MethodsIn sum, 233 individuals with AMD attending a stress-related disorders day care unit (78.5 % females, mean age 39.0 years old) participated in a cross-sectional study. Participants completed the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Multidimensional Fatigue Inventory-20, and Pittsburgh Sleep Quality Index self-report questionnaires, as well as an exercise capacity workload test for assessing objective fatigue and polysomnography monitoring for evaluation of sleep structure. ResultsIn individuals with AMD, exercise capacity workload was associated with lower percent of stage 1 sleep (β = - 0.17, p = 0.006), REM latency (β = -0.13, p = 0.042), and wake after sleep onset (β = -0.12, p = 0.039). General fatigue was associated with a higher percent of body movements (β = 0.12, p = 0.047), as well as mental fatigue was associated with a higher percent of body movements (β = 0.13, p = 0.029), and a higher score on the PSQI (β = 0.21, p = 0.002). ConclusionsObjective sleep characteristics were associated with objective assessment of fatigue, while subjective sleep quality was associated with subjectively assessed mental fatigue.

P200: Association between sleep disturbance and subjective well-being among community- dwelling older people: a serial multiple mediation model

Objective:Sleep disturbance is negatively associated with subjective well-being in older people, but the potential underlying mechanisms of this association remain unclear. This study aimed to disentangle the pathways linking subjective versus objective sleep disturbance to subjective well-being through the serial mediation effect of loneliness and depression among community- dwelling older people.Methods:This cross-sectional study was conducted in Sakai city of Japan. A total of 212 aged 65 and over participated in this study. The Athens Insomnia Scale, UCLA Loneliness Scale, Geriatric Depression Scale, and Self-perceived well-being were used to assess subjective sleep quality, loneliness, depression, and subjective well-being, respectively. A non-wearable actigraphy device was used to evaluate the objective sleep quality. Total sleep time, sleep latency, sleep efficiency, wake after sleep onset, number of awakenings, and average activity during sleep were recorded. Serial multiple mediation analysis was performed using SPSS PROCESS Version 4.1 macro. This study was approved by the Institutional Review Board of Osaka University.Results:Subjective sleep disturbance was found to impact subjective well-being through three significant mediation pathways: (1) loneliness (B=-0.024, 95% CI=-0.055, -0.004), which accounted for 25.72% of the total effect, (2) depression (B=-0.020, 95% CI=-0.044, -0.001), which accounted for 20.94% of the total effect, and (3) loneliness and depression (B=-0.008, 95% CI=-0.019, -0.001), accounting for 8.93% of the total effect. The total mediating effect was 55.58%. As for the objective sleep disturbance, the wake after sleep onset can indirectly impact subjective well-being through loneliness (B=0.005, 95% CI=0.001, 0.010), depression (B=-0.005, 95% CI=-0.011, -0.001), and both (B=0.002, 95% CI=0.001, 0.004); the number of awakenings can indirectly impact subjective well-being through loneliness (B=0.041, 95% CI= 0.012, 0.085), depression (B=-0.034, 95% CI=-0.076, -0.002), and both (B=0.018, 95% CI=0.005, 0.036); the average activity during sleep can also indirectly impact subjective well- being through loneliness (B=0.137, 95% CI=0.034, 0.275), depression (B=-0.128, 95% CI=- 0.282, -0.010), and both (B=0.055, 95% CI=0.011, 0.118).Conclusion:These findings provided new insights into possible avenues for improving subjective well- being among older people through sleep-based interventions with a multi-faceted approach to mental health.

Risk factors for injury complaints leading to restricted participation in Athletics (Track and Field): a secondary analysis of data from 320 athletes over one season

ObjectiveTo investigate if several potential risk factors were associated with time to injury complaints leading to participation restriction in Athletics (ICPR).MethodsWe performed a secondary analysis of data collected during 39...

Sleep Quality and Day‐to‐Day Variability: Relation to Alzheimer’s pathology in Cognitively Unimpaired Older Adults At‐Risk of AD Dementia

AbstractBackgroundIncreasing evidence suggests a link between sleep and late‐life Alzheimer disease’s (AD) pathology. We investigated whether sleep degradation might be accompanied by faster AD pathology accumulation and/or whether early AD pathologic changes might be accompanied by sleep changes before the onset of cognitive symptoms.MethodWe investigated 228 PREVENT‐AD participants with available sleep data who underwent Aβ, [18F] NAV‐4694, and tau,[18F] Flortaucipir, positron emission tomography (PET). Longitudinal subjective sleep quality data were available for 191 participants (follow‐up:1.03±0.19y), longitudinal objective sleep data measured with actigraphy was available for 152 participants (follow‐up:2.5±1.24y), and longitudinal PET scans were available for 104 participants (follow‐up:4.3±0.24y). We assessed sleep quality using the Pittsburgh sleep quality index (PSQI) global score along with 7‐day actigraphy to indicate sleep duration, efficiency, and fragmentation index. Daily variation in sleep was measured using cross‐sectional and longitudinal standard deviations across the 7 days of actigraphy. Linear mixed effect models tested for longitudinal association of baseline sleep measures with PET outcomes over time. We also examined whether an increase in PET AD tracer uptake predicted changes in sleep quality and day‐to‐day variability. Every model controlled for age and sex.ResultWe found no association between sleep measures and Aβ PET.Higher baseline PSQI scores were associated with higher levels of tau over time (p = 0.004, R2 = 0.034, 𝛽 = 0.007, Fig.1, A). Higher baseline variability of sleep duration and fragmentation index were also associated with higher levels of tau longitudinally (p = 0.001, R2 = 0.05, 𝛽 = 0.001, Fig.1, B; p = 0.029, R2 = 0.022, 𝛽 = 0.01; Fig.1, C). Furthermore, increased tau at baseline was associated with lower sleep quality (p = 0.006, R2 = 0.026, 𝛽 = 4.12, Fig.2, A), and with higher sleep duration variability over time (p = 0.004, R2 = 0.06, 𝛽 = 61.56, Fig.1, B.)ConclusionPoor sleep quality and higher day‐to‐day sleep variability in older age could contribute to faster rate of tau pathology accumulation, which could in turn disrupt sleep further. Targeting sleep disturbances may therefore serve in delaying tau burden and slowing down disease progression.

Impact of Preoperative Sleep Disturbances on Postoperative Delirium in Patients with Intracranial Tumors: A Prospective, Observational, Cohort Study.

Postoperative delirium (POD) is prevalent in craniotomy patients and is associated with high mortality. Sleep disturbances are receiving increasing attention from clinicians as associated risk factors for postoperative complications. This study aimed to determine the impact of preoperative sleep disturbances on POD in craniotomy patients. We recruited 130 patients undergoing elective craniotomy for intracranial tumors between May 1st and December 30th, 2022. Preoperative subjective sleep disturbances were assessed using the Pittsburgh Sleep Quality Index on the day of admission. We also measured objective perioperative sleep patterns using a dedicated sleep monitoring device 3 days before and 3 days after the surgery. POD was assessed twice daily using the Confusion Assessment Model for the Intensive Care Unit within the first week after craniotomy. Preoperative sleep disturbances were diagnosed in 49% of the study patients, and POD was diagnosed in 22% of all the study patients. Sleep disturbances were an independent risk factor for POD (OR: 2.709, 95% CI: 1.020-7.192, P = 0.045). Other risk factors for POD were age (OR: 3.038, 95% CI: 1.195-7.719, P = 0.020) and the duration of urinary catheterization (OR: 1.246, 95% CI: 1.025-1.513, P = 0.027). Perioperative sleep patterns (including sleep latency, deep sleep duration, frequency of awakenings, apnea-hypopnea index, and sleep efficiency) were significantly associated with POD. This study demonstrated that preoperative sleep disturbances predispose patients undergoing craniotomy to POD, also inferred a correlation between perioperative sleep patterns and POD. The targeted screening and intervention specifically for sleep disturbances during the perioperative period are immensely required.

Sleep Quality and Day‐to‐Day Variability: Relation to Alzheimer’s pathology in Cognitively Unimpaired Older Adults At‐Risk of AD Dementia

AbstractBackgroundIncreasing evidence suggests a link between sleep and late‐life Alzheimer disease’s (AD) pathology. We investigated whether sleep degradation might be accompanied by faster AD pathology accumulation and/or whether early AD pathologic changes might be accompanied by sleep changes before the onset of cognitive symptoms.MethodWe investigated 228 PREVENT‐AD participants with available sleep data who underwent Aβ, [18F] NAV‐4694, and tau,[18F] Flortaucipir, positron emission tomography (PET). Longitudinal subjective sleep quality data were available for 191 participants (follow‐up:1.03±0.19y), longitudinal objective sleep data measured with actigraphy was available for 152 participants (follow‐up:2.5±1.24y), and longitudinal PET scans were available for 104 participants (follow‐up:4.3±0.24y). We assessed sleep quality using the Pittsburgh sleep quality index (PSQI) global score along with 7‐day actigraphy to indicate sleep duration, efficiency, and fragmentation index. Daily variation in sleep was measured using cross‐sectional and longitudinal standard deviations across the 7 days of actigraphy. Linear mixed effect models tested for longitudinal association of baseline sleep measures with PET outcomes over time. We also examined whether an increase in PET AD tracer uptake predicted changes in sleep quality and day‐to‐day variability. Every model controlled for age and sex.ResultWe found no association between sleep measures and Aβ PET. Higher baseline PSQI scores were associated with higher levels of tau over time (p = 0.004, R2 = 0.034, 𝛽 = 0.007, Fig.1, A). Higher baseline variability of sleep duration and fragmentation index were also associated with higher levels of tau longitudinally (p = 0.001, R2 = 0.05, 𝛽 = 0.001, Fig.1, B; p = 0.029, R2 = 0.022, 𝛽 = 0.01; Fig.1, C). Furthermore, increased tau at baseline was associated with lower sleep quality (p = 0.006, R2 = 0.026, 𝛽 = 4.12, Fig.2, A), and with higher sleep duration variability over time (p = 0.004, R2 = 0.06, 𝛽 = 61.56, Fig.1, B.)ConclusionPoor sleep quality and higher day‐to‐day sleep variability in older age could contribute to faster rate of tau pathology accumulation, which could in turn disrupt sleep further. Targeting sleep disturbances may therefore serve in delaying tau burden and slowing down disease progression.

Glycemic and sleep effects of daytime compared with those of overnight infusions of home parenteral nutrition in adults with short bowel syndrome: A quasi-experimental pilot trial

BackgroundPatients with short bowel syndrome (SBS) dependent on home parenteral nutrition (HPN) commonly cycle infusions overnight, likely contributing to circadian misalignment and sleep disruption. MethodsThe objective of this quasi-experimental, single-arm, controlled, pilot trial was to examine the feasibility, safety, and efficacy of daytime infusions of HPN in adults with SBS without diabetes. Enrolled patients were fitted with a continuous glucose monitor and wrist actigraph and were instructed to cycle their infusions overnight for 1 wk, followed by daytime for another week. The 24-h average blood glucose, the time spent >140 mg/dL or <70 mg/dL, and sleep fragmentation were derived for each week and compared using Wilcoxon signed-rank test. Patient-reported quality-of-life outcomes were also compared between the weeks. ResultsTwenty patients (mean age, 51.7 y; 75% female; mean body mass index, 21.5 kg/m2) completed the trial. Overnight infusions started at 21:00 and daytime infusions at 09:00. No serious adverse events were noted. There were no differences in 24-h glycemia (daytime—median: 93.00 mg/dL; 95% CI: 87.7–99.9 mg/dL, compared with overnight—median: 91.1 mg/dL; 95% CI: 89.6–99.0 mg/dL; P = 0.922). During the day hours (09:00–21:00), the mean glucose concentrations were 13.5 (5.7–22.0) mg/dL higher, and the time spent <70 mg/dL was 15.0 (−170.0, 22.5) min lower with daytime than with overnight HPN. Conversely, during the night hours (21:00–09:00), the glucose concentrations were 16.6 (−23.1, −2.2) mg/dL lower with daytime than with overnight HPN. There were no differences in actigraphy-derived measures of sleep and activity rhythms; however, sleep timing was later, and light at night exposure was lower with daytime than with overnight HPN. Patients reported less sleep disruptions due to urination and fewer episodes of uncontrollable diarrhea or ostomy output with daytime HPN. ConclusionsDaytime HPN was feasible and safe in adults with SBS and, compared with overnight HPN, improved subjective sleep without increasing 24-h glucose concentrations. This trial was registered at clinicaltrials.gov as NCT04743960 (https://classic.clinicaltrials.gov/ct2/show/NCT04743960).

Sleep and Pain in Veterans with Chronic Pain: Effects of Psychological Pain Treatment and Temporal Associations.

Chronic pain is highly prevalent in US military Veterans. Non-opioid and non-pharmacologic treatments are recommended when clinically appropriate, but research on the mechanisms underlying benefits of these treatments is lacking. Here, we examined the role of sleep in the effects of three non-pharmacologic pain treatments in Veterans. Specifically, we investigated whether treatment effects on sleep predicted treatment effects on pain occurring later, or vice versa. Veterans enrolled in a randomized controlled trial were invited to participate in this supplementary sleep study. A total of 174 Veterans were randomized to one of three 8-session, in-person, group-based pain treatments: hypnosis, mindfulness meditation, or education control. Measurements included self-reported sleep disturbance, pain intensity, and pain catastrophizing; sleep duration was assessed with actigraphy. Sleep and pain measurements were obtained at baseline, posttreatment, and 3-month posttreatment follow-up. At baseline, average pain intensity was moderate (mean ± SD: 5.7 ± 1.7 on the 0-10 Numeric Rating Scale), pain catastrophizing was just below the clinically relevant threshold (mean ± SD: 28.6 ± 12.2 on the Pain Catastrophizing Scale), and subjective sleep disturbance exceeded the US population average (mean ± SD: 58.5 ± 8.1 on the Patient Reported Outcomes Measurement Information System Sleep Disturbance - Short Form). By contrast, objective sleep duration was consistent with the recommended daily sleep amount of 7-8 h for adults (mean ± SD: 8.3 ± 1.4 h). Across treatment conditions, pain intensity, pain catastrophizing, and subjective sleep disturbance were significantly less at posttreatment and 3-month follow-up than at baseline (p < 0.001). Actigraphic sleep duration did not differ significantly as a function of time. There was a high degree of covariation among the measures of pain intensity, pain catastrophizing, and sleep disturbance (p < 0.05). However, self-reported sleep disturbance was not significantly correlated with actigraphic sleep duration (|r| <= 0.13, p > 0.05). Sleep and pain variables observed at prior assessments predicted these same variables at subsequent assessments. There was no significant evidence that changes in pain preceded changes in sleep or that changes in sleep preceded changes in pain (all p > 0.05). For this study's Veterans, treatment-related changes in sleep and pain appeared to occur in parallel. The concomitant changes in sleep and pain suggest that therapies improving pain in Veterans may yield attendant benefits for the treatment of sleep, and possibly vice versa.

Association between self-reported food intake and subjective sleep quality among truck drivers in a city in Southern Brazil.

Sleep is an activity of great importance for maintaining the homeostasis of the human body and some components may interfere with the quality of sleep, including the pattern of food consumption. Truck drivers may constitute a population particularly sensitive to this association, since they are routinely exposed to situations that may interfere with food intake and sleep quality. Thus, this study investigated the association between self-reported food intake and sleep quality in truck drivers. This was a cross-sectional study, with drivers who traveled in a city in southern Brazil. Food intake was evaluated through the average of food intake over the last 30 days. Food intake was evaluated in two forms: division in food groups and evaluation only tryptophan-rich foods. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). In addition to the descriptive analysis, to identify possible associations between food intake and sleep quality, linear regression, crude and adjusted for confounding variables, were performed to obtain the Beta and Beta adjusted (Betaadj), respectively, and p-value. A total of 352 truck drivers, mostly males, mean age 48.4 (±11.6) years, with a frequent consumption of meat, fruits, vegetables, sweets, and energy drinks participated in this study. The frequent consumption of dairy products (Betaadj: --0.614. p-value 0.004) and fruits (Betaadj: --0.342. p-value 0.034) was associated with lower PSQI score, while the consumption of energy drinks was associated with a higher PSQI score (Betaadj: 0.923. p-value <0.001). The frequency of consumption of tryptophan-rich foods was not associated with sleep quality. Fruits and dairy products are associated with better subjective sleep quality, while energy drinks are associated with worse sleep quality in truck drivers, whereas dietary tryptophan-rich foods intake was not associated with sleep quality.

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

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

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

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

Effects of Railway-induced Noise and Vibration on Sleep Disturbance in Detached Houses

Railway-induced noise and vibrations cause adverse effects on the daily life of people living in detached houses, especially in Japanese urban districts. Our previous studies revealed that annoyance due to each of noise and vibrations differed according to railway category: high-speed Shinkansen railway and conventional railway. In addition, we quantified the respective impact of noise and vibration exposures on individual annoyances by the above railway categories. Following these studies, we tried to clarify the effects of noise and vibrations on subjective sleep disturbance of people living in detached houses. Datasets used for the analysis were common with the previous studies. Applying the multiple-logistic regression analysis to the individual data, we estimated respective effects of noise and vibration exposures on sleep disturbance. Night sound pressure level and maximum vibration level in the vertical direction were used as noise and vibration exposures, respectively. In either railway category, sleep disturbance was affected not only by noise exposure but also by vibration exposure. In addition, we clarified that noise exposure has a larger effect on sleep disturbance than vibration exposure for conventional railways; in contrast, for Shinkansen railways, vibration exposure more affected sleep disturbance than noise exposure.

Impact of irregular sleep pattern, and sleep quality on glycaemic parameters and endothelial function in adolescents and young adults with type 1 diabetes.

This study investigated the impact of comprehensive sleep patterns on glycaemic parameters and endothelial function in adolescents and young adults with type 1 diabetes (T1D). Thirty subjects with type 1 diabetes (aged 13-25) without chronic complications participated. For 1 week, glucose levels were monitored by real-time continuous glucose monitoring (CGM) and sleep was simultaneously assessed by actigraphy. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Flow-mediated dilatation (FMD) measured endothelial function at the brachial artery. Insulin sensitivity was determined by calculated estimated glucose disposal rate (eGDR). Glycaemic control was assessed using haemoglobin A1C (HbA1C) levels. To address potential confounding by metabolic syndrome on the FMD results, three affected subjects were excluded from FMD correlation analyses. Participants with PSQI scores >5 had a lower %FMD compared with those with scores ≤5 (4.6 ± 3.7% vs. 7.6 ± 3.0%, p = 0.03). Multivariate analysis indicated that lower sleep efficiency and higher sleep duration variability were associated with higher HbA1C levels (β = -0.076, 95%CI [-0.145, -0.008], p = 0.029; β = 0.012, 95%CI [0.001, 0.023], p = 0.033). Irregular sleep timing and lower sleep efficiency were related to decreased insulin sensitivity (sleep midpoint irregularity β = -1.581, 95%CI [-2.661, -0.502], p = 0.004, and sleep efficiency β = 0.147, 95%CI [0.060, 0.235], p = 0.001). No significant associations were found between glycaemic parameters and FMD. Our study demonstrated that sleep irregularity in type 1 diabetes was associated with glycaemic control and insulin resistance, while poor subjective sleep quality was linked to endothelial dysfunction. Promoting healthy sleep habits, including consistent sleep timing could benefit metabolic and cardiovascular health in type 1 diabetes.

What’s your religious coping profile? Differences in religious orientation and subjective sleep among religious coping groups in the United States

ObjectivesTo determine various profiles/subgroups of religious copers based on indices of positive and negative religious coping; and to determine whether religious copers differ in their religious orientations, subjective sleep characteristics, and strategies used to cope with sleep problems. MethodSix hundred and ninety-five adults (77.3% female, 70.4% White) in the United States completed a 20-minute online questionnaire in January 2020. ResultsResults of a latent profile analysis, based on 8 indicators of positive and negative religious coping, indicated a 5-class solution: (i) “Absent” (n = 101, 14.5%); (ii) “Anxious” (n = 122, 17.6%); (iii) “Ambivalent” (n = 101, 14.5%); (iv) “Secure” (n = 200, 28.8%); and (v) “Conflicted” copers (n = 171, 24.6%). Results of MANOVA tests indicated that Secure copers reported the least religious doubt and highest religious-based social support. Conflicted and Anxious copers had the worst sleep quality, while Secure, Ambivalent, and Absent copers had healthier sleep profiles. In terms of strategies used to cope with sleep problems, Secure and Conflicted copers reported the greatest use of prayer and meditation, while the use of technology was most prevalent among Conflicted and Anxious copers. ConclusionsIndividuals differ in their combined use of positive and negative religious coping, which is related to differences in their religious orientation, sleep characteristics, and strategies used to cope with sleep problems. Religious leaders should be mindful of the diverse ways in which religious coping strategies are harnessed to effectively cater to the unique religious and sleep needs of their members.

Correlation analysis of heart rate variations and glucose fluctuations during sleep

ObjectiveThe body's glucose concentration is influenced by carbohydrate intake, insulin-induced carbohydrate reduction, and hepatic glycogen breakdown induced by stress hormones. This study investigated the potential of employing glucose fluctuations as a measure of stress by examining the relationship between heart rate variability (HRV) data and glucose levels during sleep in healthy subjects. MethodsIn this cross-sectional study, a chest-worn electrocardiogram (ECG) and continuous glucose monitoring device (CGM) were respectively used to monitor the heart rate intervals and glucose fluctuations of five subjects (two males, three females) during sleep. A time-series correlation analysis was performed on the HRV data extracted from heart rate intervals and the corresponding glucose fluctuation data. ResultsThe time-series analysis of ECG and CGM data collected from subjects during sleep (n = 25 nights) revealed a moderate negative correlation between glucose levels and HRV, with a cross-correlation coefficient of r = −0.453. ConclusionSimilar to HRV, changes in stress levels can be detected by observing glucose fluctuations, particularly during sleep when the impact of food intake can be eliminated. Our findings highlight a significant correlation between glucose levels and HRV, indicating that glucose fluctuations can be used as an indicator of autonomic nervous system activity in an exploratory study.

Association between frailty and sleep quality in people living with multiple sclerosis and obesity: An observational cross-sectional study

BackgroundA majority of the people with multiple sclerosis (pwMS) experience sleep disturbances. Frailty is also common in pwMS. The geriatric literature strongly suggests that frailty is associated with worse sleep outcomes in community-dwelling older adults, but this association has yet to be explored among pwMS. This study focused on examining the association between frailty and sleep quality in pwMS. MethodsSeventy-six people with both MS and obesity (mean age: 47.6 ± 10.9 years, 81.6 % female, mean body mass index (BMI): 37.10 ± 5.5 kg/m2, mean Patient Determined Disease Steps (PDDS): 0.82 ± 1.20) were included in this cross-sectional secondary analysis. A comprehensive frailty index (FI) based on 41 health deficits from various health domains was calculated based on standardized procedures. Sleep quality was determined by the Pittsburgh Sleep Quality Index questionnaire (PSQI). ResultsOverall, 67.1 % of the participants were identified as non-frail (FI ≤ 0.25), and 32.9 % were identified as frail (FI > 0.25). A significant correlation was observed between FI scores and global PSQI scores (ρ = 0.43, p < 0.05). Cross-tabulation analyses revealed that frail participants had worse subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and higher use of sleep medications compared to non-frail participants (p < 0.05). ConclusionsThe current study identified a significant association between frailty and sleep quality in people with both MS and obesity with minimal disability. These findings underscore the importance of untangling the relationship between frailty and sleep quality in pwMS. These results could lead to a more targeted approach for rehabilitation interventions aiming to improve frailty in MS.