Journal of Sleep Research最新文献

This study aimed to examine the improvement in performance and functional magnetic resonance imaging correlates of motor learning after a daytime nap versus a period of resting wakefulness among individuals with traumatic brain injury. A sample of 32 individuals with traumatic brain injury was randomly assigned to a Sleep (N = 17) or Wake (N = 15) group after a period of training on a motor sequential learning task. A 45-min nap opportunity was provided for the Sleep group, while the Wake group watched a documentary for 45 min. Performance at the end of training was compared with their performance after the nap or wake intervention. Before and after the intervention, the motor sequential learning task was completed in the magnetic resonance imaging scanner to examine the relationship between change in performance and neural activation. Participants in the Sleep group showed significant gains from the end of training to after the intervention, whereas the Wake group did not. The functional magnetic resonance imaging results showed that relative to the Wake group, the Sleep group showed significantly decreased activation post-intervention in the anterior cingulate/paracingulate, cerebellum, cuneus/precuneus, and inferior parietal lobule including angular and supramarginal gyri. Importantly, across both groups, increased task performance at post-intervention was associated with decreased activation in the anterior cingulate/paracingulate and cerebellum. This study demonstrated the enhancing effect of a nap on motor learning performance in a sample of individuals with traumatic brain injury, with patterns of neural activation suggesting that the sequence was more automatized in the Sleep group. Strategic placement of a nap after an intense period of motor learning in the medical rehabilitation setting may have important implications for maximizing recovery after traumatic brain injury.

The discovery of rapid eye movement sleep in 1953 led to numerous studies investigating the relationship between rapid eye movement sleep abnormalities and psychiatric disorders. The most salient findings were the association of rapid eye movement sleep alterations-reduced rapid eye movement sleep latency, increased rapid eye movement sleep volume of total sleep, and increased rapid eye movement density-with major depression. This paper briefly reviews the history of rapid eye movement sleep research in psychiatry with a focus on the work related to major depressive disorder and some of the various theories that have been proposed to explain the associated rapid eye movement sleep abnormalities. Given the increasing evidence that rapid eye movement sleep is important for emotional processing, memory and cognition, a better understanding of the underlying mechanisms for the relationship between rapid eye movement sleep and mood disorders could lead to improved treatments for these common and disabling illnesses.

The present study aims at identifying sleep patterns in insomnia in a clinical sample using three strategies to define poor nights. Sleep diaries and self-reported questionnaires were collected from 77 clinical patients with insomnia. The conditional probabilities of observing a poor night after 1, 2, or 3 consecutive poor nights were computed according to three strategies with same criteria for sleep onset latency, wake after sleep onset, and sleep efficiency, but varying criterion for total sleep time. Latent profile analyses were conducted to derive sleep patterns. Uni- and multivariate analyses were conducted to characterise the sleep patterns identified. A total of 1586 nights were analysed. The strategy used significantly influenced the average percentage of reported poor nights. Two to three sleep patterns were derived per strategy. Within each strategy, sleep patterns differed from each other on sleep variables and night-to-night variability. Results suggest the existence of sleep patterns in insomnia among individuals consulting in psychological clinics. Adding a total sleep time of 6-h cut-off as a criterion to define poor nights increases the accuracy of the strategy to define poor night and allows to identify sleep patterns of poor nights in insomnia.

Previous studies indicated that patients with isolated rapid eye movement (REM) sleep behaviour disorder (iRBD) exhibit alterations in spectral electroencephalographic (EEG), spindle, and slow-wave features. As it is currently unknown how these EEG features evolve over time, this study aimed to evaluate their temporal progression in patients with iRBD in comparison to controls. We included 23 patients with iRBD and 23 controls. Two polysomnographies (baseline and follow-up) were recorded with a mean (standard deviation) interval of 4.0 (2.5) years and were automatically analysed for sleep stages, spectral bandpower, spindles, and slow waves. We used linear models to evaluate differences at each time point, and linear mixed-effects models to analyse differences in temporal progression between the groups. At baseline, patients with iRBD presented EEG slowing both in REM (expressed as significantly reduced α-bandpower and increased δ-bandpower in frontal channels) and in non-REM (NREM) sleep (significantly increased slow-to-fast ratio in central channels). These differences vanished at follow-up. In both REM and NREM sleep, γ-bandpower was increased at follow-up in patients with iRBD, resulting in significantly different temporal progression between groups (in occipital channels during REM sleep and frontal channels during NREM sleep). Relative power of sleep spindles was significantly higher at baseline in patients with iRBD in frontal channels, but we observed a significant reduction over time in central channels. Finally, slow waves were significantly shorter in patients with iRBD at both time-points. Our results underscore the need of considering longitudinal data when analysing sleep EEG features in patients with iRBD. The observed temporal changes as markers of progression of neurodegeneration require further investigations.

Obstructive airway disease is associated with sleep disturbances. We aimed to assess the relationship between lung function and sleep disorder symptoms using cross-sectionally collected data between March 2017 and August 2021 from the Undiagnosed Chronic Obstructive Pulmonary Disease and Asthma Population study, a prospective community-based multi-site case-finding study. Undiagnosed Chronic Obstructive Pulmonary Disease and Asthma Population study participants with respiratory symptoms but without diagnosed lung disease who completed spirometry and the Global Sleep Assessment Questionnaire were included. We conducted multivariate linear regression models for forced expiratory volume in 1 s, forced vital capacity and forced expiratory volume in 1 s/forced vital capacity by Global Sleep Assessment Questionnaire responses adjusted for confounders. The same models were employed to examine respiratory symptoms, as reported on the St George's Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test, by Global Sleep Assessment Questionnaire responses. Logistic regression models were used to assess the association of undiagnosed obstructive airway disease with sleep symptoms. Amongst 2093 adults included in the study, 48.3% were female and the median age was 63 years (interquartile range 53-72). Two-hundred and five (9.79%) subjects met spirometry criteria for undiagnosed chronic obstructive pulmonary disease, and 191 (9.13%) for undiagnosed asthma. There were no significant associations between spirometry measures and sleep symptoms (p > 0.5), controlling for age, sex, body mass index, smoking and comorbidities. Those with undiagnosed asthma were more likely to report insomnia "at least sometimes" versus "never" (odds ratio 2.58, 95% confidence interval: 1.27-6.19, p = 0.02). Respiratory symptoms were associated with sleep symptoms, with significant (p < 0.05) increases in St George's Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test scores in those reporting most sleep symptoms. Overall, we found an association between undiagnosed asthma and insomnia, and between respiratory and sleep disorder symptoms.

The current exploratory pilot study examined whether social rhythm regularity, as measured by a social rhythm metric, was associated with: (1) the regularity of circadian rhythms and/or sleep regularity metrics; and (2) sleep quality, affective function and alcohol use. Late adolescents (18-22 years old) who drink alcohol (n = 36; 61.1% female, M_age = 21.26 years) completed a 14-day ecological momentary assessment protocol, wore a wrist actigraph for 14 days, and completed two overnight visits (Thursday and Sunday) to assess dim light melatonin onset. Sleep regularity metrics included standard deviation, composite phase deviation, social jet lag and inter-daily stability. We used dim light melatonin onset data to calculate the stability of the circadian phase (Sunday minus Thursday). Participants completed surveys and ecological momentary assessments that assessed global and daily sleep quality, affective function, and alcohol use. Correlational analysis and robust regression modelling were used. More regular social rhythms were associated with higher regularities of mid-sleep timing based on standard deviations, but were not associated with other sleep regularity metrics or stability of the circadian phase. More regular social rhythms were associated with better sleep quality, but were not associated with affective function or alcohol use. Social rhythm regularity is a unique construct compared with existing sleep quality metrics. In contrast with the social zeitgeber hypothesis, social rhythm regularity was not associated with circadian rhythm regularity measured by dim light melatonin onset. However, social rhythm regularity may be an under-recognized contributor to better sleep quality.

The duration of sleep data collection from actigraphy is often influenced by practical factors (e.g. workdays versus non-workdays), but the impact of the variation of duration on outcome measures of interest has not been well explored. This study investigates the effect of the duration of actigraphy measurement on non-parametric measures of 24-hr sleep-wake rhythms. We examined regularity inter-daily stability and fragmentation intra-daily variation over 14 days or the first 7 days in participants (n = 41) undergoing evaluation for sleep disorders. Bland-Altman plots assessed the impact of fewer than 14 or 7 days, respectively, on inter-daily stability and intra-daily variation scores. Intra-daily variation values were also calculated for each day and compared with the 14-day intra-daily variation. Compared with the entire 14-day period, using shorter durations (< 7 days) led to a higher estimated bias and increased variance in the limits of agreement for inter-daily stability. Intra-daily variation values showed increased variation in the limits of agreement with fewer days. Similar trends were observed when comparing shorter actigraphy periods 3 or 5 days-7 days. Daily intra-daily variation calculations indicate that individuals with higher daily fragmentation experienced more pronounced day-to-day fragmentation and greater variability in the degree of fragmentation, in a linear association between daily intra-daily variation standard deviation and 14-day intra-daily variation values. Our data indicate that a minimum of 7 full days of actigraphy is recommended to reduce measurement errors, and intra-daily variation and inter-daily stability derived from less than 7 days cannot be compared with those from more than 7 days without significant error.

The efficacy of digital brief behavioural treatment for insomnia using a smartphone application in conjunction with light therapy was investigated in university students who had insomnia symptoms with late chronotypes. In this two-arm parallel randomized-controlled trial, participants with insomnia symptoms and late chronotypes were recruited between October and November 2023. The duration of the intervention program was 4 weeks. The smartphone application provides digital brief behavioural treatment for insomnia, including programs for advanced phases. The intervention group used blue-light-emitting diode glasses in the morning after waking up for 2-4 weeks. The primary outcome was a change in the Insomnia Severity Index during the study period. The Insomnia Severity Index was obtained weekly using a web questionnaire. Of the 28 students, 14 each were assigned to the intervention and control groups. The mean Insomnia Severity Index scores at baseline were 12.2 and 12.5; after 4 weeks, they declined to 7.2 and 10.6 in the intervention and control groups, respectively. Primary analysis using a linear mixed model showed a significant improvement in the temporal trends of the Insomnia Severity Index in the intervention group (p < 0.001). The scores on the Morningness-Eveningness Questionnaire (p = 0.008) and RU-SATED (p = 0.005) significantly improved in the intervention group relative to the control group following the intervention. This study demonstrated the effectiveness of the digital brief behavioural treatment for insomnia with light therapy in participants with both insomnia symptoms and late chronotypes.

Frailty and sleep disturbances are two major concerns in late adulthood, that not only profoundly threaten health and wellbeing at the individual level but place enormous demands on our healthcare systems. Given that both constructs represent dynamic states that are preventable and reversible, understanding the potential pathways to and effects of these variables on one another is critical in providing effective and tailored support. However, despite growing interest in the relationship between sleep and frailty, only one study to date has directly explored their potential bidirectionality. Accordingly, this study was designed to extend the current understanding by investigating the reciprocal relationship of frailty and sleep quality at the multidimensional level. Specifically, the bidirectionality of these relationships was considered separately for physical, psychological, cognitive, and social frailty. Four random-intercept cross-lagged panel models with three time points were conducted, using 3192 older adults (M_age = 60.21; 46.37% female at baseline) from the UK Biobank. The results revealed that while physical, psychological, and cognitive frailty were neither predictive of, nor predicted by, sleep quality, social frailty and sleep share a reciprocal relationship. These data therefore offer important preliminary evidence for the efficacy of early intervention and prevention strategies aimed at enhancing sleep quality to reduce social frailty, and vice versa.

A randomised, placebo-controlled, parallel-group study was conducted to examine the effect of periocular skin warming before bedtime on sleep and anxiety in female workers with mild sleep difficulty. A total of 64 participants were included in the study, which consisted of a 1-week baseline period and a 4-week intervention period. They were randomly assigned to either the Warm group (N = 32) or the Sham group (N = 32) and were instructed to wear eye masks (warming or sham) before their habitual bedtime during the intervention period. The study found that the Athens Insomnia Scale score after the intervention was significantly lower in the Warm group compared to the Sham group. Additionally, participants in the warm condition showed a decrease in subjective sleep onset latency, better restorative sleep, and improved subjective anxiety before bedtime. A significant reduction in wake after sleep onset was observed in the Warm group at 4 weeks, and this decrease was significantly associated with the degree of improvement in subjective anxiety before bedtime. Furthermore, regular periocular skin warming before bedtime decreased sleep reactivity and improved well-being. In conclusion, the study suggests that periocular skin warming may be an effective approach for female workers with sleep problems, as it can easily be incorporated into daily life.