Pub Date : 2024-08-10DOI: 10.1093/sleepadvances/zpae058
C. Faucher, L. Borne, A. Behler, B. Paton, J. Giorgio, J. Fripp, R. Thienel, M. Lupton, M. Breakspear
Evidence suggests that poor sleep impacts on cognition, brain health and dementia risk but the nature of the association is poorly understood. This study examined how self-reported sleep duration, napping, and subjective depression symptoms are associated to the brain-cognition relationship in older adults, using sulcal width as a measure of relative brain health. A canonical Partial Least Squares (PLS) analysis was used to obtain two composite variables that relate cognition and sulcal width in a cross-sectional study of 137 adults aged 46-72. We used a combination of ANCOVA and path analyses to test the associations of self-reported sleep duration, napping, and subjective depression symptoms with the brain-cognition relationship. We observed a significant main effect of sleep duration on sulcal width, with participants reporting 7 hours showing narrower sulci than other durations. This effect remained significant after including subjective depression as a covariate, which also had a significant main effect on sulcal width in the model. There was no significant effect of napping on sulcal width. In path analyses where the effects of age, self-reported sleep duration and depression symptoms were investigated together, sulcal width mediated the relationship between age and cognition. We also observed a significant indirect effect of sulci width in the subjective depression-cognition relationship. Findings suggest that self-reported sleep duration and subjective depression may each be independently associated with brain morphology, which is related to cognitive functions. Results could help inform clinical trials and related intervention studies that aim at delaying cognitive decline in adults at risk of developing dementia.
{"title":"A Central Role of Sulcal Width in the Associations of Sleep Duration and Depression with Cognition in Mid to Late Life","authors":"C. Faucher, L. Borne, A. Behler, B. Paton, J. Giorgio, J. Fripp, R. Thienel, M. Lupton, M. Breakspear","doi":"10.1093/sleepadvances/zpae058","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae058","url":null,"abstract":"\u0000 \u0000 \u0000 Evidence suggests that poor sleep impacts on cognition, brain health and dementia risk but the nature of the association is poorly understood. This study examined how self-reported sleep duration, napping, and subjective depression symptoms are associated to the brain-cognition relationship in older adults, using sulcal width as a measure of relative brain health.\u0000 \u0000 \u0000 \u0000 A canonical Partial Least Squares (PLS) analysis was used to obtain two composite variables that relate cognition and sulcal width in a cross-sectional study of 137 adults aged 46-72. We used a combination of ANCOVA and path analyses to test the associations of self-reported sleep duration, napping, and subjective depression symptoms with the brain-cognition relationship.\u0000 \u0000 \u0000 \u0000 We observed a significant main effect of sleep duration on sulcal width, with participants reporting 7 hours showing narrower sulci than other durations. This effect remained significant after including subjective depression as a covariate, which also had a significant main effect on sulcal width in the model. There was no significant effect of napping on sulcal width. In path analyses where the effects of age, self-reported sleep duration and depression symptoms were investigated together, sulcal width mediated the relationship between age and cognition. We also observed a significant indirect effect of sulci width in the subjective depression-cognition relationship.\u0000 \u0000 \u0000 \u0000 Findings suggest that self-reported sleep duration and subjective depression may each be independently associated with brain morphology, which is related to cognitive functions. Results could help inform clinical trials and related intervention studies that aim at delaying cognitive decline in adults at risk of developing dementia.\u0000","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141920904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-27DOI: 10.1093/sleepadvances/zpae053
Bradley E Karlin, Ryan J Anderson, Jillian M Rung, Charlotte Drury-Gworek, Tyson S Barrett
Insomnia has substantial and wide-ranging negative effects on clinical and functional outcomes and on health care expenditures, yet few individuals receive gold-standard insomnia treatment. The current article examines provider and patient outcomes associated with real-world implementation of Cognitive Behavioral Therapy for Insomnia (CBT-I), as part of a pilot initiative designed to establish initial capability for evidence-based insomnia treatment within one of the largest payor-provider systems in the United States. Provider training outcomes were assessed using the CBT-I Competency Rating Scale and self-report measures. Patient outcomes were assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-9. All clinicians (N = 11) achieved competency in CBT-I and reported large increases in knowledge and confidence related to insomnia and insomnia treatment. Clinicians also reported high intention to deliver CBT-I and significant improvements in overall job satisfaction following competency-based CBT-I training. Among all patients who initiated CBT-I (N = 48), mixed effects modeling demonstrated significant reduction in average ISI scores (12.57 to 5.88, SEs = 1.08-1.14). More than two-thirds of patients (68.8%) completed treatment. Among completers of this brief treatment, mean insomnia severity improvement was 71% (Hedges g = 1.56). Findings provide support for the feasibility and effectiveness of real-world CBT-I implementation, extending past findings to a private, payor-provider context. Patient and provider-level outcomes suggest the significant opportunity private systems may have in increasing the availability of gold-standard treatment for insomnia.
{"title":"Impact of Real-World Implementation of Evidence-Based Insomnia Treatment within a Large Payor-Provider Health System: Initial Provider and Patient-Level Outcomes","authors":"Bradley E Karlin, Ryan J Anderson, Jillian M Rung, Charlotte Drury-Gworek, Tyson S Barrett","doi":"10.1093/sleepadvances/zpae053","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae053","url":null,"abstract":"\u0000 \u0000 \u0000 Insomnia has substantial and wide-ranging negative effects on clinical and functional outcomes and on health care expenditures, yet few individuals receive gold-standard insomnia treatment. The current article examines provider and patient outcomes associated with real-world implementation of Cognitive Behavioral Therapy for Insomnia (CBT-I), as part of a pilot initiative designed to establish initial capability for evidence-based insomnia treatment within one of the largest payor-provider systems in the United States.\u0000 \u0000 \u0000 \u0000 Provider training outcomes were assessed using the CBT-I Competency Rating Scale and self-report measures. Patient outcomes were assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-9.\u0000 \u0000 \u0000 \u0000 All clinicians (N = 11) achieved competency in CBT-I and reported large increases in knowledge and confidence related to insomnia and insomnia treatment. Clinicians also reported high intention to deliver CBT-I and significant improvements in overall job satisfaction following competency-based CBT-I training. Among all patients who initiated CBT-I (N = 48), mixed effects modeling demonstrated significant reduction in average ISI scores (12.57 to 5.88, SEs = 1.08-1.14). More than two-thirds of patients (68.8%) completed treatment. Among completers of this brief treatment, mean insomnia severity improvement was 71% (Hedges g = 1.56).\u0000 \u0000 \u0000 \u0000 Findings provide support for the feasibility and effectiveness of real-world CBT-I implementation, extending past findings to a private, payor-provider context. Patient and provider-level outcomes suggest the significant opportunity private systems may have in increasing the availability of gold-standard treatment for insomnia.\u0000","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-27DOI: 10.1093/sleepadvances/zpae054
Bradley E Karlin, Ryan J Anderson, Jillian M Rung, Charlotte Drury-Gworek, Tyson S Barrett
Insomnia has profound negative effects on behavioral health, physical health, and functional domains. Leveraging claims data from one of the nation’s largest payor-provider systems, the current study examined real-world prevalence of insomnia, comorbidity of insomnia with behavioral health and other sleep disorders, and the impact of insomnia on total health care costs. Prevalence and costs associated with insomnia were assessed by examining claims data on approximately 3 million insured members during the year 2022. Using propensity score matching, total health care expenditures were calculated and compared for members with insomnia relative to matched cohorts without insomnia. Generalized linear modeling tested for differences between the cohorts. Nine percent of members were identified as having insomnia; 64% of those also had a depression, anxiety, and/or substance use disorder. Median total health care costs among individuals with insomnia were 4-6 times greater than among those without insomnia. A disproportionate amount (21.1%) of total claims spend came from members with insomnia. Findings demonstrate a high degree of clinical need and behavioral health comorbidity associated with insomnia within a large insured cohort. Beyond the clinical significance, the current results demonstrate substantial financial need and opportunity for adequately treating insomnia. This is especially the case for the high proportion of members with insomnia and co-occurring depression, anxiety, and/or substance use disorders. Overall, the findings point to the important role payors and providers may have in promoting greater attention to sleep and insomnia.
{"title":"Clinical and Financial Significance of Insomnia within a Large Payor-Provider Health System","authors":"Bradley E Karlin, Ryan J Anderson, Jillian M Rung, Charlotte Drury-Gworek, Tyson S Barrett","doi":"10.1093/sleepadvances/zpae054","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae054","url":null,"abstract":"\u0000 \u0000 \u0000 Insomnia has profound negative effects on behavioral health, physical health, and functional domains. Leveraging claims data from one of the nation’s largest payor-provider systems, the current study examined real-world prevalence of insomnia, comorbidity of insomnia with behavioral health and other sleep disorders, and the impact of insomnia on total health care costs.\u0000 \u0000 \u0000 \u0000 Prevalence and costs associated with insomnia were assessed by examining claims data on approximately 3 million insured members during the year 2022. Using propensity score matching, total health care expenditures were calculated and compared for members with insomnia relative to matched cohorts without insomnia. Generalized linear modeling tested for differences between the cohorts.\u0000 \u0000 \u0000 \u0000 Nine percent of members were identified as having insomnia; 64% of those also had a depression, anxiety, and/or substance use disorder. Median total health care costs among individuals with insomnia were 4-6 times greater than among those without insomnia. A disproportionate amount (21.1%) of total claims spend came from members with insomnia.\u0000 \u0000 \u0000 \u0000 Findings demonstrate a high degree of clinical need and behavioral health comorbidity associated with insomnia within a large insured cohort. Beyond the clinical significance, the current results demonstrate substantial financial need and opportunity for adequately treating insomnia. This is especially the case for the high proportion of members with insomnia and co-occurring depression, anxiety, and/or substance use disorders. Overall, the findings point to the important role payors and providers may have in promoting greater attention to sleep and insomnia.\u0000","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.1093/sleepadvances/zpae051
Qinglan Ding, Jeph Herrin, Meir Kryger
To investigate the sex-specific association between habitual snoring and overall cancer prevalence and subtypes, and to examine the influence of age, body mass index (BMI), and sleep duration on this association. This study utilized data from the National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2020 and included 15,892 participants aged 18 and over. We employed inverse probability of treatment weighting (IPTW) based on propensity scores to adjust for confounders when comparing the prevalence of cancer between habitual snorers and non-habitual snorers for each sex and cancer type. Subgroup analyses were conducted based on sleep duration, age, and BMI categories. The cohort (mean age 48.2 years, 50.4% female, 30.5% habitual snorers) reported 1,385 cancer cases. In men, habitual snoring was linked to 26% lower odds of any cancer (OR 0.74, 95% CI 0.66-0.83), while in women, it showed no significant difference except lower odds of breast cancer (OR 0.77, 95% CI 0.63-0.94) and higher odds of cervix cancer (OR 1.54, 95% CI 1.18-2.01). Age and sleep duration significantly influenced the snoring-cancer relationship, with notable variations by cancer type and sex. Habitual snoring exhibits sex-specific associations with cancer prevalence, showing lower prevalence in men and varied results in women. These findings emphasize the critical need for further research to uncover the biological mechanisms involved. Future investigations should consider integrating sleep characteristics with cancer prevention and screening strategies, focusing on longitudinal research and the integration of genetic and biomarker analyses to full understand these complex relationships.
研究习惯性打鼾与癌症总患病率和亚型之间的性别特异性关联，并探讨年龄、体重指数（BMI）和睡眠时间对这种关联的影响。 本研究利用了 2005 年至 2020 年期间的美国国家健康与营养调查（NHANES）数据，包括 15,892 名 18 岁及以上的参与者。在比较不同性别和癌症类型的习惯性打鼾者和非习惯性打鼾者的癌症患病率时，我们采用了基于倾向分数的反向治疗概率加权法（IPTW）来调整混杂因素。根据睡眠时间、年龄和体重指数类别进行了分组分析。 研究组（平均年龄 48.2 岁，50.4% 为女性，30.5% 为习惯性打鼾者）共报告了 1,385 例癌症病例。在男性中，习惯性打鼾导致罹患任何癌症的几率降低了 26%（OR 0.74，95% CI 0.66-0.83），而在女性中，除了罹患乳腺癌的几率较低（OR 0.77，95% CI 0.63-0.94）和罹患宫颈癌的几率较高（OR 1.54，95% CI 1.18-2.01）外，没有明显差异。年龄和睡眠时间对打鼾与癌症之间的关系有明显影响，不同癌症类型和性别之间也有明显差异。 习惯性打鼾与癌症发病率的关系因性别而异，男性的发病率较低，而女性的发病率则各不相同。这些发现强调了进一步研究揭示相关生物机制的迫切需要。未来的调查应考虑将睡眠特征与癌症预防和筛查策略结合起来，侧重于纵向研究以及基因和生物标记分析的整合，以充分了解这些复杂的关系。
{"title":"Sex-Specific Associations Between Habitual Snoring and Cancer Prevalence: Insights from a U.S. Cohort Study","authors":"Qinglan Ding, Jeph Herrin, Meir Kryger","doi":"10.1093/sleepadvances/zpae051","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae051","url":null,"abstract":"\u0000 \u0000 \u0000 To investigate the sex-specific association between habitual snoring and overall cancer prevalence and subtypes, and to examine the influence of age, body mass index (BMI), and sleep duration on this association.\u0000 \u0000 \u0000 \u0000 This study utilized data from the National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2020 and included 15,892 participants aged 18 and over. We employed inverse probability of treatment weighting (IPTW) based on propensity scores to adjust for confounders when comparing the prevalence of cancer between habitual snorers and non-habitual snorers for each sex and cancer type. Subgroup analyses were conducted based on sleep duration, age, and BMI categories.\u0000 \u0000 \u0000 \u0000 The cohort (mean age 48.2 years, 50.4% female, 30.5% habitual snorers) reported 1,385 cancer cases. In men, habitual snoring was linked to 26% lower odds of any cancer (OR 0.74, 95% CI 0.66-0.83), while in women, it showed no significant difference except lower odds of breast cancer (OR 0.77, 95% CI 0.63-0.94) and higher odds of cervix cancer (OR 1.54, 95% CI 1.18-2.01). Age and sleep duration significantly influenced the snoring-cancer relationship, with notable variations by cancer type and sex.\u0000 \u0000 \u0000 \u0000 Habitual snoring exhibits sex-specific associations with cancer prevalence, showing lower prevalence in men and varied results in women. These findings emphasize the critical need for further research to uncover the biological mechanisms involved. Future investigations should consider integrating sleep characteristics with cancer prevention and screening strategies, focusing on longitudinal research and the integration of genetic and biomarker analyses to full understand these complex relationships.\u0000","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141804952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.1093/sleepadvances/zpae052
Yeonsu Song, Jennifer L Martin, Susan M McCurry, M. Kelly, Edmond Teng, Cathy A. Alessi, Michael R Irwin, Steve Cole
Poor sleep is associated with increased inflammation, thereby increasing the risk of chronic diseases and mortality. However, the effects of behavioral sleep interventions on the upstream inflammatory system are unknown among family care partners (CP). The present study explored the role of a behavioral sleep intervention program on inflammatory gene expression. This was part of a randomized controlled trial of a sleep intervention for dementia care dyads with sleep problems. Thirty dyads were randomized to sleep intervention or control groups. Sleep outcomes for CP were assessed with one week of actigraphy and sleep diary, and the Pittsburgh Sleep Quality Index (PSQI). Other information included CP demographics, body mass index (BMI), and intensity of caregiving tasks. All outcomes were collected at baseline, post-treatment, and 3-month follow-up. Neither group showed any significant differential changes in gene expression from baseline to post-treatment or 3-month follow-up. A decrease in inflammatory gene expression was significantly associated with more nights of good sleep (i.e., nights without trouble falling or staying asleep at night). This finding remained significant after controlling for group (intervention/control), timepoint (baseline, post-treatment, and 3-month follow-up), and CP characteristics (e.g., age, ethnicity). Although better sleep was associated with decreased inflammatory gene expression, this study did not demonstrate any benefits of a behavioral sleep intervention over control, most likely due to a small sample. Studies with larger sample sizes are needed to test the specific aspects of disturbed sleep that relate to inflammatory biology among CP of persons living with dementia.
{"title":"Poor Sleep and Inflammatory Gene Expression Among Care Partners of Persons Living with Dementia: A Pilot Trial of a Behavioral Sleep Intervention","authors":"Yeonsu Song, Jennifer L Martin, Susan M McCurry, M. Kelly, Edmond Teng, Cathy A. Alessi, Michael R Irwin, Steve Cole","doi":"10.1093/sleepadvances/zpae052","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae052","url":null,"abstract":"\u0000 \u0000 \u0000 Poor sleep is associated with increased inflammation, thereby increasing the risk of chronic diseases and mortality. However, the effects of behavioral sleep interventions on the upstream inflammatory system are unknown among family care partners (CP). The present study explored the role of a behavioral sleep intervention program on inflammatory gene expression.\u0000 \u0000 \u0000 \u0000 This was part of a randomized controlled trial of a sleep intervention for dementia care dyads with sleep problems. Thirty dyads were randomized to sleep intervention or control groups. Sleep outcomes for CP were assessed with one week of actigraphy and sleep diary, and the Pittsburgh Sleep Quality Index (PSQI). Other information included CP demographics, body mass index (BMI), and intensity of caregiving tasks. All outcomes were collected at baseline, post-treatment, and 3-month follow-up.\u0000 \u0000 \u0000 \u0000 Neither group showed any significant differential changes in gene expression from baseline to post-treatment or 3-month follow-up. A decrease in inflammatory gene expression was significantly associated with more nights of good sleep (i.e., nights without trouble falling or staying asleep at night). This finding remained significant after controlling for group (intervention/control), timepoint (baseline, post-treatment, and 3-month follow-up), and CP characteristics (e.g., age, ethnicity).\u0000 \u0000 \u0000 \u0000 Although better sleep was associated with decreased inflammatory gene expression, this study did not demonstrate any benefits of a behavioral sleep intervention over control, most likely due to a small sample. Studies with larger sample sizes are needed to test the specific aspects of disturbed sleep that relate to inflammatory biology among CP of persons living with dementia.\u0000","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141804222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-20DOI: 10.1093/sleepadvances/zpae049
Yuxi Xie, Brooke C Feeney
Although a significant body of research has revealed associations between romantic relationship experiences and sleep quality, there has not been clarity regarding the mechanisms underlying such associations. Toward this end, we review the existing studies that have tested mechanisms linking romantic relationship experiences to sleep quality. Guided by both theory and existing research, we organize our review around five key categories of mechanisms that may explain associations between romantic relationship experiences and sleep quality: emotional/affective responses, self-perceptions, social perceptions, self-regulation, and biological functioning. Our review of the literature indicates strong evidence in support of the mediating effects of emotional/affective mechanisms (e.g., emotions and mood states) in explaining associations between various aspects of romantic relationships (e.g., relationship satisfaction, partner conflicts, attachment orientation) and sleep quality. Although there is ample theoretical support for the other mechanisms proposed, and although all proposed mechanisms have been separately linked to both romantic relationship experiences and sleep quality, few studies have directly tested them, pointing to profitable directions for future research. Understanding underlying mechanisms will enable the development of wise, process-based interventions that target specific mechanisms to improve couple members’ sleep quality and romantic relationship functioning.
{"title":"A Narrative Review of Mechanisms Linking Romantic Relationship Experiences to Sleep Quality","authors":"Yuxi Xie, Brooke C Feeney","doi":"10.1093/sleepadvances/zpae049","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae049","url":null,"abstract":"\u0000 Although a significant body of research has revealed associations between romantic relationship experiences and sleep quality, there has not been clarity regarding the mechanisms underlying such associations. Toward this end, we review the existing studies that have tested mechanisms linking romantic relationship experiences to sleep quality. Guided by both theory and existing research, we organize our review around five key categories of mechanisms that may explain associations between romantic relationship experiences and sleep quality: emotional/affective responses, self-perceptions, social perceptions, self-regulation, and biological functioning. Our review of the literature indicates strong evidence in support of the mediating effects of emotional/affective mechanisms (e.g., emotions and mood states) in explaining associations between various aspects of romantic relationships (e.g., relationship satisfaction, partner conflicts, attachment orientation) and sleep quality. Although there is ample theoretical support for the other mechanisms proposed, and although all proposed mechanisms have been separately linked to both romantic relationship experiences and sleep quality, few studies have directly tested them, pointing to profitable directions for future research. Understanding underlying mechanisms will enable the development of wise, process-based interventions that target specific mechanisms to improve couple members’ sleep quality and romantic relationship functioning.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-19DOI: 10.1093/sleepadvances/zpae050
N. Shattuck, P. Matsangas
The purpose of the study was to compare the fatigue levels, work/rest patterns, health-related behaviors, and well-being of galley workers with other sailors on United States Navy ships while underway. Analysis was based on a retrospective comparison of data from three fit-for-duty groups of sailors: 67 galley workers, 192 non-watchstanders, and 466 watchstanders. Participants completed questionnaires (Epworth Sleepiness Scale [ESS], Insomnia Severity Index [ISI], Pittsburgh Sleep Quality Index [PSQI], Profile of Mood States [POMS]) and activity logs, and wore actigraphs. Galley workers slept MD=6.57 (IQR=1.42) hours/day and worked MD=12.8 (IQR=2.42) hours/day. Approximately 84% of the galley workers were classified as poor sleepers, ~57% reported having excessive daytime sleepiness (EDS), and ~38% reported elevated insomnia symptoms. Compared to non-watchstanders, galley workers had worse scores on POMS (total mood disturbance, tension-anxiety, depression, anger-hostility, fatigue, confusion-bewilderment), ESS, ISI, and PSQI. Compared to non-watchstanders, galley workers had a higher risk for symptoms of EDS (75%), symptoms of clinically relevant insomnia (126%), and for being classified as poor sleepers (27%). Galley workers slept less and worked on average two hours/day more than non-watchstanders. Compared to watchstanders, galley workers had worse ESS, ISI, and anger-hostility scores. More watchstanders napped compared to galley workers. Although they are considered day workers, the sleep patterns, fatigue levels, and mood of galley workers are comparable to, or worse than, watchstanders or other non-watchstanders. To ameliorate the effects of long work hours on sailor well-being, ship leadership should consider adopting strategies to improve galley workers’ well-being.
{"title":"Recipe for Fatigue: Sleep, work patterns, and well-being of galley workers on Surface Ships of the United States Navy","authors":"N. Shattuck, P. Matsangas","doi":"10.1093/sleepadvances/zpae050","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae050","url":null,"abstract":"\u0000 \u0000 \u0000 The purpose of the study was to compare the fatigue levels, work/rest patterns, health-related behaviors, and well-being of galley workers with other sailors on United States Navy ships while underway.\u0000 \u0000 \u0000 \u0000 Analysis was based on a retrospective comparison of data from three fit-for-duty groups of sailors: 67 galley workers, 192 non-watchstanders, and 466 watchstanders. Participants completed questionnaires (Epworth Sleepiness Scale [ESS], Insomnia Severity Index [ISI], Pittsburgh Sleep Quality Index [PSQI], Profile of Mood States [POMS]) and activity logs, and wore actigraphs.\u0000 \u0000 \u0000 \u0000 Galley workers slept MD=6.57 (IQR=1.42) hours/day and worked MD=12.8 (IQR=2.42) hours/day. Approximately 84% of the galley workers were classified as poor sleepers, ~57% reported having excessive daytime sleepiness (EDS), and ~38% reported elevated insomnia symptoms. Compared to non-watchstanders, galley workers had worse scores on POMS (total mood disturbance, tension-anxiety, depression, anger-hostility, fatigue, confusion-bewilderment), ESS, ISI, and PSQI. Compared to non-watchstanders, galley workers had a higher risk for symptoms of EDS (75%), symptoms of clinically relevant insomnia (126%), and for being classified as poor sleepers (27%). Galley workers slept less and worked on average two hours/day more than non-watchstanders. Compared to watchstanders, galley workers had worse ESS, ISI, and anger-hostility scores. More watchstanders napped compared to galley workers.\u0000 \u0000 \u0000 \u0000 Although they are considered day workers, the sleep patterns, fatigue levels, and mood of galley workers are comparable to, or worse than, watchstanders or other non-watchstanders. To ameliorate the effects of long work hours on sailor well-being, ship leadership should consider adopting strategies to improve galley workers’ well-being.\u0000","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-11DOI: 10.1093/sleepadvances/zpae046
Riley Forbes, B. Duce, C. Hukins, C. Ellender
The objective of this study was to investigate the association between demographic, clinical, and interface factors and non-invasive ventilation (NIV) usage. A retrospective cohort analysis of 478 patients prescribed NIV from 2013 to 2021 was performed. Demographic factors, clinical indications for NIV, and interface factors were collected, and linear regression was conducted to evaluate the association between these variables and NIV usage (hr/night). The average usage of the cohort was 6.5hr/night±4.6, with an average age of 57 years±16 and body mass index (BMI) of 40.5kg/m2±14.7. The cohort was mostly male (n = 290, 60.6%). The most common indications for NIV prescription were high pressure requirement for obstructive sleep apnoea (HPR, n = 190, 39.7%), neuromuscular disease (NMD, n = 140, 29.3%) and obesity hypoventilation syndrome (OHS, n = 111, 23.2%). A diagnosis of NMD was a significant predictor of higher NIV usage (8.0±6.1hr/night) in multivariate analysis (p = 0.036). The HPR sub-cohort had the lowest usage of all indications. Age and BMI did not predict usage. A nasal interface (p <0.01) and lower expiratory positive airway pressure (EPAP) setting (p <0.001) were associated with increased NIV usage. This study highlights the multifaceted nature of NIV usage. Where demographic factors were not consistent predictors of usage, interface and clinical indication were associated with usage. These findings highlight that the HPR users are a group at risk of low usage.
{"title":"Factors associated with non-invasive ventilation usage in patients with hypoventilation disorders","authors":"Riley Forbes, B. Duce, C. Hukins, C. Ellender","doi":"10.1093/sleepadvances/zpae046","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae046","url":null,"abstract":"\u0000 \u0000 \u0000 The objective of this study was to investigate the association between demographic, clinical, and interface factors and non-invasive ventilation (NIV) usage.\u0000 \u0000 \u0000 \u0000 A retrospective cohort analysis of 478 patients prescribed NIV from 2013 to 2021 was performed. Demographic factors, clinical indications for NIV, and interface factors were collected, and linear regression was conducted to evaluate the association between these variables and NIV usage (hr/night).\u0000 \u0000 \u0000 \u0000 The average usage of the cohort was 6.5hr/night±4.6, with an average age of 57 years±16 and body mass index (BMI) of 40.5kg/m2±14.7. The cohort was mostly male (n = 290, 60.6%). The most common indications for NIV prescription were high pressure requirement for obstructive sleep apnoea (HPR, n = 190, 39.7%), neuromuscular disease (NMD, n = 140, 29.3%) and obesity hypoventilation syndrome (OHS, n = 111, 23.2%). A diagnosis of NMD was a significant predictor of higher NIV usage (8.0±6.1hr/night) in multivariate analysis (p = 0.036). The HPR sub-cohort had the lowest usage of all indications. Age and BMI did not predict usage. A nasal interface (p <0.01) and lower expiratory positive airway pressure (EPAP) setting (p <0.001) were associated with increased NIV usage.\u0000 \u0000 \u0000 \u0000 This study highlights the multifaceted nature of NIV usage. Where demographic factors were not consistent predictors of usage, interface and clinical indication were associated with usage. These findings highlight that the HPR users are a group at risk of low usage.\u0000","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141658298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-10DOI: 10.1093/sleepadvances/zpae047
N. Sakai, Kazuhiro Komi, Naoya Nishino, Yutaka Kuroki, Seiji Nishino
Tongkat Ali (TA), also known as Eurycoma longifolia, has been used as a traditional herbal medicine for anti-aging, evidenced by clinical trials presenting the beneficial effects on energy, fatigue, and mood disturbance. We have recently shown that TA supplementation dose-dependently enhances the rest-activity pattern in C57BL/6 mice. Since destabilization of wakefulness and sleep is one of the typical symptoms of not only the elderly but also narcolepsy, we performed sleep analysis with and without dietary TA extract supplementation in middle-aged (10-12 months old) wild-type and narcoleptic DTA mice. We found that TA supplementation enhanced diurnal rhythms of locomotion and temperature in a time-of-day-dependent manner in WT mice but attenuated in DTA mice. In WT mice, TA supplementation consolidated wakefulness with long bout duration and led to less entries into sleep state during the active period, while it consolidated NREM sleep with long bout duration during the resting period. Neither disturbed sleep and wake cycle nor cataplexy was sufficiently improved in DTA mice. EEG spectral analysis revealed that TA supplementation enhanced SWA at both delta and low delta frequencies (0.5-4.0 and 0.5-2.0 Hz) during the light period, suggesting TA extract may induce vigilance during the active period, which then elicits a rebound effect during the resting period. Interestingly, DTA mice also slightly, but significantly, increased SWA at low frequencies during the light period. Taken together, our results suggest that TA supplementation enhances the Yin-Yang balance of sleep, temperature, and locomotion in WT mice, while its efficacy is limited in narcoleptic mice.
东革阿里（Tongkat Ali，TA）又名 Eurycoma longifolia，一直被用作抗衰老的传统草药，临床试验证明它对精力、疲劳和情绪障碍有好处。我们最近的研究表明，在 C57BL/6 小鼠体内补充一定剂量的 TA 可增强其休息-活动模式。由于觉醒和睡眠的不稳定性不仅是老年人的典型症状之一，也是嗜睡症的典型症状之一，我们对中年（10-12 个月大）野生型和嗜睡症 DTA 小鼠进行了补充和不补充 TA 提取物的睡眠分析。我们发现，在 WT 小鼠中，补充 TA 会增强运动和体温的昼夜节律，其方式与时间有关，但在 DTA 小鼠中会减弱。在WT小鼠中，补充TA能巩固清醒状态，且持续时间长，并导致在活动期进入睡眠状态的次数减少，而在休息期，补充TA能巩固NREM睡眠，且持续时间长。DTA小鼠的睡眠和觉醒周期紊乱以及惊厥都没有得到充分改善。脑电图频谱分析表明，在光照期间，TA补充剂增强了delta和低delta频率（0.5-4.0和0.5-2.0赫兹）的SWA，这表明TA提取物可能在活动期间诱导警觉，然后在休息期间引起反弹效应。有趣的是，DTA 小鼠在光照期间也会轻微但显著地增加低频的 SWA。综上所述，我们的研究结果表明，补充TA能增强WT小鼠睡眠、体温和运动的阴阳平衡，而对嗜睡小鼠的疗效有限。
{"title":"Eurycoma longifolia (Tongkat Ali) supplementation enhances sleep and wake consolidation in wild-type, but not in narcoleptic mice","authors":"N. Sakai, Kazuhiro Komi, Naoya Nishino, Yutaka Kuroki, Seiji Nishino","doi":"10.1093/sleepadvances/zpae047","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae047","url":null,"abstract":"\u0000 Tongkat Ali (TA), also known as Eurycoma longifolia, has been used as a traditional herbal medicine for anti-aging, evidenced by clinical trials presenting the beneficial effects on energy, fatigue, and mood disturbance. We have recently shown that TA supplementation dose-dependently enhances the rest-activity pattern in C57BL/6 mice. Since destabilization of wakefulness and sleep is one of the typical symptoms of not only the elderly but also narcolepsy, we performed sleep analysis with and without dietary TA extract supplementation in middle-aged (10-12 months old) wild-type and narcoleptic DTA mice. We found that TA supplementation enhanced diurnal rhythms of locomotion and temperature in a time-of-day-dependent manner in WT mice but attenuated in DTA mice. In WT mice, TA supplementation consolidated wakefulness with long bout duration and led to less entries into sleep state during the active period, while it consolidated NREM sleep with long bout duration during the resting period. Neither disturbed sleep and wake cycle nor cataplexy was sufficiently improved in DTA mice. EEG spectral analysis revealed that TA supplementation enhanced SWA at both delta and low delta frequencies (0.5-4.0 and 0.5-2.0 Hz) during the light period, suggesting TA extract may induce vigilance during the active period, which then elicits a rebound effect during the resting period. Interestingly, DTA mice also slightly, but significantly, increased SWA at low frequencies during the light period. Taken together, our results suggest that TA supplementation enhances the Yin-Yang balance of sleep, temperature, and locomotion in WT mice, while its efficacy is limited in narcoleptic mice.","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141659045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-09DOI: 10.1093/sleepadvances/zpae045
Linchen He, Jill A Rabinowitz, Yang An, C. Jackson, Ryan Hellinger, Sarah K. Wanigatunga, J. Schrack, Luigi Ferrucci, Eleanor M Simonsick, Kirsten Koehler, A. Spira
Few studies of middle-aged and older adults have examined the association between age and sleep using objective sleep measures. We examined these associations in adults aged ≥40 years using wrist actigraphy, and investigated whether these associations differed by sex and race. Participants were 468 cognitively normal adults aged ≥40 years enrolled in the Baltimore Longitudinal Study of Aging who completed wrist actigraphy. We used Generalized Least Squares Models to examine the associations of age with actigraphic sleep parameters, including total sleep time (TST), sleep efficiency, sleep onset latency, and wake after sleep onset (WASO). We conducted interaction and stratification analyses to test whether cross-sectional age-sleep associations were modified by sex and race. In analyses adjusting for sex, body mass index, and individual medical conditions, older age was associated with longer TST from ages 40-70 that plateaued after age 70. Older age also was associated with lower sleep efficiency, longer sleep onset latency, and greater WASO. In men only, after age 70, older age was associated with shorter TST, lower sleep efficiency, longer onset latency, and greater WASO. However, we did not observe any significant interactions of race with age. Older age was associated with longer TST from ages 40-70 and with poorer sleep quality after age 40, and these relationships might vary by sex. Future studies with larger sample sizes are needed to investigate mechanisms that may account for sex differences in the observed age-sleep associations.
{"title":"Age and Objectively Measured Sleep: Investigating Associations and Interactions by Sex and Race in Middle-Aged and Older Adults","authors":"Linchen He, Jill A Rabinowitz, Yang An, C. Jackson, Ryan Hellinger, Sarah K. Wanigatunga, J. Schrack, Luigi Ferrucci, Eleanor M Simonsick, Kirsten Koehler, A. Spira","doi":"10.1093/sleepadvances/zpae045","DOIUrl":"https://doi.org/10.1093/sleepadvances/zpae045","url":null,"abstract":"\u0000 \u0000 \u0000 Few studies of middle-aged and older adults have examined the association between age and sleep using objective sleep measures. We examined these associations in adults aged ≥40 years using wrist actigraphy, and investigated whether these associations differed by sex and race.\u0000 \u0000 \u0000 \u0000 Participants were 468 cognitively normal adults aged ≥40 years enrolled in the Baltimore Longitudinal Study of Aging who completed wrist actigraphy. We used Generalized Least Squares Models to examine the associations of age with actigraphic sleep parameters, including total sleep time (TST), sleep efficiency, sleep onset latency, and wake after sleep onset (WASO). We conducted interaction and stratification analyses to test whether cross-sectional age-sleep associations were modified by sex and race.\u0000 \u0000 \u0000 \u0000 In analyses adjusting for sex, body mass index, and individual medical conditions, older age was associated with longer TST from ages 40-70 that plateaued after age 70. Older age also was associated with lower sleep efficiency, longer sleep onset latency, and greater WASO. In men only, after age 70, older age was associated with shorter TST, lower sleep efficiency, longer onset latency, and greater WASO. However, we did not observe any significant interactions of race with age.\u0000 \u0000 \u0000 \u0000 Older age was associated with longer TST from ages 40-70 and with poorer sleep quality after age 40, and these relationships might vary by sex. Future studies with larger sample sizes are needed to investigate mechanisms that may account for sex differences in the observed age-sleep associations.\u0000","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141663758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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