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The effects of an exercise program on inflammation in adults who differ according to obstructive sleep apnea severity 运动计划对阻塞性睡眠呼吸暂停严重程度不同的成年人炎症的影响
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-30 DOI: 10.1007/s41105-023-00505-w
Devon A. Dobrosielski, Karla A. Kubitz, Mary F. Walter, Hyunjeong Park, Christopher Papandreou, Susheel P. Patil

Exercise improves chronic inflammation and is recommended as a first-line medical or behavioral treatment for OSA with obesity. We examined whether the effects of an exercise program on inflammatory blood markers differed according to severity of OSA among obese adults. Overweight (BMI > 27 kg/m2) adults were evaluated for OSA using overnight polysomnography and subsequently classified as exhibiting no-to-mild OSA (AHI < 15 events/hour) or moderate-to-severe OSA (AHI ≥ 15 events/hour). Cardiorespiratory fitness, body composition assessed by DXA, fasting metabolic parameters and adipokines (i.e., glucose, insulin, leptin and adioponectin), and multiple markers of inflammation (i.e., CRP, IL-4, IL-8 and TNF-α) were measured at baseline (Pre) and following a 6-week (3 days per week) comprehensive exercise program (Post). Ten adults (Age: 48 ± 8 years; W:6; M:4) with no/mild OSA and 12 adults (Age: 54 ± 8 years; W:5; M:7) with moderate/severe OSA completed all aspects of the trial. No significant differences in age, cardiorespiratory fitness, body composition, fasting metabolic parameters and most inflammatory markers were observed between groups at baseline. Exercise training decreased total fat mass (Pre: 41,167 ± 13,315 g; Post: 40,311 ± 12,657 g; p = 0.008), leptin (Pre: 26.7 ± 29.6 pg/ml; Post: 22.7 ± 19.4 pg/ml; p = 0.028) and adiponectin (Pre: 16.6 ± 10.9 µg/ml; Post: 11.0 ± 10.6 µg/ml; p = 0.004) in those with moderate/severe OSA. Among those with no/mild OSA, exercise training resulted in a decrease in total fat mass (Pre = 37,332 ± 20,258 g; Post: 37,068 ± 18,268 g, p = 0.037). These data suggest that while 6 weeks of exercise reduced adipokines in those with moderate-to-severe OSA, it was not sufficient to improve common markers of inflammation among overweight adults with OSA.

运动可改善慢性炎症,被推荐为治疗肥胖性 OSA 的一线药物或行为疗法。我们研究了运动项目对炎症血液标志物的影响是否会因肥胖成人 OSA 的严重程度而有所不同。对体重超重(体重指数为 27 千克/平方米)的成年人使用夜间多导睡眠图进行了 OSA 评估,随后将其分为无至轻度 OSA(AHI 为 15 次/小时)或中至重度 OSA(AHI ≥ 15 次/小时)。在基线(前)和为期 6 周(每周 3 天)的综合锻炼计划(后)之后,分别测量了心肺功能、通过 DXA 评估的身体成分、空腹代谢参数和脂肪因子(即葡萄糖、胰岛素、瘦素和厌氧连蛋白)以及多种炎症指标(即 CRP、IL-4、IL-8 和 TNF-α)。10 名无/轻度 OSA 成人(年龄:48 ± 8 岁;女:6;男:4)和 12 名中度/重度 OSA 成人(年龄:54 ± 8 岁;女:5;男:7)完成了试验的所有环节。各组之间在年龄、心肺功能、身体成分、空腹代谢指标和大多数炎症标志物方面没有明显的基线差异。在中度/重度 OSA 患者中,瘦素(事前:26.7 ± 29.6 pg/ml;事后:22.7 ± 19.4 pg/ml;p = 0.028)和脂肪连通素(事前:16.6 ± 10.9 µg/ml;事后:11.0 ± 10.6 µg/ml;p = 0.004)的变化幅度更大。在无/轻度 OSA 患者中,运动训练导致总脂肪量减少(前:37,332 ± 20,258 g;后:37,068 ± 18,268 g,p = 0.037)。这些数据表明,虽然 6 周的运动能降低中度至重度 OSA 患者的脂肪因子,但不足以改善 OSA 超重成人的常见炎症指标。
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引用次数: 0
Unintended consequences: college students’ melatonin usage, sleep disturbance, and depressive symptoms 意外后果:大学生使用褪黑激素、睡眠障碍和抑郁症状
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-22 DOI: 10.1007/s41105-023-00506-9
Jack S. Peltz, Ronald Rogge

With such high rates of undergraduate sleep problems, students have chosen to take melatonin, an over-the-counter supplement that can facilitate sleep. Questions remain as to the effectiveness of melatonin for sleep problems, and questions have emerged about its impact on mental health. Accordingly, the current study examined how ongoing melatonin usage might impact relative changes in college students’ sleep disturbance and ultimately their depressive symptoms. The two-wave (baseline and 2-month follow-up), online sample consisted of 331 undergraduates (86% female; Mage = 21.3, SD = 2.4), who reported on melatonin usage, sleep disturbance, and depressive symptoms. Controlling for sleep hygiene, socio-economic status, and gender, our model demonstrated a significant indirect effect from ongoing melatonin usage to depressive symptoms. Specifically, melatonin consumption predicted relative increases in sleep disturbance, which, in turn, predicted corresponding increases in students’ depressive symptoms. Given the increasing prevalence of melatonin usage, the potential for unforeseen consequences remains high. Results suggest that the negative consequences of melatonin use can include both college students’ mental health and their sleep. Given the efficacy of addressing sleep problems with cognitive or behavioral strategies, it is essential that student support services highlight alternatives to melatonin and the potential problems associated with its use.

由于大学生睡眠问题的发生率如此之高,学生们选择服用褪黑素,这是一种可以促进睡眠的非处方补充剂。但褪黑素对睡眠问题的疗效仍存在疑问,其对心理健康的影响也出现了问题。因此,本研究探讨了持续服用褪黑素会如何影响大学生睡眠障碍的相对变化,并最终影响他们的抑郁症状。两波(基线和两个月的随访)在线样本包括 331 名大学生(86% 为女性;年龄 = 21.3,标准差 = 2.4),他们报告了褪黑激素的使用情况、睡眠障碍和抑郁症状。在对睡眠卫生、社会经济地位和性别进行控制后,我们的模型显示,褪黑激素的持续使用对抑郁症状有显著的间接影响。具体来说,褪黑激素的使用会导致睡眠障碍的相对增加,而睡眠障碍的增加又会导致学生抑郁症状的相应增加。鉴于褪黑素的使用越来越普遍,出现意外后果的可能性仍然很大。研究结果表明,使用褪黑素的负面影响可能包括大学生的心理健康和睡眠。考虑到通过认知或行为策略解决睡眠问题的效果,学生支持服务部门有必要强调褪黑素的替代品以及使用褪黑素可能带来的问题。
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引用次数: 0
Quetiapine improves sensorimotor gating deficit in a sleep deprivation-induced rat model 喹硫平可改善睡眠剥夺诱导大鼠模型中的感觉运动门控缺陷
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-14 DOI: 10.1007/s41105-023-00504-x
Öznur Özge Özcan, Burcu Çevreli, Arzu Temizyürek, Mesut Karahan, Muhsin Konuk

Background

Sleep deprivation (SD) impairs pre-stimulus inhibition, but the effect of quetiapine (QET) remains largely unknown.

Objective

This study aimed to investigate the behavioral and cognitive effects of QET in both naïve and sleep-deprived rats.

Materials and methods

Seven groups (n = 49) of male Wistar Albino rats were used in this study. SD was performed using the modified multiple platform technique in a water tank for 72 h. Our study consists of two experiments investigating the effect of QET on pre-pulse inhibition (PPI) of the acoustic startle reflex. The first experiment tested the effect of short- and long-term administration of QET on PPI response in non-sleeping (NSD) rats. The second experiment used 72 h REM sleep deprivation as a model for SD-induced impairment of the PPI response. Here, we tested the effect of QET on the % PPI of SD rats by short- and long-term intraperitoneal injection at the last 90 min of sleep SD and immediately subsequently tested for PPI.

Results

72 h SD impaired PPI, reduced startle amplitude, and attenuated the PPI% at + 4 dB, + 8 dB, and + 16 dB prepulse intensities. 10 mg/kg short and long-term QET administration completely improved sensorimotor gating deficit, increased startle amplitude, and restored the impaired PPI% at + 4 dB, + 8 dB, and + 16 dB after 72 h SD in rats.

Conclusion

Our results showed short- and long-term administration of QET improved sensorimotor gating deficit in 72 h SD. Further research is required for the etiology of insomnia and the dose-related behavioral effects of QET.

背景睡眠剥夺(SD)会损害刺激前抑制,但是喹硫平(QET)的影响在很大程度上仍不为人所知。我们的研究包括两个实验,调查 QET 对声惊反射前脉冲抑制 (PPI) 的影响。第一个实验测试了短期和长期服用 QET 对非睡眠(NSD)大鼠 PPI 反应的影响。第二个实验使用 72 小时快速眼动睡眠剥夺作为 SD 引起的 PPI 反应受损模型。在此,我们测试了 QET 对 SD 大鼠 PPI 百分比的影响,方法是在 SD 睡眠的最后 90 分钟进行短期和长期腹腔注射,随后立即进行 PPI 测试。10 mg/kg 短期和长期 QET 给药可完全改善大鼠的感觉运动门控缺陷,增加惊跳振幅,并恢复大鼠在 + 4 dB、+ 8 dB 和 + 16 dB 预脉冲强度下受损的 PPI%。关于失眠的病因和 QET 的剂量相关行为效应,还需要进一步研究。
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引用次数: 0
Correction to: Effect of physical activity on sleep problems in sedentary adults: a scoping systematic review 更正为体育锻炼对久坐成年人睡眠问题的影响:范围界定系统综述
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-12 DOI: 10.1007/s41105-023-00507-8
Anushree Rai, Mosab M. Aldabbas, Zubia Veqar
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引用次数: 0
Urbanisation negatively impacts sleep health and mood in adolescents: a comparative study of female students from city and rural schools of North India 城市化对青少年睡眠健康和情绪的负面影响:对印度北部城市和农村学校女生的比较研究
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-11 DOI: 10.1007/s41105-023-00503-y
Nisha Singh, Neelu Anand Jha, Vinod Kumar

This study investigated the impact of social settings on sleep, physical and mental health in female adolescents of North India (latitude 29.5 oN; longitude 77.5 oE). Using a battery of questionnaires, we compared the chronotype, sleep–wake pattern, sleep health (e.g. sleep quality, daytime sleepiness and fatigue) and mood (via depression, anxiety and stress symptoms) in female students (age 14–18 years) from rural (N = 719) and urban (N = 1033) schools separated by about 35 km, but families had almost similar socio-demographic details. The morning type was prevalent amongst rural, whilst the evening type was prevalent amongst urban students who also had access to smart phones, suggesting a possible greater use of the internet. There were greater negative sleep effects, daytime sleepiness, overall poor sleep quality, higher fatigue and anxiety levels in urban than the rural cohort. Interestingly, these measures also differed between school days and free days, suggesting an impact of the conflict between internal biological and social timings (= social jet lag). We also found a significant relationship between chronotype, internet addiction, mood-related parameters and measures of sleep health. Overall, these results suggest a possible impact of social settings on sleep health and mood-related behaviours in female adolescents.

本研究调查了社会环境对北印度(北纬 29.5 度;东经 77.5 度)女性青少年睡眠、身心健康的影响。通过一系列调查问卷,我们比较了农村学校(719 人)和城市学校(1033 人)女生(14-18 岁)的时间型、睡眠-觉醒模式、睡眠健康(如睡眠质量、白天嗜睡和疲劳)和情绪(通过抑郁、焦虑和压力症状),这两所学校相距约 35 公里,但家庭的社会人口详情几乎相似。农村学生多在早上出现睡眠障碍,而城市学生则多在晚上出现睡眠障碍,而且他们还能使用智能手机,这表明他们可能更多地使用互联网。与农村学生相比,城市学生在睡眠负面影响、白天嗜睡、总体睡眠质量差、疲劳和焦虑程度方面的表现更为突出。有趣的是,这些指标在上学日和放学日之间也存在差异,这表明内部生物时间和社会时间之间的冲突(=社会时差)产生了影响。我们还发现,时序型、网络成瘾、情绪相关参数和睡眠健康指标之间存在着重要关系。总之,这些结果表明,社会环境可能会对女性青少年的睡眠健康和情绪相关行为产生影响。
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引用次数: 0
Efficacy of cognitive behavioral therapy for insomnia in the perinatal period: a meta-analysis of randomized controlled trials 认知行为疗法对围产期失眠症的疗效:随机对照试验荟萃分析
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-10 DOI: 10.1007/s41105-023-00502-z
Shuya Feng, Bingqin Dai, Huawei Li, Huili Fu, Yunping Zhou

The meta-analysis aims to explore the effect of cognitive behavioral therapy for insomnia (CBT-I) in the perinatal period. Randomized controlled trials (RCTs) assessed the effects of CBT-I in perinatal women with insomnia, published in English, were eligible. Electronic searches were performed using PubMed, Embase (Elsevier), PsycINFO (Ebsco), and Web of Science (Clarivate Analytics). Insomnia Severity Index (ISI) as the primary outcome was used to estimate the pooled effects and durable efficacy of CBT-I. The secondary outcome measures were Edinburgh Postnatal Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI). Of 46 studies reviewed, seven studies met the inclusion criteria. The meta-analysis indicated significant improvement in insomnia as measured with the ISI (standardized mean difference (SMD) = − 0.62, 95% confidence intervals (CI) − 0.77, − 0.47, I2 = 28%). At the follow-up time point, the meta-analysis indicated the durable efficacy of CBT-I (SMD = − 0.47, 95% CI − 0.90, − 0.03, I2 = 73%). Definite improvement of CBT-I on EPDS (SMD = -0.31, 95% CI − 0.55, − 0.06, I2 = 33%) and PSQI (SMD = − 0.82, 95% CI − 1.27, − 0.38, I2 = 68%) score change post-intervention were found. In sub-analyses, CBT-I had similar effect sizes, independent of possible modifiers (study population, comparison group, delivery format, etc.). This meta-analysis demonstrates that CBT-I is effective in alleviating insomnia, depression, and sleep quality among perinatal women. It is equally important to find that CBT-I has a durable efficacy on insomnia in the perinatal period. However, it is necessary to include larger samples and conduct rigorous RCTs to further explore this issue.

荟萃分析旨在探讨围产期失眠认知行为疗法(CBT-I)的效果。符合条件的随机对照试验(RCT)评估了 CBT-I 对围产期妇女失眠症的影响,这些试验均以英语发表。使用 PubMed、Embase(Elsevier)、PsycINFO(Ebsco)和 Web of Science(Clarivate Analytics)进行电子检索。失眠严重程度指数(ISI)作为主要结果,用于估算 CBT-I 的综合效果和持久疗效。次要结果指标为爱丁堡产后抑郁量表(EPDS)和匹兹堡睡眠质量指数(PSQI)。在所审查的 46 项研究中,有 7 项符合纳入标准。荟萃分析表明,用 ISI 测量的失眠情况有明显改善(标准化平均差 (SMD) = - 0.62,95% 置信区间 (CI) - 0.77, - 0.47,I2 = 28%)。在随访时间点,荟萃分析表明 CBT-I 具有持久疗效(SMD = - 0.47,95% CI - 0.90,- 0.03,I2 = 73%)。CBT-I对干预后EPDS(SMD = -0.31,95% CI -0.55,-0.06,I2 = 33%)和PSQI(SMD = -0.82,95% CI -1.27,-0.38,I2 = 68%)得分变化的改善是肯定的。在子分析中,CBT-I 具有相似的效应大小,不受可能的调节因素(研究人群、对比组、授课形式等)的影响。这项荟萃分析表明,CBT-I 能有效缓解围产期妇女的失眠、抑郁和睡眠质量。同样重要的是,CBT-I 对围产期失眠症具有持久疗效。然而,有必要纳入更多的样本并进行严格的 RCT 研究来进一步探讨这一问题。
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引用次数: 0
A review for the impacts of circadian disturbance on urological cancers 昼夜节律紊乱对泌尿系统肿瘤影响的研究进展
IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-05 DOI: 10.1007/s41105-023-00500-1
Tao Li, Yiting Jiang, Yunjin Bai, Kehua Jiang, Guangshi Du, Peng Chen, Chao Luo, Lei Li, Jun Qiao, Jun Shen

Circadian rhythm is an internal timing system and harmonizes a variety of cellular, behavioral, and physiological processes to daily environment. Circadian disturbance caused by altered life style or disrupted sleep patterns inevitably contributes to various disorders. As the rapidly increased cancer occurrences and subsequent tremendous financial burdens, more researches focus on reducing the morbidity rather than treating it. Recently, many epidemiologic studies demonstrated that circadian disturbance was tightly related to the occurrence and development of cancers. For urinary system, numerous clinical researches observed the incidence and progress of prostate cancer were influenced by nightshift work, sleep duration, chronotypes, light exposure, and meal timing, this was also proved by many genetic and fundamental findings. Although the epidemiological studies regarding the relationship between circadian disturbance and kidney/bladder cancers were relative limited, some basic researches still claimed circadian disruption was closely correlated to these two cancers. The role of circadian chemotherapy on cancers of prostate, kidney, and bladder were also explored, however, it has not been regularly recommended considering the limited evidence and poor standard protocols. Finally, the researches for the impacts of circadian disturbance on cancers of adrenal gland, penis, testis were not found at present. In general, a better understanding the relationship between circadian disturbance and urological cancers might help to provide more scientific work schedules and rational lifestyles which finally saving health resource by reducing urological tumorigenesis, however, the underlying mechanisms are complex which need further exploration.

昼夜节律是一种内在的定时系统,它协调了各种细胞、行为和生理过程与日常环境的关系。由于生活方式的改变或睡眠模式的中断而引起的昼夜节律紊乱不可避免地会导致各种疾病。随着癌症发病率的迅速增加和随之而来的巨大经济负担,更多的研究集中在降低发病率而不是治疗癌症上。近年来,许多流行病学研究表明,昼夜节律紊乱与癌症的发生发展密切相关。对于泌尿系统,大量临床研究发现前列腺癌的发病和进展受夜班工作、睡眠时间、睡眠类型、光照和进餐时间的影响,许多遗传学和基础研究也证实了这一点。尽管关于昼夜节律紊乱与肾癌/膀胱癌之间关系的流行病学研究相对较少,但一些基础研究仍认为昼夜节律紊乱与这两种癌症密切相关。也探讨了昼夜化疗在前列腺癌、肾癌和膀胱癌中的作用,然而,考虑到证据有限和标准方案不佳,它尚未被定期推荐。最后,关于昼夜节律紊乱对肾上腺癌、阴茎癌、睾丸癌影响的研究目前尚未见。总之,更好地了解昼夜节律紊乱与泌尿系统肿瘤的关系,有助于提供更科学的工作安排和合理的生活方式,从而减少泌尿系统肿瘤的发生,从而节省健康资源,但其潜在的机制是复杂的,需要进一步探索。
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引用次数: 0
Link between insomnia, cognitive impairment and stroke 失眠、认知障碍和中风之间的联系
4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-11-10 DOI: 10.1007/s41105-023-00501-0
Keisuke Suzuki
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引用次数: 0
Alterations in Per2, Bcl2 gene expression, and oxidative status in aged rats liver after light pulse at night 夜间光脉冲对老龄大鼠肝脏Per2、Bcl2基因表达及氧化状态的影响
4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-11-05 DOI: 10.1007/s41105-023-00495-9
Rehab E. El-Hennamy, Heba A. Elmasry
Abstract The aging process is characterized by circadian rhythm disruption, in physiology and behavior, which could result from weak entrainment. Light is the most potent cue that entrains the central circadian clock, which in turn synchronizes peripheral clocks in animal tissues. Period 2 (Per2 ) is one of the clock genes that respond to light. Moreover, oxidative stress could entrain the clock. Therefore, the present work aimed to investigate the role of light when applied late at night on the Per2 , B cell lymphoma 2 ( Bcl2 ) gene expression, and oxidative status in aged rats. Aged rats were divided into a control group and a group exposed to a 30-min light pulse applied daily during the subjective night at 5 am (ZT 22) for 4 weeks. Per2 and Bcl2 gene expression were quantified in liver tissue. To evaluate oxidative status, Glutathione (GSH), nitric oxide (NO), and malondialdehyde (MDA) were estimated. The light pulse reduced the expression levels of Per2 and Bcl2 mRNA. Although it diminished the levels of malondialdehyde (MDA), nitric oxide (NO) levels were elevated and the glutathione (GSH) levels were declined. In conclusion, the light pulse late at night abolished Per2 mRNA circadian rhythm and reduced its expression in the liver of the aged rat. Similarly, it diminished the anti-apoptotic gene expression, Bcl2 . Moreover, it might attenuate oxidative stress through the reduction in MDA levels.
衰老过程的特征是生理和行为上的昼夜节律中断,这可能是由弱夹带引起的。光是携带中央生物钟的最有力的线索,而中央生物钟反过来又与动物组织中的外围时钟同步。周期2 (Per2)是对光线有反应的时钟基因之一。此外,氧化应激可能会使生物钟紊乱。因此,本研究旨在探讨夜间光照对老龄大鼠Per2、B细胞淋巴瘤2 (Bcl2)基因表达和氧化状态的影响。老龄大鼠分为对照组和实验组,每天在主观夜间5点(zt22)接受30分钟光脉冲照射,持续4周。测定肝组织中Per2和Bcl2基因的表达。为了评估氧化状态,评估谷胱甘肽(GSH)、一氧化氮(NO)和丙二醛(MDA)。光脉冲降低了Per2和Bcl2 mRNA的表达水平。虽然它降低了丙二醛(MDA)水平,但一氧化氮(NO)水平升高,谷胱甘肽(GSH)水平下降。综上所述,夜间光脉冲可改变老龄大鼠肝脏中Per2 mRNA的昼夜节律,降低其表达。同样,它降低了抗凋亡基因Bcl2的表达。此外,它可能通过降低MDA水平来减轻氧化应激。
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引用次数: 0
Restless legs syndrome, periodic limb movements of sleep, and subclinical cardiovascular disease 不宁腿综合征,睡眠周期性肢体运动,亚临床心血管疾病
4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-11-02 DOI: 10.1007/s41105-023-00497-7
Kevin J. Hochstrasser, Steven C. Rogers, Arshed Quyyumi, Dayna Johnson, Victoria Pak, Amit J. Shah, David B. Rye, Lynn Marie Trotti
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引用次数: 0
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Sleep and Biological Rhythms
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