Pub Date : 2025-10-08DOI: 10.3390/clockssleep7040057
Sergey Malykh, Valeriia Demareva
Academic performance in adolescence is influenced by both cognitive capacity and physiological factors such as sleepiness. However, the interaction between these dimensions remains understudied. This pilot study examined whether daytime sleepiness moderates the relationship between working memory and academic achievement in a sample of 601 schoolchildren aged 11 to 17 years. Participants completed a digital visuospatial working memory task and self-reported their daytime sleepiness using the Pediatric Daytime Sleepiness Scale (PDSS). Academic performance was assessed through official grades in Mathematics, Language, and Literature. Regression analyses showed that working memory (total score and average reaction time) and daytime sleepiness were independent predictors of academic performance. These findings support our hypotheses that cognitive and physiological factors each contribute to school success. However, no significant moderation effects were found in the full sample. Subgroup analyses revealed that working memory predicted academic outcomes only among students with normal sleepiness levels, whereas in high-sleepiness students, cognitive predictors lost significance and PDSS scores emerged as the dominant predictor. These results suggest that elevated daytime sleepiness can undermine the positive impact of working memory on academic performance. The findings highlight the importance of assessing both cognitive skills and physiological readiness when evaluating students. They also suggest that sleep-focused interventions may improve learning outcomes, especially during adolescence.
{"title":"Does Daytime Sleepiness Moderate the Relationship Between Working Memory and Academic Performance in Schoolchildren? A Pilot Study.","authors":"Sergey Malykh, Valeriia Demareva","doi":"10.3390/clockssleep7040057","DOIUrl":"10.3390/clockssleep7040057","url":null,"abstract":"<p><p>Academic performance in adolescence is influenced by both cognitive capacity and physiological factors such as sleepiness. However, the interaction between these dimensions remains understudied. This pilot study examined whether daytime sleepiness moderates the relationship between working memory and academic achievement in a sample of 601 schoolchildren aged 11 to 17 years. Participants completed a digital visuospatial working memory task and self-reported their daytime sleepiness using the Pediatric Daytime Sleepiness Scale (PDSS). Academic performance was assessed through official grades in Mathematics, Language, and Literature. Regression analyses showed that working memory (total score and average reaction time) and daytime sleepiness were independent predictors of academic performance. These findings support our hypotheses that cognitive and physiological factors each contribute to school success. However, no significant moderation effects were found in the full sample. Subgroup analyses revealed that working memory predicted academic outcomes only among students with normal sleepiness levels, whereas in high-sleepiness students, cognitive predictors lost significance and PDSS scores emerged as the dominant predictor. These results suggest that elevated daytime sleepiness can undermine the positive impact of working memory on academic performance. The findings highlight the importance of assessing both cognitive skills and physiological readiness when evaluating students. They also suggest that sleep-focused interventions may improve learning outcomes, especially during adolescence.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-02DOI: 10.3390/clockssleep7040056
Julia Glueck, Celina Pluim McDowell, Yakeel T Quiroz, Alice Cronin-Golomb, Jeanne F Duffy
Older adults are vulnerable to changes in sleep with age. Poor sleep quality is associated with self-reported cognitive changes, which can occur before the onset of objective cognitive decline associated with Mild Cognitive Impairment and Alzheimer's disease. The objective of this study was to examine associations between self-reported sleep complaints, objective sleep quality, and self-reported cognitive changes and their relations to symptoms of depression and anxiety in a group of community-dwelling older adults. Adults aged ≥ 50 without dementia (n = 45) were recruited and completed 1-2 weeks of rest-activity monitoring using a wrist-worn device, underwent a test of global cognitive functioning (Mini-Mental State Examination; MMSE), and completed questionnaires assessing insomnia (Insomnia Severity Index; ISI), subjective sleep quality (Pittsburgh Sleep Quality Index; PSQI), self-reported cognitive changes (Cognitive Function Instrument; CFI), and symptoms of depression and anxiety (Beck Depression Inventory-II; BDI-II and Generalized Anxiety Disorder 7-item assessment; GAD-7). Pearson partial correlations assessed relations among subjective and objective sleep quality, insomnia ratings, CFI ratings, and global cognition, while controlling for BDI-II and GAD-7 ratings. Exploratory analyses examined the correlation between PSQI component scores and CFI ratings and global cognition. Greater ISI (r = 0.50, p ≤ 0.001) ratings significantly correlated with higher CFI scores. PSQI total ratings and actigraphy-based measures (n = 41) did not significantly correlate with CFI scores. Exploratory PSQI subscale analyses revealed that worse subjective sleep quality (r = 0.31, p = 0.048), shorter sleep duration (r = 0.32, p = 0.04), and greater use of sleep medications (r = 0.31, p = 0.048) correlated with higher CFI scores. Poorer sleep quality due to less time spent asleep, fragmented or disturbed sleep, and requiring medications to sleep, may be associated with greater memory concerns. Alternatively, worries about cognition may deleteriously affect sleep. Subjective measures of sleep quality may be useful to identify older adults at increased risk of cognitive decline.
随着年龄的增长,老年人的睡眠很容易发生变化。睡眠质量差与自我报告的认知变化有关,这可能发生在与轻度认知障碍和阿尔茨海默病相关的客观认知能力下降发生之前。本研究的目的是在一组社区居住的老年人中检查自我报告的睡眠抱怨、客观睡眠质量和自我报告的认知变化之间的联系及其与抑郁和焦虑症状的关系。招募年龄≥50岁、无痴呆的成年人(n = 45),使用腕带设备完成1-2周的休息-活动监测,接受全球认知功能测试(迷你精神状态检查;MMSE),完成失眠症评估问卷(失眠严重指数;ISI)、主观睡眠质量(匹兹堡睡眠质量指数;PSQI)、自我报告的认知变化(认知功能工具;(Beck抑郁量表- ii; BDI-II和广泛性焦虑障碍7项评估;GAD-7)。Pearson偏相关评估主观和客观睡眠质量、失眠评分、CFI评分和整体认知之间的关系,同时控制BDI-II和GAD-7评分。探索性分析检验了PSQI成分得分与CFI评分和整体认知之间的相关性。较高的ISI评分(r = 0.50, p≤0.001)与较高的CFI评分显著相关。PSQI总评分和基于活动记录的测量(n = 41)与CFI评分无显著相关。探索性PSQI子量表分析显示,较差的主观睡眠质量(r = 0.31, p = 0.048)、较短的睡眠时间(r = 0.32, p = 0.04)和较多的睡眠药物使用(r = 0.31, p = 0.048)与较高的CFI评分相关。睡眠时间较短、睡眠碎片化或不安,以及需要药物才能入睡,导致睡眠质量较差,这些都可能与记忆力问题有关。另外,对认知能力的担忧可能会有害地影响睡眠。对睡眠质量的主观测量可能有助于识别认知能力下降风险增加的老年人。
{"title":"Self-Reported Insomnia and Poor Sleep Quality Are Associated with Self-Reported Cognitive Changes in Older Adults.","authors":"Julia Glueck, Celina Pluim McDowell, Yakeel T Quiroz, Alice Cronin-Golomb, Jeanne F Duffy","doi":"10.3390/clockssleep7040056","DOIUrl":"10.3390/clockssleep7040056","url":null,"abstract":"<p><p>Older adults are vulnerable to changes in sleep with age. Poor sleep quality is associated with self-reported cognitive changes, which can occur before the onset of objective cognitive decline associated with Mild Cognitive Impairment and Alzheimer's disease. The objective of this study was to examine associations between self-reported sleep complaints, objective sleep quality, and self-reported cognitive changes and their relations to symptoms of depression and anxiety in a group of community-dwelling older adults. Adults aged ≥ 50 without dementia (<i>n</i> = 45) were recruited and completed 1-2 weeks of rest-activity monitoring using a wrist-worn device, underwent a test of global cognitive functioning (Mini-Mental State Examination; MMSE), and completed questionnaires assessing insomnia (Insomnia Severity Index; ISI), subjective sleep quality (Pittsburgh Sleep Quality Index; PSQI), self-reported cognitive changes (Cognitive Function Instrument; CFI), and symptoms of depression and anxiety (Beck Depression Inventory-II; BDI-II and Generalized Anxiety Disorder 7-item assessment; GAD-7). Pearson partial correlations assessed relations among subjective and objective sleep quality, insomnia ratings, CFI ratings, and global cognition, while controlling for BDI-II and GAD-7 ratings. Exploratory analyses examined the correlation between PSQI component scores and CFI ratings and global cognition. Greater ISI (<i>r</i> = 0.50, <i>p</i> ≤ 0.001) ratings significantly correlated with higher CFI scores. PSQI total ratings and actigraphy-based measures (<i>n</i> = 41) did not significantly correlate with CFI scores. Exploratory PSQI subscale analyses revealed that worse subjective sleep quality (<i>r</i> = 0.31, <i>p</i> = 0.048), shorter sleep duration (<i>r</i> = 0.32, <i>p</i> = 0.04), and greater use of sleep medications (<i>r</i> = 0.31, <i>p</i> = 0.048) correlated with higher CFI scores. Poorer sleep quality due to less time spent asleep, fragmented or disturbed sleep, and requiring medications to sleep, may be associated with greater memory concerns. Alternatively, worries about cognition may deleteriously affect sleep. Subjective measures of sleep quality may be useful to identify older adults at increased risk of cognitive decline.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12551010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.3390/clockssleep7040055
Shauna Stevenson, Haresh Suppiah, Toby Mündel, Matthew Driller
Ambient temperature and thermoregulation influence sleep quality. This study investigated the effects of a temperature-controlled mattress cover on sleep and perceptual outcomes in healthy adults. In a randomised, counterbalanced, crossover design, 34 healthy adults (20 F, 14 M; age, 30 ± 5 y) used a temperature-controlled mattress cover for 14 nights, following ≥3 nights of familiarisation. The temperature feature was on for 7 nights (POD) and off for 7 nights (CON). Sleep was assessed via wrist actigraphy, while heart rate (HR), heart rate variability (HRV), and respiratory rate (RR) were recorded by embedded sensors in the mattress cover. Participants completed daily and weekly questionnaires evaluating sleep quality, thermal comfort, and thermal sensation. Linear mixed models showed significant main effects of condition favouring POD over CON for all daily perceived outcomes (all p < 0.05). A large, significant improvement in perceived sleep quality was observed (p = 0.001, d = 0.92). No significant differences were found in objective sleep metrics or biometric measures (all p ≥ 0.05). A temperature-controlled mattress cover was associated with improved subjective sleep quality and thermal-related perceptions despite minimal changes in objective or biometric outcomes, which may in part reflect expectancy, or placebo effects. Further research is needed to explore whether these perceptual benefits lead to physiological improvements over time.
环境温度和体温调节影响睡眠质量。本研究调查了温控床垫罩对健康成人睡眠和知觉结果的影响。在一项随机、平衡、交叉设计中,34名健康成人(20岁,14岁,年龄30±5岁)在熟悉床垫≥3晚后,使用温控床垫套14晚。温度功能开启7晚(POD),关闭7晚(CON)。睡眠通过腕部活动记录仪进行评估,而心率(HR)、心率变异性(HRV)和呼吸频率(RR)则由床垫套内嵌的传感器记录。参与者完成每日和每周的问卷调查,评估睡眠质量、热舒适和热感觉。线性混合模型显示,在所有日常感知结果中,POD优于CON的条件具有显著的主要影响(均p < 0.05)。观察到明显的睡眠质量改善(p = 0.001, d = 0.92)。客观睡眠指标和生物计量指标均无显著差异(p≥0.05)。温度控制的床垫套与主观睡眠质量和热相关感知的改善有关,尽管客观或生物测量结果的变化很小,这可能在一定程度上反映了预期或安慰剂效应。随着时间的推移,这些感知上的好处是否会导致生理上的改善,还需要进一步的研究来探索。
{"title":"Under the Covers: The Effect of a Temperature-Controlled Mattress Cover on Sleep and Perceptual Measures in Healthy Adults.","authors":"Shauna Stevenson, Haresh Suppiah, Toby Mündel, Matthew Driller","doi":"10.3390/clockssleep7040055","DOIUrl":"10.3390/clockssleep7040055","url":null,"abstract":"<p><p>Ambient temperature and thermoregulation influence sleep quality. This study investigated the effects of a temperature-controlled mattress cover on sleep and perceptual outcomes in healthy adults. In a randomised, counterbalanced, crossover design, 34 healthy adults (20 F, 14 M; age, 30 ± 5 y) used a temperature-controlled mattress cover for 14 nights, following ≥3 nights of familiarisation. The temperature feature was on for 7 nights (POD) and off for 7 nights (CON). Sleep was assessed via wrist actigraphy, while heart rate (HR), heart rate variability (HRV), and respiratory rate (RR) were recorded by embedded sensors in the mattress cover. Participants completed daily and weekly questionnaires evaluating sleep quality, thermal comfort, and thermal sensation. Linear mixed models showed significant main effects of condition favouring POD over CON for all daily perceived outcomes (all <i>p</i> < 0.05). A large, significant improvement in perceived sleep quality was observed (<i>p</i> = 0.001, d = 0.92). No significant differences were found in objective sleep metrics or biometric measures (all <i>p</i> ≥ 0.05). A temperature-controlled mattress cover was associated with improved subjective sleep quality and thermal-related perceptions despite minimal changes in objective or biometric outcomes, which may in part reflect expectancy, or placebo effects. Further research is needed to explore whether these perceptual benefits lead to physiological improvements over time.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-28DOI: 10.3390/clockssleep7040054
Kaitlyn Chhe, Bhavna Kalyanaraman, Sophie A Spielberger, Hui-Hsien Lin, Stephanie R Taylor, Michelle E Farkas
The protein SNAIL has been widely studied for its roles in promoting cancer invasion and resistance to apoptosis. There are multiple contributors to its expression, including self- and circadian regulation, and it has been posited that SNAIL oscillates in a circadian manner. Given the multiple factors involved, we sought to determine whether this is indeed the case. We developed a luciferase reporter that was used to demonstrate SNAIL's rhythmic nature (SNAIL:luc) in the circadian model cell line, U2OS. Considering SNAIL's relevance in breast cancer, we also assessed its oscillations in cellular models representing different levels of aggression. We incorporated the SNAIL:luc reporter in MCF10A breast epithelial cells, and MCF7 and MDA-MB-231 breast cancer cell lines, which are less and more aggressive, respectively. We found that SNAIL oscillations were present but weak in MCF7 and arrhythmic in MDA-MB-231 cells, correlating with those of core clock genes (BMAL1 and PER2) in these models. Surprisingly, MCF10A cells, whose core clock genes possess robust circadian expression patterns, did not have rhythmic oscillations of SNAIL. Our findings suggest that SNAIL is under circadian control, but this is cell line/tissue dependent, setting the stage for additional studies to better understand the impacts of various factors contributing to its expression.
{"title":"Reporter-Mediated Evaluation of the Circadian Oscillations of <i>SNAIL</i> Across In Vitro Models.","authors":"Kaitlyn Chhe, Bhavna Kalyanaraman, Sophie A Spielberger, Hui-Hsien Lin, Stephanie R Taylor, Michelle E Farkas","doi":"10.3390/clockssleep7040054","DOIUrl":"10.3390/clockssleep7040054","url":null,"abstract":"<p><p>The protein SNAIL has been widely studied for its roles in promoting cancer invasion and resistance to apoptosis. There are multiple contributors to its expression, including self- and circadian regulation, and it has been posited that <i>SNAIL</i> oscillates in a circadian manner. Given the multiple factors involved, we sought to determine whether this is indeed the case. We developed a luciferase reporter that was used to demonstrate <i>SNAIL</i>'s rhythmic nature (<i>SNAIL:luc</i>) in the circadian model cell line, U2OS. Considering <i>SNAIL</i>'s relevance in breast cancer, we also assessed its oscillations in cellular models representing different levels of aggression. We incorporated the <i>SNAIL:luc</i> reporter in MCF10A breast epithelial cells, and MCF7 and MDA-MB-231 breast cancer cell lines, which are less and more aggressive, respectively. We found that <i>SNAIL</i> oscillations were present but weak in MCF7 and arrhythmic in MDA-MB-231 cells, correlating with those of core clock genes (<i>BMAL1</i> and <i>PER2</i>) in these models. Surprisingly, MCF10A cells, whose core clock genes possess robust circadian expression patterns, did not have rhythmic oscillations of <i>SNAIL</i>. Our findings suggest that <i>SNAIL</i> is under circadian control, but this is cell line/tissue dependent, setting the stage for additional studies to better understand the impacts of various factors contributing to its expression.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Animal studies show that sleep regulation depends on subcortical networks, but whether the connectivity between subcortical areas contributes to human sleep variability remains unclear. We investigated whether the effective connectivity between the LC and hypothalamic subparts during wakefulness relates to sleep electrophysiology. Thirty-three younger (~22 y, 27 women) and 18 late middle-aged (~61 y, 14 women) healthy individuals underwent 7-Tesla functional MRI during wakefulness to assess LC-hypothalamus effective connectivity. Additionally, sleep EEG was recorded at night in the lab to examine the relationships between effective connectivity measures and REM sleep theta energy as well as sigma power prior to REM. Connectivity analyses revealed strong mutual positive influences between the LC and both the anterior-superior and posterior hypothalamus, consistent with animal studies. Aging was negatively associated with the connectivity from the anterior-superior hypothalamus (including the preoptic area) to the LC. In late middle-aged adults, but not younger adults, stronger effective connectivity from the anterior-superior hypothalamus to the LC was associated with lower REM theta energy. This association extended to other low-frequency bands during REM and NREM sleep. These findings highlight the age-dependent modulation of LC-hypothalamus interactions and their potential roles in sleep regulation, providing new insights into neural mechanisms underlying age-related sleep changes.
{"title":"The Crosstalk Between the Anterior Hypothalamus and the Locus Coeruleus During Wakefulness Is Associated with Low-Frequency Oscillations Power During Sleep.","authors":"Nasrin Mortazavi, Puneet Talwar, Ekaterina Koshmanova, Roya Sharifpour, Elise Beckers, Ilenia Paparella, Fermin Balda, Christine Bastin, Fabienne Collette, Laurent Lamalle, Christophe Phillips, Mikhail Zubkov, Gilles Vandewalle","doi":"10.3390/clockssleep7040053","DOIUrl":"10.3390/clockssleep7040053","url":null,"abstract":"<p><p>Animal studies show that sleep regulation depends on subcortical networks, but whether the connectivity between subcortical areas contributes to human sleep variability remains unclear. We investigated whether the effective connectivity between the LC and hypothalamic subparts during wakefulness relates to sleep electrophysiology. Thirty-three younger (~22 y, 27 women) and 18 late middle-aged (~61 y, 14 women) healthy individuals underwent 7-Tesla functional MRI during wakefulness to assess LC-hypothalamus effective connectivity. Additionally, sleep EEG was recorded at night in the lab to examine the relationships between effective connectivity measures and REM sleep theta energy as well as sigma power prior to REM. Connectivity analyses revealed strong mutual positive influences between the LC and both the anterior-superior and posterior hypothalamus, consistent with animal studies. Aging was negatively associated with the connectivity from the anterior-superior hypothalamus (including the preoptic area) to the LC. In late middle-aged adults, but not younger adults, stronger effective connectivity from the anterior-superior hypothalamus to the LC was associated with lower REM theta energy. This association extended to other low-frequency bands during REM and NREM sleep. These findings highlight the age-dependent modulation of LC-hypothalamus interactions and their potential roles in sleep regulation, providing new insights into neural mechanisms underlying age-related sleep changes.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12551093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-24DOI: 10.3390/clockssleep7040052
Ahmed Arabi, Humam Emad Rajha, Osama Alkeilani, Ahmad Hamdan, Dima Nasrallah, Giridhara R Babu
Background: Circadian Syndrome (CircS) encompasses a range of cardiometabolic risk factors that contribute to an increased susceptibility to cardiovascular diseases and type 2 diabetes. Understanding the factors that underpin CircS is essential. This study primarily aims to examine the association between hypothyroidism and CircS in adults. A secondary analysis compares this association with that between hypothyroidism and Metabolic Syndrome (MetS). Additionally, the dose-response relationship between serum free thyroxine (FT4) levels and CircS probability is explored.
Methods: This cross-sectional study includes 4050 National Health and Nutrition Examination Survey (NHANES) participants (2007-2012). Hypothyroidism was classified into (1) drug-managed, (2) non-drug-managed (NDM) primary, and (3) NDM central hypothyroidism, based on self-reported medication use and serum TSH/FT4 levels. CircS was defined as having ≥5 of its eight components, including MetS criteria, depression, short sleep, and non-alcoholic fatty liver disease.
Results: Our results showed that hypothyroidism was significantly associated with CircS (OR: 1.58, 95% CI 1.26-1.98) and MetS (OR: 1.19, 95% CI 1.01-1.42). An inverse, non-linear relationship between serum FT4 levels and the probability of CircS was observed.
Conclusions: The results underscore a significant association between hypothyroidism and CircS and MetS, with FT4 levels inversely related to CircS probability. These findings highlight hypothyroidism's potential role in CircS pathogenesis and prevention.
背景:昼夜节律综合征(CircS)包括一系列心脏代谢危险因素,这些因素有助于增加心血管疾病和2型糖尿病的易感性。理解支撑circ的因素至关重要。本研究主要旨在探讨成人甲状腺功能减退与CircS之间的关系。二级分析比较了这种关联与甲状腺功能减退和代谢综合征(MetS)之间的关系。此外,还探讨了血清游离甲状腺素(FT4)水平与CircS概率之间的剂量-反应关系。方法:本横断面研究包括4050名2007-2012年全国健康与营养调查(NHANES)参与者。根据自我报告的用药情况和血清TSH/FT4水平,将甲状腺功能减退分为(1)药物管理型、(2)非药物管理型(NDM)原发性和(3)NDM中枢性甲状腺功能减退。CircS被定义为具有8个组成部分中的≥5个,包括MetS标准、抑郁、睡眠不足和非酒精性脂肪肝。结果:我们的结果显示甲状腺功能减退与CircS (OR: 1.58, 95% CI 1.26-1.98)和MetS (OR: 1.19, 95% CI 1.01-1.42)显著相关。观察到血清FT4水平与CircS发生概率呈反比非线性关系。结论:结果强调了甲状腺功能减退与CircS和MetS之间的显著关联,FT4水平与CircS的概率呈负相关。这些发现强调了甲状腺功能减退在CircS发病机制和预防中的潜在作用。
{"title":"Exploring the Cross-Sectional Association Between Hypothyroidism and Circadian Syndrome: Insights from NHANES 2007-2012.","authors":"Ahmed Arabi, Humam Emad Rajha, Osama Alkeilani, Ahmad Hamdan, Dima Nasrallah, Giridhara R Babu","doi":"10.3390/clockssleep7040052","DOIUrl":"10.3390/clockssleep7040052","url":null,"abstract":"<p><strong>Background: </strong>Circadian Syndrome (CircS) encompasses a range of cardiometabolic risk factors that contribute to an increased susceptibility to cardiovascular diseases and type 2 diabetes. Understanding the factors that underpin CircS is essential. This study primarily aims to examine the association between hypothyroidism and CircS in adults. A secondary analysis compares this association with that between hypothyroidism and Metabolic Syndrome (MetS). Additionally, the dose-response relationship between serum free thyroxine (FT4) levels and CircS probability is explored.</p><p><strong>Methods: </strong>This cross-sectional study includes 4050 National Health and Nutrition Examination Survey (NHANES) participants (2007-2012). Hypothyroidism was classified into (1) drug-managed, (2) non-drug-managed (NDM) primary, and (3) NDM central hypothyroidism, based on self-reported medication use and serum TSH/FT4 levels. CircS was defined as having ≥5 of its eight components, including MetS criteria, depression, short sleep, and non-alcoholic fatty liver disease.</p><p><strong>Results: </strong>Our results showed that hypothyroidism was significantly associated with CircS (OR: 1.58, 95% CI 1.26-1.98) and MetS (OR: 1.19, 95% CI 1.01-1.42). An inverse, non-linear relationship between serum FT4 levels and the probability of CircS was observed.</p><p><strong>Conclusions: </strong>The results underscore a significant association between hypothyroidism and CircS and MetS, with FT4 levels inversely related to CircS probability. These findings highlight hypothyroidism's potential role in CircS pathogenesis and prevention.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-19DOI: 10.3390/clockssleep7030051
Vaida T R Verhoef, Karin C H J Smolders, Geert Peeters, Sebastiaan Overeem, Yvonne A W de Kort
Diagnosis and monitoring of daytime sleepiness remain challenging and are strongly reliant on subjective assessments. To revisit common monitoring tools and explore new assessment modalities, we investigated the response of daily and momentary subjective measures of sleepiness and fatigue and skin temperature to sleep restriction, assessed between- and within-day variations in these responses, and studied their convergence. Seventeen healthy participants (aged 19-32 years, seven females, ten males) participated in a field study employing ecological momentary assessment. After a one-week baseline, two sleep conditions (4 h/night vs. 7-9 h/night, actigraphy-controlled; three nights each) were counterbalanced across participants. During the experimental conditions, sleepiness and fatigue were assessed using subjective rating scales administered in daily diary questionnaires and experience sampling questionnaires (10 notifications per day), while distal and proximal skin temperatures were continuously recorded. Results revealed significant effects of sleep restriction on distal and proximal skin temperature and daily reports of sleepiness and fatigue, independent of the number of sleep-restricted nights. The effects on momentary assessments were moderated by day, reflecting a cumulative effect of the sleep restriction from Days 1 to 3. The effects of sleep restriction on momentary sleepiness and fatigue ratings or hourly skin temperature metrics were not significantly moderated by time of day. Hourly skin temperatures (distal skin temperature and temperature gradient) were significantly related to subjective sleepiness and fatigue. In conclusion, all self-reports were sensitive to the sleep restriction, but momentary assessments illustrate the manipulation's cumulative effects and captured temporal dynamics in sleepiness and fatigue within days. This investigation showed overlap between sleepiness and fatigue experiences as reflected in medium to strong associations. Skin temperature correlates with momentary subjective sleepiness (and fatigue); however, considering it a proxy for daytime sleepiness remains exploratory.
{"title":"Sleepiness and Fatigue as Consequences of Cumulative Sleep Restriction: Insights from Fine-Grained Subjective Measures and Skin Temperature in the Field.","authors":"Vaida T R Verhoef, Karin C H J Smolders, Geert Peeters, Sebastiaan Overeem, Yvonne A W de Kort","doi":"10.3390/clockssleep7030051","DOIUrl":"10.3390/clockssleep7030051","url":null,"abstract":"<p><p>Diagnosis and monitoring of daytime sleepiness remain challenging and are strongly reliant on subjective assessments. To revisit common monitoring tools and explore new assessment modalities, we investigated the response of daily and momentary subjective measures of sleepiness and fatigue and skin temperature to sleep restriction, assessed between- and within-day variations in these responses, and studied their convergence. Seventeen healthy participants (aged 19-32 years, seven females, ten males) participated in a field study employing ecological momentary assessment. After a one-week baseline, two sleep conditions (4 h/night vs. 7-9 h/night, actigraphy-controlled; three nights each) were counterbalanced across participants. During the experimental conditions, sleepiness and fatigue were assessed using subjective rating scales administered in daily diary questionnaires and experience sampling questionnaires (10 notifications per day), while distal and proximal skin temperatures were continuously recorded. Results revealed significant effects of sleep restriction on distal and proximal skin temperature and daily reports of sleepiness and fatigue, independent of the number of sleep-restricted nights. The effects on momentary assessments were moderated by day, reflecting a cumulative effect of the sleep restriction from Days 1 to 3. The effects of sleep restriction on momentary sleepiness and fatigue ratings or hourly skin temperature metrics were not significantly moderated by time of day. Hourly skin temperatures (distal skin temperature and temperature gradient) were significantly related to subjective sleepiness and fatigue. In conclusion, all self-reports were sensitive to the sleep restriction, but momentary assessments illustrate the manipulation's cumulative effects and captured temporal dynamics in sleepiness and fatigue within days. This investigation showed overlap between sleepiness and fatigue experiences as reflected in medium to strong associations. Skin temperature correlates with momentary subjective sleepiness (and fatigue); however, considering it a proxy for daytime sleepiness remains exploratory.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-17DOI: 10.3390/clockssleep7030050
Toni Ghayad, Anaïs Mungo, Matthieu Hein
Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent disorder in the pediatric population. Furthermore, there appears to be a special relationship between ADHD and Restless Legs Syndrome (RLS). The objective of this review was therefore to provide an updated overview of the current literature regarding the prevalence of RLS and its potential clinical impact in pediatric ADHD subjects (<18 years). A systematic literature review was carried out in May 2025 in the PubMed-Medline database according to PRISMA criteria. After evaluation by two readers of the 147 identified articles, 9 articles investigating the prevalence of RLS with or without assessment of its potential clinical impact were selected for this systematic literature review. The prevalence of RLS in children and adolescents with ADHD showed significant variation, ranging from 11% to 54%. One study found a significant impact of RLS on academic performance and life skills in pediatric ADHD subjects. Three studies highlighted higher severity of ADHD complaints in subjects with comorbid RLS. One study reported higher RLS severity scores in the ADHD+RLS group and significantly more severe scores in the "hyperactive-impulsive" ADHD subtype. Two studies identified a significant association between a family history of RLS and RLS+ADHD comorbidity. Compared with the general pediatric population, the prevalence of RLS appears to be higher in pediatric ADHD subjects. Finally, this comorbid sleep disorder could worsen the severity of ADHD symptoms and complicate its clinical management.
{"title":"Prevalence and Clinical Impact of Restless Legs Syndrome in Pediatric Populations with Attention-Deficit/Hyperactivity Disorder: A Systematic Review.","authors":"Toni Ghayad, Anaïs Mungo, Matthieu Hein","doi":"10.3390/clockssleep7030050","DOIUrl":"10.3390/clockssleep7030050","url":null,"abstract":"<p><p>Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent disorder in the pediatric population. Furthermore, there appears to be a special relationship between ADHD and Restless Legs Syndrome (RLS). The objective of this review was therefore to provide an updated overview of the current literature regarding the prevalence of RLS and its potential clinical impact in pediatric ADHD subjects (<18 years). A systematic literature review was carried out in May 2025 in the PubMed-Medline database according to PRISMA criteria. After evaluation by two readers of the 147 identified articles, 9 articles investigating the prevalence of RLS with or without assessment of its potential clinical impact were selected for this systematic literature review. The prevalence of RLS in children and adolescents with ADHD showed significant variation, ranging from 11% to 54%. One study found a significant impact of RLS on academic performance and life skills in pediatric ADHD subjects. Three studies highlighted higher severity of ADHD complaints in subjects with comorbid RLS. One study reported higher RLS severity scores in the ADHD+RLS group and significantly more severe scores in the \"hyperactive-impulsive\" ADHD subtype. Two studies identified a significant association between a family history of RLS and RLS+ADHD comorbidity. Compared with the general pediatric population, the prevalence of RLS appears to be higher in pediatric ADHD subjects. Finally, this comorbid sleep disorder could worsen the severity of ADHD symptoms and complicate its clinical management.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sleep in intensive care unit (ICU) patients is frequently disrupted, which may adversely affect their overall health and recovery. Despite the implementation of various strategies to promote sleep, accurately assessing its quality remains complex. This pilot study aimed to evaluate both the quality and quantity of sleep in ICU patients using actigraphy (ACT) and the Richards-Campbell Sleep Questionnaire (RCSQ) and to compare the diagnostic performance of these two tools. We conducted a prospective observational study including 228 ICU patients. Sleep was assessed using both RCSQ and ACT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the discriminative ability of each tool (Area Under the Curve [AUC], sensitivity, specificity), with optimal cut-off points determined using Youden's Index. The Mann-Whitney U test was used to compare sleep parameters between patients classified as having good or poor sleep based on ACT measurements. The mean RCSQ score was 38.16 ± 17.09, indicating poor perceived sleep quality. Sleep onset latency (based on RCSQ) was 35.71 ± 21.44 min, with a mean of 40.32 ± 20.03 awakenings. According to ACT, sleep latency was 39.23 ± 22.09 min, and total sleep duration was 198.15 ± 128.42 min (approximately 3 h and 18 min), which is significantly below recommended levels. The average number of awakenings recorded was 24.85. In terms of diagnostic performance, the RCSQ demonstrated excellent discriminative ability (AUC = 1.00 for the total score), while ACT showed more variable results: total sleep duration had a good AUC of 0.91, while sleep latency showed a lower performance with an AUC of 0.50. The RCSQ proved to be more reliable than ACT in assessing sleep quality in ICU patients, providing consistent results across multiple parameters, including sleep depth, latency, and number of awakenings. Conversely, ACT yielded less consistent findings, particularly regarding sleep latency and nighttime interruptions. Further studies are warranted to refine objective tools for evaluating sleep in critically ill patients.
重症监护病房(ICU)患者的睡眠经常被打乱,这可能对他们的整体健康和康复产生不利影响。尽管实施了各种促进睡眠的策略,但准确评估睡眠质量仍然很复杂。本初步研究旨在利用活动记录仪(ACT)和Richards-Campbell睡眠问卷(RCSQ)评估ICU患者的睡眠质量和数量,并比较这两种工具的诊断性能。我们对228例ICU患者进行了前瞻性观察性研究。采用RCSQ和ACT对睡眠进行评估。采用受试者工作特征(ROC)曲线分析评估各工具的判别能力(曲线下面积(Area Under the curve, AUC)、敏感性、特异性),并采用约登指数确定最佳截断点。曼-惠特尼U检验用于比较根据ACT测量分为睡眠质量好或睡眠质量差的患者之间的睡眠参数。RCSQ平均得分为38.16±17.09,提示感知睡眠质量较差。睡眠发作潜伏期(基于RCSQ)为35.71±21.44 min,平均醒来40.32±20.03次。根据ACT,睡眠潜伏期为39.23±22.09 min,总睡眠时间为198.15±128.42 min(约3小时18分钟),明显低于推荐水平。平均醒来次数为24.85次。在诊断性能方面,RCSQ表现出优秀的判别能力(AUC = 1.00的总分),而ACT表现出更多的变数:总睡眠持续时间的AUC较好,为0.91,而睡眠潜伏期的AUC较低,为0.50。RCSQ在评估ICU患者睡眠质量方面比ACT更可靠,在多个参数(包括睡眠深度、潜伏期和醒来次数)中提供一致的结果。相反,ACT得出的结果不太一致,尤其是在睡眠潜伏期和夜间中断方面。需要进一步的研究来完善评估危重病人睡眠的客观工具。
{"title":"Sleep Quality Assessment in Intensive Care Units: Comparing Actigraphy and the Richards Campbell Sleep Questionnaire-A Pilot Study in the Moroccan Context.","authors":"Abdelmajid Lkoul, Keltouma Oumbarek, Youssef Bouchriti, Asmaa Jniene, Tarek Dendane","doi":"10.3390/clockssleep7030049","DOIUrl":"10.3390/clockssleep7030049","url":null,"abstract":"<p><p>Sleep in intensive care unit (ICU) patients is frequently disrupted, which may adversely affect their overall health and recovery. Despite the implementation of various strategies to promote sleep, accurately assessing its quality remains complex. This pilot study aimed to evaluate both the quality and quantity of sleep in ICU patients using actigraphy (ACT) and the Richards-Campbell Sleep Questionnaire (RCSQ) and to compare the diagnostic performance of these two tools. We conducted a prospective observational study including 228 ICU patients. Sleep was assessed using both RCSQ and ACT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the discriminative ability of each tool (Area Under the Curve [AUC], sensitivity, specificity), with optimal cut-off points determined using Youden's Index. The Mann-Whitney U test was used to compare sleep parameters between patients classified as having good or poor sleep based on ACT measurements. The mean RCSQ score was 38.16 ± 17.09, indicating poor perceived sleep quality. Sleep onset latency (based on RCSQ) was 35.71 ± 21.44 min, with a mean of 40.32 ± 20.03 awakenings. According to ACT, sleep latency was 39.23 ± 22.09 min, and total sleep duration was 198.15 ± 128.42 min (approximately 3 h and 18 min), which is significantly below recommended levels. The average number of awakenings recorded was 24.85. In terms of diagnostic performance, the RCSQ demonstrated excellent discriminative ability (AUC = 1.00 for the total score), while ACT showed more variable results: total sleep duration had a good AUC of 0.91, while sleep latency showed a lower performance with an AUC of 0.50. The RCSQ proved to be more reliable than ACT in assessing sleep quality in ICU patients, providing consistent results across multiple parameters, including sleep depth, latency, and number of awakenings. Conversely, ACT yielded less consistent findings, particularly regarding sleep latency and nighttime interruptions. Further studies are warranted to refine objective tools for evaluating sleep in critically ill patients.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-15DOI: 10.3390/clockssleep7030048
Sophia Anne Marie B Villanueva, Huei-Bin Wang, Kyle Nguyen-Ngo, Caihan Tony Chen, Gemma Stark, Gene D Block, Cristina A Ghiani, Christopher S Colwell
Individuals with neurodevelopmental disorders (NDDs) often experience sleep disturbances and are frequently exposed to light during nighttime hours. Our previous studies using the Contactin-associated protein-like 2 (Cntnap2) knockout (KO) mouse model of NDDs demonstrated that nighttime light exposure adversely affected behavioral measures. In this study, we exposed wild-type (WT) and Cntnap2 KO mice to an ultradian lighting cycle (T7), which alternates 3.5 h of light and 3.5 h of darkness, hypothesizing that this lighting protocol would mimic the impact of nighttime light exposure seen in standard light-dark cycles with dim light at night (DLaN). However, adult WT and Cntnap2 KO mice held under the T7 cycle did not show the increased grooming behavior or reduced social interaction observed in Cntnap2 KO mice exposed to DLaN. The T7 cycle lengthened the circadian period and weakened the rhythm amplitude without abolishing rhythmicity in either genotype. Finally, opposite to DLaN, neither the T7 cycle nor constant darkness (DD) elicited an increase in cFos expression in the basolateral amygdala. These results demonstrate that the adverse effects of nighttime light exposure in an NDD model depend on the extent of the circadian disruption rather than light exposure alone, emphasizing the importance of circadian stability as a protective factor in NDDs.
{"title":"Dissociating the Effects of Light at Night from Circadian Misalignment in a Neurodevelopmental Disorder Mouse Model Using Ultradian Light-Dark Cycles.","authors":"Sophia Anne Marie B Villanueva, Huei-Bin Wang, Kyle Nguyen-Ngo, Caihan Tony Chen, Gemma Stark, Gene D Block, Cristina A Ghiani, Christopher S Colwell","doi":"10.3390/clockssleep7030048","DOIUrl":"10.3390/clockssleep7030048","url":null,"abstract":"<p><p>Individuals with neurodevelopmental disorders (NDDs) often experience sleep disturbances and are frequently exposed to light during nighttime hours. Our previous studies using the <i>Contactin-associated protein-like 2</i> (<i>Cntnap2</i>) knockout (KO) mouse model of NDDs demonstrated that nighttime light exposure adversely affected behavioral measures. In this study, we exposed wild-type (WT) and <i>Cntnap2</i> KO mice to an ultradian lighting cycle (T7), which alternates 3.5 h of light and 3.5 h of darkness, hypothesizing that this lighting protocol would mimic the impact of nighttime light exposure seen in standard light-dark cycles with dim light at night (DLaN). However, adult WT and <i>Cntnap2</i> KO mice held under the T7 cycle did not show the increased grooming behavior or reduced social interaction observed in <i>Cntnap2</i> KO mice exposed to DLaN. The T7 cycle lengthened the circadian period and weakened the rhythm amplitude without abolishing rhythmicity in either genotype. Finally, opposite to DLaN, neither the T7 cycle nor constant darkness (DD) elicited an increase in cFos expression in the basolateral amygdala. These results demonstrate that the adverse effects of nighttime light exposure in an NDD model depend on the extent of the circadian disruption rather than light exposure alone, emphasizing the importance of circadian stability as a protective factor in NDDs.</p>","PeriodicalId":33568,"journal":{"name":"Clocks & Sleep","volume":"7 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}